Antidiabetic effect of Dodonaea viscosa (L). Lacq. aerial parts in high fructose-fed insulin resistant rats: A mechanism based study.

To study the effect and mode of action of water extract (DVW) and polar fraction of ethanol extract (DVE-4) of D. viscosa in high-fructose diet induced insulin resistance in male Wistar rats. D. viscosa’s effects were evaluated on a battery of targets involved in glucose homeostasis (in vitro studies). Rats were rendered insulin resistant by feeding 66% (w/w) fructose and 1.1% (v/w) coconut oil mixed with normal pellet diet (NPD) for six weeks. DVW and DVE4 at different doses were administered simultaneously. At the end of the study, blood glucose, oral glucose tolerance test, lipid profile and insulin were estimated and homeostatic model assessment (HOMA) levels were calculated. In addition, enzymatic and non-enzymatic liver antioxidant levels were also estimated. Quantification of biomarker quercetin was done using HPLC. Fructose diet with DVW, DVE-4 significantly reduced blood glucose, serum insulin, HOMA, lipid profiles and significantly improved glucose tolerance and HDL-c levels. In addition, these extract and fraction also decreased oxidative stress by improving endogenous antioxidants. In different bioassays, DVW and DVE-4 inhibited protein tyrosine phosphatase-1B with IC50 65.8 and 54.9 g/ml respectively and showed partial inhibition of dipeptidyl peptidase-IV. Moreover, DVW and DVE-4, at 10 mg/ml showed 60 and 54.2% binding to peroxisome proliferator-activated receptor-g. Further, 2.1% (w/w) of quercetin was quantified in bioactive-DVE-4 using HPLC method. The results provide pharmacological evidence of D. viscosa in treatment of prediabetic conditions and these effects may be mediated by interacting with multiple targets operating in diabetes mellitus.

Mycoplasma hominis in pelvic inflammatory disease.

Fifty one cases of Pelvic Inflammatory disease (PID) and sixty one control subjects were screened for the genital mycoplasmas. Cervical swabs, urine & blood were collected from the patients and the control subjects and were processed by standard techniques for isolation and identification of bacteria, fungi and mycoplasmas. The rate of isolation of M. hominis from the PID and controls were 54.90% and 16.39% respectively, and this difference was statistically significant (p. < 0.001). Metabolic inhibition test revealed a titer of > 1:2 in 92% of the acute sera of PID against the homologous strain and there was a rise or fall in four fold titer in 45% of the convalescent sera tested for.

Natural history and response to treatment of minimal change nephrotic syndrome.

This study is a retrospective analysis of 177 patients of minimal change nephrotic syndrome seen between 1985 and 1989. Fifty nine of these had renal biopsy done and the others were diagnosed on clinical grounds. Short courses of prednisolone were used for three episodes in one year. If a fourth episode occurred in any 12 month period, cyclophosphamide was started. This was needed in 26 patients and was also used in 9 patients who did not respond to 8 weeks of prednisolone. Follow up ranged from 4 months to 5 years (mean 1.4 years). Thirty nine percent of patients sustained remission after the first course of steroids. Histological variations (presence or absence of diffuse mesangial proliferation or IgM deposits) and age made no difference to the response to treatment and subsequent relapses.

Subclavian vein catheters for haemodialysis with and without a subcutaneous tunnel.

We have retrospectively analysed the usefulness of a subcutaneous tunnel in patients undergoing haemodialysis through a double lumen subclavian catheter; 194 catheters were used in 145 patients. In 105 patients a subcutaneous tunnel was created. Entry site infection was significantly higher in the no tunnel group (30%; P < 0.02). There was no statistically significant difference in the incidence of septicaemia in the two groups. Eighty five percent of episodes of septicaemia and 67% of entry site infections were due to Staphylococcus aureus. All responded to removal of the catheter and to antibiotics. The average duration the catheter was in place was 20.39 and 21.94 days in the groups with and without tunnel respectively. The average number of dialyses was 9.13 and 9.33 per catheter in the tunnel and no tunnel groups respectively. Three patients had pneumothorax. Subclavian vein thrombosis was suspected clinically in 3 cases. There was no catheter related mortality. We concluded that while entry site infection occurred more frequently in the no tunnel group, the overall incidence of septicaemia was not different in the two groups. Creation of a subcutaneous tunnel has no added advantage.

Short term study on relative merits of acetate and bicarbonate dialysis.

We did a double blind, crossover, prospective study comparing bicarbonate and acetate containing solutions in haemodialysis. Thirty stable patients with end stage renal disease on maintenance haemodialysis while awaiting a renal transplant were each studied on three dialysis with acetate and three with bicarbonate. Nine patients developed symptoms like headache, nausea, vomiting, giddiness, and malaise and developed hypotension during acetate dialysis and three patients during bicarbonate dialysis. There were symptoms during 16.66% of acetate dialysis sessions and 5.55% of bicarbonate dialysis sessions. (P less than 0.05). There was a statistically significant decrease in PaO2 and PaCO2 on acetate dialysis at 30 minutes after initiation of dialysis. There was no significant difference in weight loss on dialysis, or in blood pressure and correction of acidosis. We conclude that bicarbonate dialysis is better tolerated, but acetate intolerance is not a major problem since we use small surface area dialysers (0.8 M2).