Evaluation of performance of two monoplex quantitative real time PCR assays in comparison to microscopy for identification of Malaria parasites.

Background: Microscopy is the gold standard for Malaria diagnosis with shortcomings such as false positives, false negatives, errors in species identification, and errors in enumeration of parasites. Quantitative real-time PCR (qPCR) has improved submicroscopic malaria diagnosis. This study evaluated the performance, concordance, correlation and methods agreement of two monoplex qPCR assays against expert malaria microscopy for the detection and enumeration of malaria parasites. Methods: This was a cross sectional study utilizing 127 archived blood samples collected from five provinces in Kenya. Malaria microscopy was conducted by two independent microscopists then 18S-rRNA-qPCR and non-18S-rRNA-qPCR assays were done to identify and quantify the infecting species. The sensitivity, specificity, and predictive values. Cohen Kappa value was used to quantify the method agreement and Bland Altman test was used to assess the bias and limits of agreement. Correlation between microscopy and qPCR parasite densities was determined by the Spearman's rank test. Statistical significance was taken at p<0.05. Results: A higher sensitivity and a lower specificity were observed in all the three plasmodium species in non 18S- rRNA-qPCR compared to 18S-rRNA-qPCR. The sensitivity and specificity of 18S-rRNA-qPCR was 91.3% and 75% in detection of P. falciparum, 67.6% and 88.1% in detection of P. malariae, and 55.8% and 91.4% in detection of P. ovale. The sensitivity and specificity of non 18S-rRNA-qPCR was 99.1% and 66.7% in detection of P. falciparum, 77.9% and 88.1% in detection of P. malariae, and 79.4% and 90.3% in detection of P. ovale. All the positive and negative predictive values were above 70% except the negative predictive value for 18S-rRNA-qPCR (47.4%). Kappa of more than 0.5 was observed between microscopy and both18S-rRNA-qPCR and non-18S-rRNA-qPCR in the detection of all three malaria parasites. The non-18S-rRNA-qPCR method had higher kappa > 0.65, in all the three species compared to 18S-rRNA-qPCR method (kappa < 0.55). There was a clear positive correlation between microscopy parasite density and the parasite densities estimated by the 18S-rRNA-qPCR and Non-18S-rRNA-qPCR (P<0.001). Conclusion: The results showed that both monoplex realtime PCR methods demonstrated a high performance compared to microscopy proving to be better methods in the identification and speciation of malaria parasites especially of low parasitemia. The realtime PCR methods also had a positive correlation with parasite density and hence can be used in accurate determination of parasite densities when compared to microscopy. Therefore, this study recommends the utilization of realtime PCR methods in the detection, speciation and quantification of both microscopic and submicroscopic malaria parasites.

Diurnal Variation in Hydration of the Cervical Intervertebral Disc Assessed Using T2 Mapping of Magnetic Resonance Imaging

Objective@#The study aimed to investigate the diurnal variation in cervical disc hydration and its relationship with cervical degeneration. @*Materials and Methods@#C3–C7 discs of 86 prospectively enrolled participants (37 males, 49 females; mean age ± standard deviation, 23.5 ± 2.5 years) were assessed using T2 mapping in the morning and evening. All discs were stratified by Miyazaki grade or C2–C7 Cobb angle and T2 values (T2). The degree of diurnal T2 variation (T2-DDV), defined as (morning T2 – evening T2)/morning T2 x 100%, was measured for the entire disc, annulus fibrosus (AF), nucleus pulposus (NP), and endplate zones. @*Results@#T2 of the entire disc decreased significantly after the daytime load (p < 0.001), with a T2-DDV of 13.3% for all discs and 16.0%, 12.2%, and 13.0% for healthy (grade I), mild degenerative (grade II), and advanced degenerative (grade III/IV) discs, respectively. T2 of regional NPs and AFs decreased significantly from morning to evening (p ≤ 0.049) except in the healthy anterior inner AF (p = 0.092). Compared with healthy discs, mild degenerative discs displayed lower T2 and T2-DDV in regional NPs (p < 0.001). Advanced degenerative discs showed higher T2-DDV in the anterior inner AF compared with healthy discs (p = 0.050). Significant diurnal T2 changes in the endplate zones were observed only in healthy discs (p = 0.013). Cervical discs in the low Cobb angle group showed higher T2-DDV in the anterior AFs and anterior NP and lower T2-DDV in the posterior AF than those in the high Cobb angle group (p ≤ 0.041). @*Conclusion@#This study characterized the diurnal variation in hydration of the cervical discs as assessed using T2 mapping and revealed early chemo-mechanical coupling dysfunction in degenerating discs. Cervical sagittal alignment on MRI can affect the diurnal stress patterns of the cervical discs. T2 mapping is sensitive to disc biomechanical dysfunction and offers translational potential from biomechanical research to clinical application.

