Evaluation of Physiochemical Properties, Thermal Behavior and Phytopharmaceutical Potential of Citrus aurantium’s Essential Oil

The study investigates the therapeutic potential of the Citrus aurantium var. amara essential oil extracted from the blossoms of the bitter orange plant by examining its chemical composition, thermal stability, and potency against infectious disease-causing pathogens. Initially, the volatile components of the essential oil were evaluated by obtaining a chromatographic fingerprint using HPTLC and FTIR spectrum identification. Furthermore, a thermal profile of the essential oil was obtained using the thermogravimetric-differential thermal analysis and differential scanning calorimetric analysis. A predetermined set of antibiotic-resistant microorganisms were used to examine the antibacterial activity of the essential oil. Lastly, its anti-inflammatory activity was assessed using the albumin denaturation assay. The research concluded that the Citrus aurantium var. Amara essential oil exhibits potential therapeutic characteristics which can be further explored through in vivo studies.

Evaluation of Clinico-Demographic Profile and Survival Rate among Patients of Head and Neck Cancer

Background: Head and Neck cancer (HNC) is a recognized major public health concern all over the world Objectives: To study age and gender predilection and clinical profile of Head & Neck Cancers Materials and Methods: This was a retrospective study including 21121 patients with Head & Neck Cancer presented to tertiary care centre, Ahmadabad. Patients' details of age, sex, site of carcinoma, stage at presentation and Outcome were recorded. The data was analyzed using MS office excel 2010 and Epi info software version 7.0. Result: Male to female ratio was 4.8:1. The most common site of presentation of tumour was in cheek mucosa (29.01 %). On comparison of different anatomical sites, majority of patients were presented in locally advanced stage. Significant association (p<0.05) was found between presentation of disease and literacy status. Overall 5 - year survival rate was 60.5% � 1.6% when disease was localized. Conclusion: Majority of patients diagnosed in locally advanced stage. Strategies for the early diagnosis and prevention of Head & Neck cancer must be undertaken by government to overcome this situation.

A Pre-history of the Morphological Index

The article deals with an over-looked period in the modern history of leprosy, namely the first decades of the th 20 Century. The introduction of soluble derivatives of traditional chaulmoogra and hydnocarpus oils for parenteral treatment was received with optimism by physicians working independently in American Hawaii and by Leonard Rogers in colonial India. They reported similar after-treatment clinical and bacteriological phenomena, but stopped short of meaningful investigation of the latter. The pioneering studies of Froilano de Melo in Portuguese Goa on quantification and interpretation of changes in bacterial morphology in stained slides are described, as also the conflict with Rogers's ideas. de Melo's three-fold 'HMG” morphological classification presaged Ridley's 'SFG' Index of five decades later. That ambiguities regarding bacterial viability based solely on morphology in stained smears, which were pointed out by de Melo, were later confirmed in the mouse foot-pad model.

Clinico-histopathological correlation and detection of anti PGL-1 antibodies in leprosy patients.

Background: Leprosy (Hansen’s disease) is one of the major health problems of the world especially in developing countries. In India, it was first described in “Sushruta Samhita ” & treated by Chaulmoogra oil and caused by Mycobacterium Leprae. Early diagnosis of leprosy, an absolute necessity for control as well as effective therapy. For this, clinical diagnosis, skin smear examination is adequate coupled with histo-pathological examination of skin and nerve lesions with modified Fite Faraco stain for demonstration of acid fast bacilli. Moreover, bacillary index is required for adequate combined chemotherapy regimen. Detection of anti PGL-1 antibodies in serum gives an added advantage for detection and monitoring treatment. Materials & Methods : A total of 85 cases of leprosy who attended outpatient department of Skin & VD, Shri Sayaji General Hospital Baroda chosen for study during '07-08' period with 75 cases from leprosy hospital, Baroda which included 50 detected patients and 25 child contacts with 25 healthy voluntary blood donors from blood bank, SSGH selected.Clinical, past and family history taken with slit skin smears stained with Z-N stain,graded and histopathological evaluation done. Serological study done from serumof leprosy patients and healthy blood donors; tested by serodia kitsand interpretation made. Results : Most cases were in 2nd to 4th decade and males dominated. Clinically most cases were of indeterminate and tuberculoid type and histologically indeterminate and borderline tuberculoid. Clinico-histopathological correlation was found most in indeterminate followed by histoid type. Voluntary blood donors were seronegative. 21 out of 48 multibacillary cases and 6 out of 28 paucibacillary showed seropositivity for anti PGL-1 antibodies (p<0.001). Conclusion : . All suspected leprosy cases clinically should be subjected to slit skin smear examination with histopathological evaluation; bacillary study which helps in diagnosis and adequate treatment of patients. Detection of antibodies to PGL-1 in patients indicate pres-ence of leprosy bacilli and useful in preclinical diagnosis and determining progress of therapy.

