Phytochemical Screening and Anti Microbial Studies of Hemidesmus Indicus.

Many forms of alternative medicines were available for those who cannot be helped by conventional medicine. Ayurvedha and Herbal medicine were two important forms of alternative medicine that was widely available in India. This work was mainly concerned with the identification of the therapeutic properties of Hemidesmus indicus. The ethanolic extract of hemidesmus indicus root was used for its anti oxidant and antimicrobial activity. Hemidesmus indicus root extract has very well anti oxidant and anti microbial activity. The ethanolic extract of Hemidesmus indicus was checked for anti microbial activity against pathogenic bacteria such as staphylococcus aures, pseudomonas aeruginosa and fungi Aspergillus niger.

Phytochemical screening and insilico approach for the identification of anti stress compounds from medicinal plants.

In India, many forms of alternative medicines are available for those who cannot be helped by conventional medicine. Ayurvedha and Herbal medicine are two important forms of alternative medicine that is widely available in India. This work was mainly concerned with the identification of the therapeutic properties of Indian medicinal plant extracts. Everyone knows that medicinal plants have disease curing properties and this is due to the compounds presents in the extracts used for the treatment. So we identified the compounds of different medicinal plants like Celastrus paniculatus, Withania somnifera, Convolvulus pluricaulis, Rauvoifia Serpentina etc which are used as medicine for Stress in Ayurvedha from previous literature. After identification using chemsketch software these compounds were designed and screened for antistress property. The proteins responsible for stress in Homo sapiens were collected using Protein databank (PDB). Active sites were identified and used for docking with the compounds. Then the compounds were docked to the Calcium channel in order find better inhibitor. Among 33 compounds 10 compounds showed best docking results for each protein. ADMET studies were performed using Molinspiration and OSIRIS server.

Oro-mandibular manifestations of primary hyperparathyroidism.

Aims and Objective : To determine the effects of Primary Hyperparathyroidism on oral cavity in a symptomatic contemporary Indian population by taking note of the following parameters: (1) Radiological alteration of lamina dura, (2) mandibular cortical width, (3) prevalence of brown tumor, and (4) mandibular tori. Study Design : Twenty-six patients of Primary Hyperparathyroidism were examined clinically and radiologically for extra- and intraoral abnormalities. Loss of lamina dura, mandibular cortical width, presence of mandibular tori, and brown tumors were assessed and correlated with serum Calcium, Phosphate, Parathormone, and Alkaline phosphatase. The results were compared with twenty-six age- and gender-matched control subjects. The data was expressed as mean ± SD, and a probability (p) value of < 0.05 was considered significant. Pearson's statistical method was used to assess the significant correlation between radiological measurements and biochemical values. Results : Generalized absence of the lamina dura was the most consistent finding and there was a significant correlation between its loss and altered parathormone, alkaline phosphatase, and inorganic phosphate, but not with serum calcium or the duration of the disease. Mean values (in mm) for the cortical indices were significantly lower in the patients compared to the controls and correlated significantly with parathormone and alkaline phosphatase. None of the patients had mandibular tori and only one patient had a brown tumor. Conclusion : Loss of lamina dura, ground glass appearance, and mandibular cortical width reduction are common findings in primary hyperparathyroidism and these are significantly correlated with elevated parathormone and alkaline phosphatase. However, the presence of brown tumors and oral tori are less commonly encountered features.

Larva currens in a case of organophosphorous poisoning.

A 20-year-old healthy farmer consumed organophosphorous poison. On third day he developed diarrhoea and on fourth day linear serpiginous ulcers appeared on both buttocks. Clinically lesions were considered as decubitus ulcers. By stool examination and other laboratory investigations it was diagnosed as cutaneous larva currens due to Strongyloides stercoralis in a case of organophosphorus poisoning. Patient responded very well to a course of albendazole.

Mannan antigen detection in the diagnosis of patients with invasive candidiasis.

BACKGROUND & OBJECTIVES: With the increase in the incidence of invasive candidiasis (IC) in recent years, there is a need to improve the sensitivity of diagnosis. A conventional technique like blood culture is positive in nearly 50 per cent of cases. To improve the diagnostic efficiency in invasive candidiasis mannan antigen detection holds promise. Hence mannan antigen detection was evaluated in patients with suspected invasive candidiasis in the Paediatric Intensive Care Unit (PICU). METHODS: A prospective study, involving 186 consecutive patients admitted to the PICU of the Advanced Paediatric Center at the Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh between March 1999 and November 1999 were followed up for possible invasive candidiasis. Sixty five children clinically suspected to have sepsis and at risk for developing IC and or who stayed in the hospital more than 5 days were further evaluated for the diagnosis of IC by collecting two blood culture samples 48 h apart and by mannan antigen and anti-mannan antibody detection. Both antigen and antibody were detected by in-house standardized techniques: antibody by whole cell agglutination (WCA) and antigen by sandwich enzyme linked immunosorbent assay (ELISA). RESULTS: Twenty of 65 patients (30.7%) were positive by blood culture. Mannan antigen was positive in all 20 patients and significant anti-mannan antibody titre (> or = 128) was present in 12 (60%) patients. Mannan antigen was detected in 15 more patients, who were negative for isolation of Candida from blood. Twelve of these patients had febrile episode not responding to antibacterial therapy but responding to fluconazole/itraconazole therapy indicating that the patients possibly had IC. Mannan concentration was also found to be significantly higher in the patients with Candida isolated from blood. INTERPRETATION & CONCLUSION: Thus, the present study confirms the earlier claim that mannan antigen detection possibly improves the diagnostic efficiency of IC.

Calcitropic hormonal status in north Indian patients with end-stage renal disease.