Anesthetic management of a parturient with Marfan syndrome scheduled for cesarean section: case report and review of literature / Manejo anestésico de una parturienta con síndrome de Marfan programada para cesárea: informe de un caso y revisión de la literatura

Abstract: Introduction: Marfan syndrome is an inherited disorder that affects connective tissue. Case: We report the anesthetic management of a parturient with Marfan syndrome scheduled for an elective C-section. Successful use of a combined spinal-epidural technique was used to provide neuraxial anesthesia; however, she presented an unfavorable evolution due to maternal sepsis. Likewise, a literature review of combined spinal-epidural anesthesia for C-sections in Marfan syndrome pregnant women was performed. Conclusion: Anesthetic management of parturients affected by Marfan syndrome during the cesarean section can be challenging. Strict blood pressure control during the intraoperative period has cornerstone importance. Likewise, neuraxial techniques have a significant percentage of failure in these patients.

Resumen: Introducción: El síndrome de Marfan es un desorden hereditario que afecta el tejido conectivo. Caso: Reportamos el manejo anestésico de una parturienta con síndrome de Marfan programada para una cesárea electiva. Para administrar anestesia neuroaxial se utilizó un bloqueo combinado espinal-epidural; sin embargo, la paciente presentó una evolución desfavorable debido a sepsis materna. Asimismo, se realizó una revisión de la literatura del uso de esta técnica anestésica para cesárea en gestantes con síndrome de Marfan. Conclusión: El manejo anestésico de parturientas afectadas por este síndrome puede ser complicado. El control estricto de la presión arterial durante el intraoperatorio tiene importancia fundamental. Además, las técnicas neuroaxiales tienen un porcentaje significativo de fallo en estas pacientes.

Development of diabetes register in low-mid income country VII: summary of series

Background: This is a summarizing discussion of the series. Six pieces of articles have been presented including two pilot studies and survey of the perception of healthcare professionals. The other four presented case observations from the different levels of health facilities.Methods: In this summary, a comparison between the four grades of facilities is presented with focus on completeness of patients’ contact details and clinical information regarding basic anthropometric data that can be easily collected anywhere.Results: It shows evidence that capacity and scope of diabetes services are in tandem i.e., least at the primary level and most at the tertiary facility. It also shows albeit anecdotal that the private general practices may be doing best in what they have capacity to do.Conclusions: The capacity for diabetes service in all tiers of the healthcare system. The need to advocate for diabetes register as a means to improve quality of service is highlighted.

A Case Series of Staphylococcus lugdunensis Infection in Cancer Patients at an Academic Cancer Institute in the United States

