Safety and efficacy of an herbal formulation in patients with renal calculi - A 28 week, randomized, double-blind, placebo-controlled, parallel group study

Background: Urolithiasis is a growing problem worldwide. Many a times, asymptomatic stones are keptunder observation. Many herbal preparations are available for the same, but they lack proper scientificdocumentation.Objective: To study the anti-urolithiatic effect of an herbal preparation, Subap Plus (IP) capsules in patients with asymptomatic renal calculi of size ranging from 4 to 9 mm.Material and methods: This was a prospective, randomized, double-blind, placebo-controlled clinical trialconducted in a tertiary care hospital in Pune, India.Patients with asymptomatic renal calculi of 4e9 mm size were randomized (1:1, block randomization) toone of the group Subap Plus (treatment group) or placebo (placebo group). The study outcome includedchange in visual analog scale (VAS), change in the surface area and density of calculi and their expulsion.Statistical analysis was performed using student's t-test and Chi-square test.Results: A total of 120 patients were screened and 84 were enrolled who met the eligibility criteria, ofwhich 65 patients completed the trial (treatment, n ¼ 34; placebo, n ¼ 31). The VAS score significantlydecreased in the treatment group (6.9e1.8) than placebo group (7.2e6.8) (p < 0.001). The surface areaand density were decreased by 47.58% (p < 0.008) and 43.01% (p < 0.001), respectively, in the treatmentgroup than the placebo group. The expulsion of calculi was significantly higher in the treatment groupthan placebo group (20.59 vs. 3.23%, p < 0.03).Conclusion: Patients treated with herbal formulation showed better expulsion rate and reduction insurface area and density than the placebo group.© 2018 Transdisciplinary University, Bangalore and World Ayurveda Foundation. Publishing Services byElsevier B.V. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

Prevalence of myopia among school going children.

Background: Poor vision in childhood affects performance in school or at work and has a negative influence on the future life of the child. Moreover planning of a youth’s career is very much dependent on the visual acuity, especially in jobs for navy, military, railways and aviation. This warrants early detection and treatment of refractive errors to prevent permanent disability. Hence present study was planned with the objective to determine, the prevalence of myopia among school children. Methods: An institution based cross sectional study was carried out among primary and high school children of 7 – 15 years of age. A total of 4429 children were studied over a period of one year. Visual acuity was performed among all children. Myopic children were referred for further evaluation and management. Data was entered in excel and analyzed using proportions and chi square test. Results: The prevalence of myopia was 6%. It was more among girls 155 (58.27%) than boys 111 (41.73%) were boys. 91.73% had bilateral myopia. Visual acuity improved in 95% of cases after correction. Myopia was more common among social class IV compared to social class VI. Conclusions: Early diagnosis and visual rehabilitation of myopic students can be achieved by periodic eye examination at regular intervals by school teachers and basic health workers and this can help in preventing the development of amblyopia thereby reducing the burden of morbidity due to myopia.

Sero-prevalence of Anti-HCV in HIV Infected Patients.

Human immunodeficiency virus (HIV) is known to influence the natural history of infections with certain hepatitis viruses and interactions between HIV and hepatitis viruses may potentiate HIV replication. There is high degree of epidemiological similarity between hepatitis B virus and HIV as regard to high-risk group and route of transmission. Limited information is available about the prevalence of hepatitis C virus in patients with human immunodeficiency virus in relation to specific risk factors or about the influence of hepatitis C virus coinfection on survival. Present study deals with the study of concurrent infection of HCV with HIV infection. In the study of 110 HIV seropositive patients, 6 (5.45%) were positive for HCV. The difference was highly significant compared to controls (p value < 0.0001). The studies of association of HCV in HIV cases are rare in India. Therefore the present study was undertaken to look at the prevalence of HCV in different groups and different stages of HIV infected patients.

Effect Of Saliva Contamination And Different Decontamination Modes On Dentin Bond Strength During Bonding With Single Bottle Adhesive.