Antioxidant and hepatoprotective action of Asparagus racemosus Willd. root extracts.

The antioxidant activities of the crude hydro-alcoholic extract (CE) and its four fractions viz. methanol (MF), ethyl acetate (EF), n-Butanol (BF), and precipitated aqueous (PAF) of A.racemosus roots tested decreased in the order of EF > MF > CE > BF > PAF when investigated by DPPH free radical scavenging assay. Under iron induced lipid peroxidation almost similar results were observed except that the activity was more in PAF than BF. Hepatoprotective activity of the extracts was also demonstrable in vivo by the inhibition of–CCl4 induced formation of lipid peroxides in the liver of rats by pretreatment with the extracts. CCl4–induced hepatotoxicity in rats, as judged by the raised serum enzymes viz. glutamate oxaloacetate transaminase, glutamate pyruvate transaminase, alkaline phosphatase and total and direct bilirubin as well as oxidant enzyme viz. malon dialdehyde were prevented, while antioxidant enzymes viz. superoxide dismutase, reduced glutathione and catalase were elevated by pretreatment with the extracts, demonstrating the potent hepatoprotective action of the roots of A. racemosus.

Liposomal drug delivery system from laboratory to clinic.

The main objective of drug delivery systems is to deliver a drug effectively, specifically to the site of action and to achieve greater efficacy and minimise the toxic effects compared to conventional drugs. Amongst various carrier systems, liposomes have generated a great interest because of their versatility. Liposomes are vesicular concentric bilayered structures, which are biocompatible, biodegradable and nonimmumnogenic. They can control the delivery of drugs by targeting the drug to the site of action or by site avoidance drug delivery or by prolonged circulation of drugs. Amphotericin B (Amp B) remains the drug of choice in most systemic mycoses and also as a second line treatment for Kala azar. However, its toxic effects often limit its use. Although the liposome delivery system has been tried for several drugs, only a few have been used in patients due to the slow development of necessary large-scale pharmaceutical procedures. This paper reviews the development of the technique for liposomal Amphotericin B (L-Amp-LRC-1, Fungisome) drug delivery system in our laboratory in collaboration with the department of Biochemistry, Delhi University in India and proving the safety and efficacy of this preparation in clinical practice. It also attempts to compare the efficacy and benefits of our product for Indian patients with those of similar products and it includes facts from the publications that flowed from our work. As compared to conventional Amp B, Fungisome is infused over a much shorter period requiring a smaller volume and no premedication. It was found to be safe in patients who had developed serious unacceptable toxicity with conventional Amp B. In renal transplant patients, Fungisome did not produce any nephrotoxicity. Fungisome is effective in fungal infections resistant to fluconazole, conventional Amp B and in virgin and resistant cases of visceral leishmaniasis. The cost of any drug is of great significance, especially in India. We have therefore devoted a section of our review to the relative costs of our product and those of other commercially available products. This patient-worthy formulation is safe, efficacious and cheaper than the commercially available formulation of liposomal amphotericin B. The product has been patented and technology transferred to a pharmaceutical company for marketing. Results of postmarketing study also document safety and efficacy as observed in premarketing studies. A brief review of this work is provided here.

