Spontaneous subdural hematoma in a multigravida with chronic kidney disease and superadded pre-eclampsia detected by MRI: a case report

Chronic kidney disease and pre-eclampsia are both known individual culprits for significant morbidity and mortality of mother and child worldwide. Non traumatic spontaneous subdural hematoma in pregnancy is a rare scenario, however stage 5 chronic kidney disease with superadded pre-eclampsia can be contributory factor for spontaneous extra axial bleed. Our patient was 25-year-old with history of end stage renal disease and chronic hypertension admitted with superadded pre-eclampsia. She had 1 living issue and 2 stillbirths. There was sudden deterioration of mental status as well as motor performance, the patient turned stupurous and was not following verbal commands. Patient was sent for MRI evaluation of brain and diagnosed as right sided subdural hematoma with significant midline shift towards the contralateral side. No intraparenchymal haemorrhage was noted.

Simultaneous extraction of pectin, fibre, anthocyanin and oil from mulberry pomace

Mulberry (Morus alba L.), (Fam. Moraceae) has characteristic tiny juicy fruits with sweet-tart taste. Its ripe fruits range in colour from white, pale, green, red, purple to black. The juice from red-purple mulberry variety has significant antioxidant value and food colouring properties. Though, a lot of research work has been carried out on mulberry juice, utilization of its pomace (processing waste comprising peel and seeds), has been largely ignored. Pomace constitutes about 40% of total fruit weight. Here, we have standardized protocols for potential extraction of pigment anthocyanin, fibre, pectin, and oil from mulberry pomace using a combination of organic and inorganic solvents and obtained an yield of 5.3% fibre, 1.58% pectin, 2.0% crude anthocyanins and 4.9% oil. The protocol allows complete utilization of waste left behind after juice extraction.

Bipolar disorder: a review of current U.S. Food and Drug Administration approved pharmacotherapy.

Bipolar disorder (BD) is a chronic disorder which usually has its onset in early adulthood. At one end of the spectrum is depression and at other is mania. Like many psychiatric illnesses, it is not treatable but its symptoms are completely manageable with medications. Commonly used drugs are mood stabilizers and atypical antipsychotics along with adjunctive medications such as anxiolytics and antidepressants. In general, a combination of these drugs is used for treatment. These drugs have significant adverse effects which add to the burden of the disease. Presently, there are 11 US Food and Drug Administration - approved drugs for management of acute mania, 3 for bipolar depression and 7 for bipolar maintenance. This review article details the use of these drugs in BD.

Ephedrine: direct, indirect or mixed acting sympathomimetic.

Ephedrine is the principal alkaloid that is responsible for the physiological effects of herb ephedra. This herb is found in literature of India and China since ancient times because of its effectiveness as an anti-asthmatic. Ephedrine is classified as sympathomimetic drug. Despite extensive work in this field, the mechanism of action of ephedrine remains controversial. Initial studies classified ephedrine as indirectly acting sympathomimetic, subsequent studies showed ephedrine acts by mixed action by releasing noradrenaline and by acting directly on receptors. However, few recent studies on rat have shown predominant direct action on adrenergic receptors. Hence, there is marked controversy existing whether ephedrine is directly, indirectly or mixed acting drug.

Ethics in animal experiments.

Ethics is very important to any research. Authors are expected to report if the research was done in an ethical manner. Various studies have highlighted the fact that reports of research involving human participants do not always give adequate information on ethical aspects of the study, such as how informed consent was obtained, and details of the ethics review. This has been reiterated in studies on articles published in Indian medical journals

Survey of “instructions to authors” of Indian medical journals for reporting of ethics and authorship criteria.

This study looked at information on ethics reporting and authorship in the “instructions to authors” section of Indian medical journals. Instructions to authors in 59 Indian medical journals were examined for guidance on ethics reporting and authorship.Guidance regarding ethics was mentioned in 43 (72.8%) journals; assent from minors was mentioned in 9 (15.2%) journals; approval from an animal ethics committee was mentioned in 10 (16.9%) journals; authorship criteria were mentioned in 38 (64.5%) journals. Authorship criteria according to the International Committee of Medical Journal Editors were mentioned in 35 (59.3%) journals.

Development of meloxicam formulations utilizing ternary complexation for solubility enhancement

Meloxicam [an oxicam derivative], a relatively new cyclo-oxygenase inhibitor, is a member of enolic acid group of non-steroidal anti-inflammatory drugs. It is generally used in the treatment of rheumatoid arthritis, osteoarthritis and other joint pains. Meloxicam is practically insoluble in water [8 microg/ml], which directly influences the C[max], T[max], as well as the bioavailability of the drug. In the present study, an attempt has been made to improve the dissolution of Meloxicam by preparation of its solid dispersion using p-cyclodextrin blended with various water soluble polymer carriers i.e., HPMC [methocel IH], methylcellulose [400cps], PVP K30, HPMC [K[4]M], HPMC [50cps]. It is reported that when small amount of water soluble polymer is added to beta-cyclodextrin, its nature of solubilization significantly increases due to increase in the apparent complex stability constant. Phase solubility studies were carried out to evaluate the solubilizing power of beta-cyclodextrin along with various water soluble polymers. The solid dispersion was prepared and formulated into tablets and suspension, which were evaluated on the basis of various official tests. All the studies suggest that formulations of Meloxicam utilizing solid dispersion technique significantly enhances solubility [90 microg/ml] of the drug and results in superior formulations of the drug by using beta-cyclodextrin blended with 0.12% w/w HPMC [Methocel IH]. Ternary complexation is a valuable tool for solubility enhancement of drugs

Statistical reporting in indian pediatrics.

We analyzed 45 original articles from Indian Pediatrics for appropriateness of the statistical methods. Appropriate statistical tests (93%), no use of obscure test and use of exact P value were the positive findings observed. Sample size was calculated in 24% and confidence interval in 13%. There is a need to generate awareness regarding confidence interval and sample size calculations.