The objective of the present study is to evaluate the different mode of decontamination of saliva on dentin bond strength. Buccal/lingual surfaces of 48 extracted human molars were wet ground to create flat dentin surface, to serve as bonding area for single bond and the hybrid composite resin. The experimental teeth were then categorized into six groups of 8 teeth each and treated in the following manner. Group 1 control (without contamination), Group 2 etched surface is contaminated with saliva and saliva is decontaminated by air drying. Group 3 etched surface is contaminated and saliva was decontaminated by rinsing and blot drying.group4 uncured adhesive surface contaminated, saliva is decontaminated by rinsing and blot drying. Group 5 cured adhesive surface is contaminated, decontamination of saliva was done by rinsing and air drying. Group 6 treated similar to Group 5 with additional adhesive application after air drying. All teeth were mounted in iron mould and subjected to universal testing machine for shear bond strength. Lowest mean bond strength was found in Group2 which was significantly lower than all other Groups (p<0.01). Group5 and Group6 were significantly lower than Group1, 3 and 4. Based on this study it was found that one bottle adhesive systems are less sensitive to salivary contamination in contrast to previous generation adhesives.

Lipid lowering activity of ethanolic extract of leaves of Aegle marmelos (Linn.) in hyperlipidaemic models of Wistar albino rats.

Lipid lowering effect of 50% ethanolic extract of the leaves of A. marmelos (Linn.) was evaluated in triton and diet induced hyperlipidaemic models of Wistar albino rats. The extract at 125 and 250 mg/kg dose levels inhibited the elevation in serum cholesterol and triglycerides levels on Triton WR 1339 administration in rats. The extract at the same dose levels significantly attenuated the elevated serum total cholesterol and triglycerides with an increase in the high-density lipoprotein cholesterol in high-fat diet- induced hyperlipidaemic rats. The standard drugs atorvastatin in the former and gemfibrozil in the latter studies showed slightly better effects.

Psychological consequences in pediatric intensive care unit survivors: the neglected outcome.

OBJECTIVES: To determine whether Pediatric Intensive Care Unit (PICU) hospitalization results in adverse psychological effects and to identify the contributory factors. SETTING: Level III PICU of a tertiary center. DESIGN: Prospective cohort study. METHODS: Consecutive patients 5 years or older admitted to PICU for at least 48 hours constituted the study population. Controls were age and sex matched children hospitalized in the pediatric wards for at least 48 hours. Severity of illness was assessed by the Pediatric Risk of Mortality (PRISM) score. Level of therapeutic intervention was determined by the Therapeutic Interventions Scoring System (TISS--76 score). Temperament Measurement Schedule was used to assess the premorbid temperament. Psychological assessment was performed using Impact of Event Scale (IES), Birleson Depression Scale and the Self-Esteem Scale. Follow-up evaluation was done one month after discharge. RESULTS: There were 30 children each in the study and control groups. They had comparable pre-morbid temperament as well as scores on the self-esteem and depression scales. Significantly higher proportion of patients in PICU had intrusive thoughts (43%) as compared to controls (6.7%). Development of intrusive thoughts correlated significantly with the degree of intervention. Demographic parameters, nature of the disease, duration of hospitalization and severity of illness did not correlate with the psychological outcome. One month after discharge, scores in both groups were comparable. CONCLUSIONS: Children subjected to therapeutic interventions in the PICU develop transient psychological impairment manifested by experiencing intrusive thoughts that resolve within a month.

Effect of losartan and enalapril on cognitive deficit caused by Goldblatt induced hypertension.