The first international leprosy conference, Berlin, 1897: the politics of segregation.

The present paper examines the first attempts to internationalise the problem of leprosy, a subject hitherto overlooked by historians of imperialism and disease. The last decade of the nineteenth century saw many in the civilised countries of the imperialist West gripped by a paranoia about an invasion of leprosy via germ-laden immigrants and returning expatriates who had acquired the infection in leprosy endemic colonial possessions. Such alarmists clamoured for the adoption of vigorous leper segregation policies in such colonies. But the contagiousness of leprosy did not go unquestioned by other westerners. The convocation in Berlin of the first international meeting on leprosy revealed the interplay of differing and sometimes incompatible views about the containment of leprosy by segregation. The roles of officials from several countries, as well as the roles of five protagonists (Albert Ashmead, Jules Goldschmidt, Edvard Ehlers. Armauer Hansen, and Phineas Abraham) in the shaping of the Berlin Conference are here examined.

Medical ethics in the neurosciences.

Doctors in India are heirs to a long tradition of ethics from their own forebears and from those from the West. This paper discusses ethical aspects of topics of relevance to neurological scientists such as brain death, neural transplant and whole brain transplant. Many other topics such as ethics in research, patients with AIDS, patients in a persistent vegetative state and euthanasia deserve similar consideration and debate.

Open label, randomised, comparative phase III safety and efficacy study with conventional amphotericin B and liposomal amphotericin B in patients with systemic fungal infection.

OBJECTIVE: To compare conventional amphotericin B (c-amp B) and liposomal amphotericin B (L-AMP-LRC-1-India) in patients with systemic fungal infection in open, randomized, comparative, laboratory blind, phase III safety and efficacy study. MATERIAL AND METHODS: Formulation of liposomal amphotericin B - L-AMP-LRC-1, containing natural phospholipids, was prepared and tested at the Department of Clinical Pharmacology, Seth GS Medical College and KEM Hospital, Mumbai, India. Patients suffering from proven systemic fungal infection, were treated with c-amp B or L-AMP-LRC-1 with 17 patients in each group. Data was compared for the safety and efficacy. RESULTS: Safety: L-AMP-LRC-1 was better tolerated than c-amp B. Out of the 695 infusions of c-amp B fever occurred on 25.04% occasions in 68.42% patients, while it occurred on 2.09% occasions out of 767 infusions (in 30.43% patients of L-AMP-LRC-1. Chills occurred on 16.83% and 1.17% occasions after c-amp B and liposomal amphotericin B respectively. Other adverse effects observed on 0.2-5% of occasions were: headache, nausea, vomiting, palpitation and dizziness occurring more frequently in c-amp B group. The L-AMP-LRC-1 did not cause bronchospasm at 1 mg/kg dose in a patient who developed bronchospasm to 0.1 mg/kg dose of c-amp B. The L-AMP-LRC-1 was found to be less nephrotoxic than c-amp B and could be administered to patients who had renal problems or had undergone renal transplant. L-AMP-LRC-1 caused less hypokalemia than c-amp B. Effficacy: 17/17 patients in L-AMP-LRC-1 group and 14/17 in c-amp B group had complete response (100% and 82.35% response rate). The number of infusions and dose of amphotericin B and L-AMP-LRC-1 used were similar and required individualization of duration of treatment (in cases where response to fixed duration was not observed). All the patients were treated with 0.5 to 1.0 mg/kg/day dose of L-AMP-LRC-1 (except one patient required 2 mg/kg dose). This is markedly different from other marketed liposome and lipid formulations, which are recommended at higher (3-5 mg/kg) doses every day. At the same time L-AMP-LRC-1 being prepared from naturally occurring lipids is expected to cost at least one-third of the marketed formulation. Thus cost of every day treatment would be very much less compared to other delivery systems. Thus L-AMP-LRC-1 will be an economical and safe treatment option available to the physicians for the treatment of systemic fungal infection.