BACKGROUND@#Staphylococcus lugdunensis is a coagulase-negative staphylococcus (CoNS) that is a part of the normal human skin flora. Even though it belongs to CoNS family, it can cause severe and destructive infections in a similar fashion to Staphylococcus aureus. Skin and soft tissue infections (SSTI), bacteremia and endocarditis are amongst the most common clinical presentations. Diagnosis and clinical presentation of infections caused by S. lugdunensis in cancer patients is limited.@*MATERIALS AND METHODS@#We performed a retrospective chart review of 24 patients who had cultures positive for S. lugdunensis. Out of 24 patients, 14 patients were diagnosed with a true infection and 10 other patients were considered to be colonized with this pathogen. We analyzed clinical manifestation, treatment and response to therapy.@*RESULTS@#SSTI was the most common presentation in our study patients. All patients diagnosed with SSTI had a prior surgery or an invasive procedure at the affected site. Five urinary tract infections (UTIs), one catheter-associated bloodstream infection, and a deep pelvic abscess were other reported infections in our study. We observed that S. lugdunensis remains susceptible to a variety of antibiotics, with all isolates susceptible to vancomycin and linezolid and most remain susceptible to fluoroquinolone and trimethoprim/ sulfamethoxazole. All 14 patients received antibiotics and improved.@*CONCLUSION@#In our case series, SSTI was common and diagnosed in 50% of the patients with clinically significant isolates for S. lugdunensis. This is consistent with prior studies indicating that S. lugdunensis is a significant pathogen in SSTIs. UTI was the second most common infection type in our patient population.

Second-day Sequential Organ Failure Assessment (SOFA) score as predictor in 30–day hospital mortality among Filipino adult patients who presented with Sepsis at the Emergency Department

Introduction@#The Third International Consensus Definitions for Sepsis and Septic Shock in 2016 promoted the new definition and prognostication scheme among patients with sepsis using the Sequential Organ Failure Assessment (SOFA) scoring system. This study determined the discriminative power of the second-day SOFA scoring system in predicting 30-day hospital mortality among adult Filipino patients who presented with sepsis in a tertiary government hospital in the urban setting in the Philippines.@*Methods@#We evaluated 107 adult with sepsis presenting at the emergency department from June 1, 2017 to August 31, 2017 in a 300 bed capacity tertiary hospital. Receiving operating characteristic curves were generated to determine optimal cut off scores of the SOFA scoring system in predicting 30-day mortality. Binary logistic regression was performed to determine the association of the SOFA derivatives with hospital mortality. STATA 15 was used for data analysis. @*Results@#Second-day SOFA scores had excellent predictive ability for 30-day mortality at a cutoff point of 5, with sensitivity and specificity at 84.21% and 84.81%, respectively as compared with other SOFA derivatives at a given point in time.@*Conclusion@#The utility of second-day SOFA Score at a lower cut off score of five, has s a good discriminative power in predicting the all cause mortality among adult septic patients. This lower cut off score indicated a lower threshold trigger in identifying patients needing more intensive monitoring given the association of higher mortality risk in comparison with other studies done abroad.

A case report on a 29-year-old male with difficult to treat bronchial asthma in exacerbation: Rediscovering asthma COPD overlap syndrome (ACOS)

BACKGROUND: Asthma chornic obstructive pulmonary disorder(COPD) overlap syndrome (ACOS) was formally described by the joint project of global initiative for asthma (GINA) and global Initiative for chronic obstructive lung disease (GOLD) as persistent airflow limitation with several features usually associated with both asthma and COPD. ACOS is identified by the features shared with both asthma and COPD.The underlying cause though remains unknown,hence the project did not offer current formal definition.CASE: This is a case of a 29-year-old male, asthmatic with an eight-pack year smoking history who presented with chronic obstructive respiratory symptoms with non significant improvement on control of exacerbation despite standard maximal  therapy.Diagnostic tests such as pulmonary function Tests,2D Echo,chest CT scan and even assay for alpha 1 anti trypsin were done to rule out for other disease entities and prognosticate the patient's condition leading to the diagnosis of asthma COPD overlap syndrome (ACOS). CONCLUSION: ACOS as a disease entity is still under debate and still has no current formal definition due to lack of specific biomarkers and lack of defining characteristics.Despite this,management should not be compromised since these patients often present with higher rates of exacerbations,hospitalization,associated co morbid illness and mortality.Treatment therefore is individualized.