The present study was designed to evaluate the learning and memory, in an altered physiological state associated with increased blood pressure and activated renin angiotensin system in Wistar rats. The role of angiotensin in cognitive function was assessed by treatment with angiotensin converting enzyme (ACE) inhibitor enalapril (2 mg/kg), angiotensin 1 receptor (AT(1)) antagonist losartan (5 mg/kg) and their combination. The experimental renal hypertension was induced by the method of Goldblatt. Learning and memory was assessed using the radial arm maze test. Acetylcholine esterase (AChE) levels in the pons medulla, hippocampus, striatum and frontal cortex were measured as a cholinergic marker of learning and memory. Results indicate that in comparison to normotensive rats, renal hypertensive rats committed significantly higher number of errors and took more trials and days to learn the radial arm maze learning and exhibited memory deficit in the radial arm maze retrieval after two weeks of retention interval, indicating impaired acquisition and memory. Treatment with enalapril, losartan and their combination attenuated the observed memory deficits indicating a possible role of renin angiotensin system in cognitive function. AChE level was reduced in hippocampus and frontal cortex of renal hypertensive rats which could be attributed to the observed memory deficit in hypertensive rats. It can be concluded that, renal hypertensive rats had a poor acquisition, retrieval of the learned behavior, perhaps a possible disturbance in memory consolidation process and that this state was reversed with ACE inhibitor enalapril and AT 1 receptor antagonist losartan.

Development and in-vitro Evaluation of a Topical Drug Delivery System Containing Betamethazone Loaded Ethyl Cellulose Nanospheres

PURPOSE : Lipid nanospheres are used for the passive targeting of cosmetic agents to skin; thereby achieving major benefits such as reduction of total dose and avoidance of systemic absorption. The present study was carried out to exploit the feasibility of using polymeric nanospheres as an alternative and cheaper carrier for targeting corticosteroids to the skin. METHODS: Nanospheres were prepared from ethyl cellulose by a modified method of desolvation and cross linking. The drug betamethazone was incorporated into nanospheres and the drug : polymer ratio was evaluated to determine the carrier capacity of the polymer. In vitro release studies of drug-loaded nanospheres were carried out by the centrifugal ultrafiltration method. The kinetics of release was determined and fitted to an empirical equation. The release of drug from drug-loaded nanospheres dispersing in a conventional cream was evaluated. A comparative in vitro diffusion study was carried out between a commercial brand of cream and the cream incorporating nanospheres. RESULTS: Formulation of nanospheres of betamethazone by a modified method produced discrete particles. Studies on drug : polymer ratio showed a linear relationship between drug concentration and percentage of loading. The in vitro release of drug-loaded nanospheres was found to be first order. The comparative in vitro diffusion study between the commercial cream and the formulated cream showed a marked reduction in release rate from nanospheres-bound cream. CONCLUSION : Formulated topical cream containing nanospheres of betamethazone was found to be a potential dermal delivery system for sustaining the release of the drug

Toxicity of Nerium indicum Miller seed extract on bandicoot rat, Bandicota bengalensis Gray.

Crude extract (12.5 ml/kg) of N. indicum seed gave 100% mortality of B. bengalensis. Humanness assessment study revealed that this plant orgin chemical caused low pain and sufferings to the target pests.

Antiviral activity of medicinal plants of Nilgiris.

BACKGROUND & OBJECTIVES: Medicinal plants have been traditionally used for different kinds of ailments including infectious diseases. There is an increasing need for substances with antiviral activity since the treatment of viral infections with the available antiviral drugs often leads to the problem of viral resistance. Herpes simplex virus (HSV) causes a variety of life threatening diseases. Since the chemotherapeutic agents available for HSV infections are either low in quality or limited in efficiency, there is a need to search for new and more effective antiviral agents for HSV infections. Therefore in the present study 18 plants with ethnomedical background from different families were screened for antiviral activity against HSV-1. METHODS: Different parts of the plants collected from in and around Ootacamund, Tamil Nadu were extracted with different solvents to obtain crude extracts. These extracts were screened for their cytotoxicity against Vero cell line by assay microculture tetrazolium (MTT) trypan blue dye exclusion, proteins estimation and 3H labeling. Antiviral properties of the plant extracts were determined by cytopathic effect inhibition assay and virus yield reduction assay. RESULTS: Three plant extracts Hypericum mysorense, Hypericum hookerianum and Usnea complanta exhibited significant antiviral activity at a concentration non toxic to the cell line used. The extracts of Melia dubia, Cryptostegia grandiflora and essential oil of Rosmarinus officinalis showed partial activity at higher concentrations. INTERPRETATION & CONCLUSION: Some of the medicinal plants have shown antiviral activity. Further research is needed to elucidate the active constituents of these plants which may be useful in the development of new and effective antiviral agents.

