Body mass index, obstruction of the airflow, dyspnea, and exercise capacity index as predictor of the severity of exacerbations and systemic involvement in patients with COPD

Background: Allocation of the limited resources to the needed patients and decision making regarding timely interventions demand development of a reliable, cost effective, simple assessment tool. Several studies propose body-mass index, airflow obstruction, dyspnea, and exercise (BODE) index for this purpose in patients with Chronic obstructive pulmonary disease (COPD). The objective of this study was to assess the utility of BODE index to predict the severity of exacerbations and systemic involvement in COPD.Methods: A Present hospital based cross sectional study was carried out among 100 COPD patients. BODE index was used to assess the patients and its association was studied with various variables. The data was analyzed using one-way analysis of variance (ANOVA) test.Results: As the body index class of severity increases, the number of hospitalizations required in the past also increases and this association is statistically significant. As the severity of the disease increased as indicated by the class the mean number of exacerbations in the past increased and this association was found out to be statistically significant. As the severity of the disease increased as indicated by the class level, the mean number of days of hospitalization increased. But this increase was of small difference and hence on one-way ANOVA test was not found out to be statistically significant. As the pack years increases, the BODE index increases significantly (p value <0.001). As the severity of the disease increased, the mean body mass index decreased. Haemoglobin level was found to decrease with increase in BODE index class of severity. This association was statistically significant.Conclusions: The BODE index has been found to be a very good tool to assess the prognosis of COPD as well as severity of acute exacerbations.

Systemic absorption of 0.1% triamcinolone acetonide as topical application in management of oral lichen planus.

Context: Topical corticosteroids are the treatment of choice for oral lichen planus (OLP) due to its potential anti‑inflammatory effect. However, chronic nature of OLP often requires long‑term and frequent applications, exposing patients to local and systemic side effects. Aim: To detect the systemic absorption of 0.1% triamcinolone acetonide (TAC) through the oral mucosa of patients with OLP. Subjects and Methods: This was a pilot pharmacokinetic study carried out in the Department of Oral Medicine and Radiology in collaboration with the Department of Toxicology, over 10 months. A total of twenty patients with OLP were included and advised to apply 0.1% TAC 3 times/day for 2 weeks and 2 times/day for next 2 weeks. Blood samples were obtained on the first and second visits and analyzed for triamcinolone using High pressure liquid chromatography (HPLC). Statistical Analysis Used: Paired t‑test was done to compare visual analog scale (VAS) score for burning sensation at the first and second visits, statistically significant if P < 0.05. The baseline demographic data were analyzed using descriptive statistics. Results: Paired t‑test was done to compare VAS score for burning sensation at the first and second visits, which turned to being statistically significant (P = 0.001). Although HPLC is an established method for the detection of TAC, none of the study populations showed evidence of steroid (TAC) in the blood sample during 4 weeks of treatment duration. Conclusions: 0.1% triamcinolone is a relatively safe drug to be used with no systemic absorption in the standard dose regimen for oral lichen palnus.

Five year survey of toxicological testing of clinical body fluid samples at the poison control centre in the Indian State of Kerala.

The Poison Control Centre (PCC) at Amrita Institute of Medical Sciences, Kerala, was established in June 2003, but became fully operational from January 2005. There are only four PCCs in India recognized by the World Health Organization, of which this is one. A five-year (2005 to 2009) review of biological samples analyzed for chemicals, drugs and toxins by the analytical laboratory attached to the PCC is presented to give an indication of the commonest types of poisoning encountered in this region of India, aside from venomous bites and stings. Such data are not adequately available so far, which is also true for other parts of the country. Results of the survey show that there has been a steady rise in the receipt of samples over the entire period from 432 in 2005 to 601 in 2009. Among the samples analyzed, the commonest toxicants are pesticides, pharmaceuticals, heavy metals and alcohols. Of the pesticides, organophosphates accounted for the maximum number, while most of the remaining comprised zinc phosphide, carbamates, pyrethroids, paraquat, phosphorus, and bromadiolone. Aluminium phosphide, which is a common pesticide in some other regions, was virtually non-existent, while zinc phosphide, a rodenticide, is the second highest in incidence. Of the pharmaceuticals, the largest number comprised sedativehypnotics, while antipyretic drugs, especially paracetamol, accounted for a most of the remaining. Of the metals, the commonest was lead, followed by arsenic, mercury, iron, etc. Requests for copper testing were common, but mostly pertained to Wilson‟s disease, and not toxicity. Among the alcohols, ethanol was the commonest. Even though Kerala is rich in flora, plant toxins were low in incidence, because of the difficulty in testing for such toxins, as compared to chemicals. Bites and stings were not included in this study. Therapeutic monitoring of drugs, which accounts for a large number of samples received by the laboratory was also not part of the survey.

A comparative study on the beneficial effects of garlic (Allium sativum Linn), amla (Emblica Officinalis Gaertn)and onion (Allium cepa Linn) on the hyperlipidemia induced by butter fat and beef fat in rats.

Three months feeding of butter fat (BUF) and beef (BF) separately as components of diet at a level of 21% by weight for albino rats, significantly raised their serum and tissue lipids, lipid peroxidation and activities of certain enzymes. BUF was found to be more atherogenic than BF. On incorporation of 5% garlic, amla or onion separately in the above diets, each of them ameliorated the deleterious effects of the animal fats. A higher hyperlipidemic effect of BUF as compared to that of BF may be due to the fact that the ratio of unsaturated to saturated fats is lower for the former (0.56) than for the latter (0.75) and also that the former is richer in cholesterol content than the latter. The order of the curative effects of the vegetables are garlic>amla>onion. The better hypolipidemic effects and correction of elevated levels of certain enzymes shown by garlic and amla may be due to the facts that they contain comparatively better active principles than that found in onions.