A case report on a 29-year-old male with difficult to treat bronchial asthma in exacerbation: Rediscovering asthma COPD overlap syndrome (ACOS)

@#<p style="text-align: justify;"><strong>BACKGROUND:</strong> Asthma chornic obstructive pulmonary disorder(COPD) overlap syndrome (ACOS) was formally described by the joint project of global initiative for asthma (GINA) and global Initiative for chronic obstructive lung disease (GOLD) as persistent airflow limitation with several features usually associated with both asthma and COPD. ACOS is identified by the features shared with both asthma and COPD.The underlying cause though remains unknown,hence the project did not offer current formal definition.<br /><strong>CASE:</strong> This is a case of a 29-year-old male, asthmatic with an eight-pack year smoking history who presented with chronic obstructive respiratory symptoms with non significant improvement on control of exacerbation despite standard maximal  therapy.Diagnostic tests such as pulmonary function Tests,2D Echo,chest CT scan and even assay for alpha 1 anti trypsin were done to rule out for other disease entities and prognosticate the patient's condition leading to the diagnosis of asthma COPD overlap syndrome (ACOS). <br /><strong>CONCLUSION:</strong> ACOS as a disease entity is still under debate and still has no current formal definition due to lack of specific biomarkers and lack of defining characteristics.Despite this,management should not be compromised since these patients often present with higher rates of exacerbations,hospitalization,associated co morbid illness and mortality.Treatment therefore is individualized.</p>

A case report on a 29-year-old male with difficult to treat bronchial asthma in exacerbation: Rediscovering asthma COPD overlap syndrome (ACOS)

BACKGROUND: Asthma chornic obstructive pulmonary disorder(COPD) overlap syndrome (ACOS) was formally described by the joint project of global initiative for asthma (GINA) and global Initiative for chronic obstructive lung disease (GOLD) as persistent airflow limitation with several features usually associated with both asthma and COPD. ACOS is identified by the features shared with both asthma and COPD.The underlying cause though remains unknown,hence the project did not offer current formal definition.CASE: This is a case of a 29-year-old male, asthmatic with an eight-pack year smoking history who presented with chronic obstructive respiratory symptoms with non significant improvement on control of exacerbation despite standard maximal  therapy.Diagnostic tests such as pulmonary function Tests,2D Echo,chest CT scan and even assay for alpha 1 anti trypsin were done to rule out for other disease entities and prognosticate the patient's condition leading to the diagnosis of asthma COPD overlap syndrome (ACOS). CONCLUSION: ACOS as a disease entity is still under debate and still has no current formal definition due to lack of specific biomarkers and lack of defining characteristics.Despite this,management should not be compromised since these patients often present with higher rates of exacerbations,hospitalization,associated co morbid illness and mortality.Treatment therefore is individualized.

Unroofed Coronary Sinus: Multimodality Imaging of Geriatric Congenital Heart Disease

No abstract available.

Effect of moderate - vigorous intensity physical exercise on female sex hormones in premenopausal university students in Nnewi, Nigeri.

Background: Sedentary lifestyle and diseases associated with it is on the increase in our communities, state and country as a whole. The objective was to determine the effect of exercise on ovarian reserve status of the participants using day 3 FSH, LH and estrogen values and the ovulatory status of the participants using day 21 progesterone values. Methods: The study was a prospective comparative study. A total of 30 participants were recruited for this work. They were divided into 2 groups: 15 subjects that did exercise for 1 month and 15 controls that didn’t do any form of exercise. Baseline blood samples were collected from the two groups on day 3 and day 21 of the menstrual cycle. The subjects started exercise on day 1 of the next menstrual cycle. Blood samples were collected from the subjects and control on day 3 and day 21 of the next menstrual cycle. Results: There was significant reduction in weight and therefore BMI of the study group compared to control group and study group baseline after one month of exercise (P<0.05). There were no significant differences in the baseline levels of Estrogen, FSH, LH and progesterone between the subjects and control groups before the exercise, but after 1 month of exercise, there were significant differences in the levels of estrogen, FSH, LH and progesterone in these groups (P<0.01). Among the study group there were significant differences in the baseline and final levels of Estrogen, FSH, LH and Progesterone (P<0.01). Conclusions: The hormonal pattern shows that moderate-vigorous exercise may increase the responsiveness and sensitivity of the follicles to FSH and LH with attendant increase in ovulatory status of young females.