Evaluation of cognitive function of fluoxetine, sertraline and tianeptine in isolation and chronic unpredictable mild stress-induced depressive Wistar rats.

Depressive illness is generally associated with cognitive impairment. Serotonergic selective antidepressant drugs, fluoxetine (FLX), sertraline (SER) and tianeptine (TIA), are claimed to have less or no effect on cholinergic system, the key system involved in memory. In the present study, these drugs were evaluated for their influence on cognitive behavior in both depressive and non-depressive animals. Depression was induced by two models, (i) 60 days social isolation of litter; and ii) by applying chronic unpredictable mild stress for 21 days. Depression in the rats was confirmed by behavioral despair test. Transfer latency on elevated plus maze and inflexion ratio in passive avoidance step through behavior were employed to assess learning and memory. The results indicated that administration of fluoxetine; sertraline and tianeptine attenuated the cognitive deficits observed in depressive rats. In non-depressive rats these drugs produced retention deficit, which was found to be parameter and model dependent. Data suggested that, FLX and SER (SSRI's) effectively attenuated the isolation-induced depression and cognitive deficit, whereas TIA (SSRE) produced better effect in stress-induced depressive conditions. It was concluded that behavioral profiles of fluoxetine, sertraline and tianeptine on cognition were model and parameter dependent.

Permeabilization and in situ adsorption studies during growth and coumarin production in hairy root cultures of Cichorium intybus L.

Effect of addition of a permeabilizing agent dimethyl sulfoxide (DMSO) and a solid adsorbent, XAD -7, on growth and coumarin production in hairy root cultures of C. intybus was studied. Continuous permeabilization of the hairy root cultures of C. intybus with DMSO has been shown to be an effective strategy for enhanced release of coumarins while preserving the root viability. DMSO at 0.2% (v/v) level showed the maximum growth and coumarin production but was less as compared to control on day 28. Treatment of cells with increasing concentrations of DMSO (0.3 - 0.6 % v/v) to hairy root cultures of C. intybus, showed an inverse relationship with growth and coumarin production. Growth and production of coumarins increased with 1% media filtrate (MF) of cultures of Phytopthora parasitica var. nicotiana treatment. It was observed that treatment with DMSO (0.2% v/v) and 1% MF of P. parasitica showed the better growth and coumarin production with an increased release of coumarins as compared to the control and other treatments. It was observed that treatment of hairy root cultures with XAD-7 resulted in lesser growth and coumarin production as compared to control during the culture period. Addition of XAD-7 along with 1% MF of P. parasitica showed enhanced growth, coumarin production and increased adsorption as compared to control and lone XAD-7 treatment. Combined addition of DMSO/XAD-7 with fungal elicitor showed synergistic response in terms of biomass and coumarin production. Excretion of coumarins in both the cases was dependent on the presence of DMSO/XAD-7. These results showed that continuous permeabilization of hairy root cultures of C. intybus by using DMSO at 0.2% (v/v) level coupled with 1% MF of P. parasitica maintained viability of tissues and produced coumarins at higher level.

Antifertility activity of Ailanthus excelsa Linn. in female albino rats.

Alcoholic extract of leaf and stem bark of A. excelsa at a dose of 250 mg equivalent of plant material/kg body weight, exhibited remarkably high anti-implantation and early abortifacient activities. The results are in agreement with the traditional use of this plant as a abortifacient by the Irula women of the Nilgiri district.