BACKGROUND: Bone disease in chronic renal failure has a wide spectrum that includes both high and low turnover conditions. Specific preventive and therapeutic measures require knowledge of the nature of bone involvement. Bone biopsy with static and dynamic histomorphometry is the gold standard for characterization of renal bone disease. However, non-invasive biochemical tests, especially serum intact parathyroid hormone (PTH), have a good correlation with histomorphometry. We studied the clinical and biochemical profile of bone disease in a sample of north Indian patients with chronic renal failure. METHODS: Twenty-nine patients of chronic renal failure were evaluated clinically, radiologically (subperiosteal erosions on hand X-rays) and biochemically (serum calcium, phosphorus, total alkaline phosphatase, intact PTH, osteocalcin, 25-hydroxyvitamin D, 1,25-dihydroxyvitamin D). Bone histomorphometry could be done in 4 patients. RESULTS: Serum intact PTH within or below the non-uraemic normal range, an index of low bone turnover, was seen in 17 (58.6%) patients. Serum osteocalcin, a bone formation marker, was within or below the non-uraemic normal range in 65.5% patients. Serum intact PTH and osteocalcin had a significant positive correlation (r = 0.6). Patient groups with clinical or radiological evidence of bone disease had serum intact PTH and osteocalcin levels comparable to those lacking such features. Serum intact PTH and total alkaline phosphatase were lower in haemodialysed (n = 25) patients than in those who had not received haemodialysis (n = 4). Low (< 10 ng/ml) serum 25-hydroxyvitamin D levels were seen in 7 (24%) patients while 1,25-dihydroxyvitamin D was low (< 15.9 pg/ml) in 20 (69%) patients. The biochemical parameters accurately reflected the bone histology (n = 4). CONCLUSIONS: Our data show that the majority of north Indian patients with chronic renal failure have biochemical evidence of low bone turnover. Empirical use of calcium salts and active vitamin D analogues without documentation of parathyroid status carry the risk of further suppression of bone turnover.

Routine screening for HIV and hepatitis B in patients undergoing cardiac catheterisation: the need to make it mandatory.

Reuse of catheters during cardiac catheterisation and interventions is a routine practice in our country. However, the reuse of catheters is complicated by the inherent difficulties in adequate sterilisation of these devices. Gas sterilisation with ethylene oxide has been found to be ineffective when residual fluid was present. Recent reports indicate an increased prevalence of blood-borne viral infections especially Hepatitis B virus and Human Immunodeficiency virus in India. We analysed the data of patients from our Institute over the past seven years (1992-1998) who underwent routine screening for Human Immunodeficiency virus and Hepatitis B virus prior to cardiac catheterisation. During this period, the prevalence of Hepatitis B virus increased by 1.5 times and that of Human Immunodeficiency virus by 2.5 fold. In this changed scenario, it is advisable to perform a mandatory screening of all the patients undergoing invasive cardiac procedures so as to minimise the risk of transmission from one patient to another and also to the catheterisation laboratory personnel. In the patients with a positive result, proper precautions can be taken and the entire material used for cardiac catheterisation can be discarded.

Primary squamous cell carcinoma of the breast in a young woman--a case report and review of literature.

A thirty-four years old woman presented with pure squamous cell carcinoma of the breast, a very rare occurrence in the younger age group. A simple mastectomy with axillary clearance was performed, followed by adjuvant radiotherapy & chemotherapy. The patient is doing well, with no evidence of recurrence thirty months (2 1/2 years after the treatment. Primary pure squamous cell carcinoma of the breast is a very rare disease. The exact histogenesis still remains obscure. There seems to be no specific prognostic correlation with the morphological characteristics of squamous cell carcinoma of the breast. The clinical behaviour of this tumor is also uncertain. Thus, further study is required to determine whether primary pure squamous cell carcinoma of the breast is to be treated as a separate entity or as the common type of breast cancer (i.e. adenocarcinoma or adenocarcinoma with squamous metaplasia.)

Tetralogy of Fallot with flap valve ventricular septal defect producing suprasystemic right ventricular pressure: echocardiographic observations.

Tetralogy of Fallot with restrictive ventricular septal defect and suprasystemic right ventricular pressure is an uncommon anomaly with high mortality rate. Very few such cases have been reported pre-operatively. This report describes echocardiographic features of five patients with restrictive ventricular septal defect due to flap valve in tetralogy of Fallot. In all the five cases, accessory or excessive tricuspid valve tissue obstructed the defect. Recognition of restrictive ventricular septal defect in tetralogy of Fallot is important because it appears to have poor prognosis.

Safety of thrombolytic therapy following acute myocardial infarction in patients above 65 years.

The safety of thrombolytic therapy for acute myocardial infarction in the elderly population has not been clearly established. In a retrospective study we evaluated the efficacy and complications of thrombolytic therapy in the elderly as compared to younger patients. Consecutive 588 patients who received thrombolytic therapy were studied. Clinical data in 136 patients aged above 65 years were compared with 85 patients below 40 years. Cigarette smoking was a common risk factor in the young (46 vs 13; p < 0.0001). Coexistent systemic diseases and conduction system disturbances (28 vs 9; p < 0.05) were common in the older patients, but the incidence of bleeding complications to thrombolytic therapy (6 vs 1; p = NS) was not found to be higher. Ninety percent of the elderly who had cardiogenic shock died. There was no significant difference between the two groups in reinfarction rate (12 vs 15; p = NS) and post-infarct angina (20 vs 20; p = NS). Coronary angiography revealed a higher incidence of multivessel disease in the elderly. To conclude, thrombolytic therapy is safe and effective even in older individuals.