Pediatric Polysomnographic Studies at a Tertiary-care Hospital in Singapore.

Objectives: To investigate the indications for conducting polysomnography studies and their outcomes. Methods: Retrospective analysis of pediatric polysomnography studies performed over a four-year period (2009-2012). Results: 425 diagnostic studies and 100 non-invasive positive-pressure ventilation titration studies were conducted. Of these, 389 were performed in male children. Obstructive sleep apnea was the most common diagnosis; 49.6% (211 studies). Other diagnoses included central apnea, narcolepsy, and periodic limb movement disorder. Night time symptoms (snoring, frequent night awakenings, restless sleep) were present in 294 children, and 161 children had daytime symptoms (excessive daytime sleepiness, early morning fatigue, poor concentration at school). 13 studies (2.5%) were inadequate for analysis, reflecting the challenges of conducting studies in children. Conclusion: Dedicated pediatric sleep laboratories with properly trained staff are important to minimize failure rates and diagnose these conditions accurately.

Furosemide Infusion in Children with Dengue Fever and Hypoxemia.

Objectives: To study the role of furosemide infusion in the management of Acute respiratory distress syndrome (ARDS) associated with dengue fever. Methods: Children between the ages of 1 month to 18 years, who fulfilled the WHO clinical criteria for dengue infection and American European Consensus Criteria criteria for ARDS with Dengue IgM positivity, were evaluated. Patients were studied as group D (receiving diuretic therapy alone) and group B (both ventilation and diuretics), and compared to a historical control group V (ventilation alone). Furosemide infusion was administered at 0.05-0.1 mg/kg/hour for 48 hours, maintaining a urine output of 2-4 mL/kg/hour. Results: There was a significant difference in survival in the three groups. Significant difference was noted between pre- and postintervention arterial blood gases with respect to PCO2 (P=0.02), pO2 (P=0.003), PaO2/FaO2 ratio (P<0.001) and alveolar-arteriolar oxygen gradient (P=0.002). Conclusion: Diuretic infusion improves outcome in dengue with ARDS.

Retinopathy of Prematurity –Promising Newer Modalities of Treatment.

Retinopathy of prematurity (ROP) is a disorder of neonatal retinal vascularization. The incidence is increasing in developing countries like India in view of the rising numbers of preterm deliveries and improved neonatal care. Traditional modalities of treatment included cryotherapy and laser therapy, which were laborious and required special training. Hence, research is on way to find novel treatment modalities directed at various levels of pathogenesis for this blinding disease. We reviewed the published and unpublished literature on newer methods of ROP management. The pathogenesis of ROP has been studied with respect to the mediators of angiogenesis. Anti vascular endothelial growth factor (Anti-VEGF) therapy has been extensively studied and the studies have demonstrated its promising role early stages of ROP. The role of Insulin like growth factor (IGF), Granulocyte colony stimulating factor (GCSF), and June kinases (JNK) inhibitors are being studied by various researchers across the world. Gene therapy holds promise in the reversal of ROP changes.

Effect of different types of tea on Streptococcus mutans: An in vitro study.

Context: If tea can be shown to have an inhibitory effect on the growth of Streptococcus mutans there can be a basis for using it as an agent for reducing caries. Aims: The aim of the study was to determine the effect of aqueous and organic extracts of three types of tea (green, oolong, and black tea) on the growth of S. mutans. Settings and Design: In vitro study. Material and Methods: Qualitative and quantitative phytochemical analysis of the three types of tea was done. Organic extracts of methanol and ethanol and aqueous extracts (50% and 100%) of tea were prepared. Fifty microliters of these extracts were inoculated into wells prepared on Mueller-Hinton agar plates that had been previously smeared with S. mutans. The agar plates were incubated at 37΀C for 24 hours. A similar procedure was followed using 0.2% chlorhexidine, which served as the positive control. Statistical Analysis Used: Analysis of variance (ANOVA), post hoc Tukey test, Student's 't ' test (two-tailed, dependent), and Student's 't' test (two-tailed, independent) were used for analysis of the data. Results: All the phytochemicals were found to be higher in oolong tea. Both aqueous and organic extracts of oolong tea showed greatest zones of inhibition, followed by green tea and black tea. Aqueous extracts of oolong and green tea showed greater zone of inhibition than chlorhexidine. All the three types of tea inhibited growth of S. mutans. The greatest inhibition was observed with aqueous extract of oolong tea. Conclusions: Oolong tea extracts (aqueous and organic) showed a greater inhibitory effect on the growth of S. mutans than the other tea extracts.

Histological changes in ovaries of mice exposed to butea monosperma: preliminary study / Cambios histológicos en ovarios de ratón expuestos a butea monosperma: estudio preliminar

In Ayurvedic practice Butea monosperma (Palash) is in clinical use for hundreds of years as a contraceptive. Seeds of Butea monosperma are also used as an anthelmitic (Ansani et al., 1979) and antimicrobial (Avirutnant & Pongpan, 1983). Butea monosperma (Fabaceae family) locally known as Palash (Dhak) if given for 3 consecutive days acts as an antifertility agent for which it has been is traditionally used since time immemorial. The objective of the present study was to search the effect of Butea monosperma seeds on the ovary of mice. Observations in the present study were massive degeneration of ova in almost all the follicles, irrespective of the stage of their development. The ova from treated animals showed different stages of necrotic process. Moreover, the arrangement of follicular cells was also disturbed. The Palash seeds in the form of powder when administered orally with distilled water, according to the body weight i.e.2g/Kg, of female mice, for three consecutive days showed notable changes in ovaries. The animals were sacrificed on day next to the last day of treatment and ovaries were extirpated. Ovaries studied histologically after Haematoxylin & Eosin staining showed most of the follicle in immature state with undefined nucleus and nucleoli in the ovum. Others showed degenerative changes in the ovum. Follicles had lost their normal shape and arrangement and organization of granulosa cells. It was conspicuous to find that almost all follicles including graafian follicles of treated ovaries were undergoing degenerative changes simultaneously. The rate of apoptosis in the granulosa cells when studied was found increased in treated cases as compared with control. The study suggests that the disintegration of ova in the ovaries is a specific effect of Butea monosperma seed administration.

En la práctica Ayurvédica Butea monosperma (Palash) se encuentra en uso clínico durante cientos de años como método anticonceptivo. Semillas de Butea monosperma también se utilizan como un antihemético y antimicrobiano. Butea monosperma (familia Fabaceae) conocida localmente como Palash (Dhak) si se administra durante 3 días consecutivos actúa como un agente anticonceptivo que se utiliza tradicionalmente desde tiempos inmemoriales. El objetivo del presente estudio fue buscar el efecto de las semillas de Butea monosperma en ovarios de ratones. Se obsevó degeneración masiva de los óvulos en casi todos los folículos, independientemente de la fase de su desarrollo. Los óvulos de los animales tratados mostraron las diferentes etapas del proceso necrótico. Por otra parte, la disposición de las células foliculares se mostró alterada. El polvo de semillas de Palash, cuando se administra a los ratones, por vía oral en agua destilada, i.e. 2g/Kg peso corporal, durante tres días produce cambios en los ovarios. Los animales se sacrificaron al día siguiente terminado el tratamiento y fueron extirpados los ovarios. Los ovarios se estudiaron histológicamente con HE mostrándose la mayoría de los folículos en estado inmaduro, con núcleo definido y nucléolos en el óvulo. Otros mostraron cambios degenerativos en los óvulos. Los folículos habían perdido su forma normal y la disposición y organización de células de la granulosa. Se encontró que casi todos los folículos incluyendo los folículos mostraban cambios degenerativos de manera simultánea. En los casos tratados, la tasa de apoptosis en las células de la granulosa estaba aumentada, en comparación con el grupo control. El estudio sugiere que la desintegración de los óvulos en los ovarios es un efecto específico de la administración de las semillas de Butea monosperma.

Importance of Ananda kanda in the history of Indian alchemy.

Rasa Săstra is an important branch of Ayurvĕda developed for achieving therapeutic benefits from mineral materials. Ananda kanda is one of this subject text which gives an elaborate description of this subject. Dĕhavada concept of Rasa Săstra has been described elaborately along with Lŏha vada in this text. This book serves an important reference text. This book serves an important reference text for students and scholars of Rasa Săstra for teaching and training practical purposes.

Prognostic assays in multiple myeloma: correlated with flow cytometry.

DNA ploidy of plasma cells in bone marrow has been indicated to play a role in treatment response of multiple myeloma. Therefore, a prospective study was done to test this correlation. Univariate DNA flow cytometry was done on 13 proved multiple myeloma patients. Patients aged below 50 years showed hypodiploidy, irrespective of 'S' phase population, where as all patients above 50 years had diploidy or hyperdiploidy, except for one patient. Early stage patients (I & II) with less than 25% plasma cells in bone marrow were all aneuploids. Patients belonging to advanced clinical stage with more than 60% plasma cells in bone marrow with aneuploidy, especially hyperdiploidy (DI > 1.15), carried a poor prognosis. It was difficult to correlate the 'S' phase fraction with other parameters from the present data. Further study with BrdU labelling to determine the proliferative status of the 'S' phase cells is needed.