Comparison of serum levels of calcium and magnesium among preeclamptic and normotensive pregnant women at Nnamdi Azikiwe University Teaching Hospital, Nnewi, Nigeria.

Background: Despite numerous studies, the exact aetiology of pre-eclampsia remains unknown. Some studies have shown that supplementation of calcium and magnesium could ameliorate the effects of pre-eclampsia. The objective of this study was to compare the calcium and magnesium levels in the serum of Nigerian women with or without pre-eclampsia. Methods: In this study, serum calcium and magnesium levels were determined using atomic absorption spectrometry in 54 patients and 48 healthy normotensive pregnant women. The mean, standard deviation, Student’s‘t’ test and Pearson correlation were employed. Results: Serum calcium was significantly lower in patients than controls (9.17 ± 0.6 vs. 7.22 ± 0.5 mg/dl. P <0.001) (t test). Plasma Magnesium was significantly lower in patients than controls 13.19 ± 1.1 vs. 9.81 ± 0.7 mg/dl. P <0.001). The systolic and diastolic blood pressure showed significant inverse correlation with both calcium and magnesium (P<0.01). Conclusion: There was significant reduction in the levels of calcium and magnesium in patients with pre-eclampsia. Dietary supplementation of these trace elements may help to prevent pre-eclampsia.

Anthelmintic activity of Cassia occidentalis L. methanolic leaf extract on Ascaridia galli and Heterakis gallinarum and its acute toxicity.

Background: Cassia occidentalis is traditionally used to treat helminth infestations in poultry. We investigated the in-vitro anthelmintic activity of the methanolic leaf extract of this plant against Heterakis gallinarum and Ascaridia galli worms and its acute toxicity. Methods: Leaves of the plant were air dried, ground into powder and extracted with 70% methanol, filtered and dried at 50℃ into a dark green semi-solid mass. The worms were isolated from fresh intestines of local chicken and pheasants or turkeys freshly slaughtered in Kampala markets. They were placed in conical flasks containing Goodwin’s solution, kept in a water bath set at 39°C and exposed to 8, 12, 16, 20 and 24mg/ml extract concentrations. Percent worm mortality was determined for each concentration at 12h intervals. piperazine and ivermectin were used as positive controls. For acute toxicity evaluation, Swiss mice were divided into 5 groups (n=6) and administered per os with extract doses of 5,000, 10,000, 15,000, 20,000 and 25,000mg/Kg. The EC50 was determined by a plot of mortality probits against log extract concentration. Results There was a concentration-dependent relationship with worm mortality. The mean worm mortality for A. galli was significantly higher for the extract than for piperazine at 16 and 20mg/ml (p<0.05) and 24 mg/ml concentrations (p<0.01). Activity against H. gallinarum was not significantly different from that of ivermectin. The EC50 of the extract was 11.78mg/ml for A. galli and 17.78mg/ml for H. gallinarum. The extract is safe according to OECD acute toxicity guidelines since no mortality and toxicity signs were observed in mice even at 25,000mg/kg. Conclusions: The study demonstrated the anthelmintic activity of C. occidentalis and this could explain its use in traditional medicine as a remedy against helminth infections over the generations in many parts of Uganda.

PD173074, a selective FGFR inhibitor, reverses MRP7 (ABCC10)-mediated MDR

Multidrug resistance protein 7 (MRP7, ABCC10) is a recently identified member of the ATP-binding cassette (ABC) transporter family, which adequately confers resistance to a diverse group of antineoplastic agents, including taxanes, vinca alkaloids and nucleoside analogs among others. Clinical studies indicate an increased MRP7 expression in non-small cell lung carcinomas (NSCLC) compared to a normal healthy lung tissue. Recent studies revealed increased paclitaxel sensitivity in the Mrp7(-/-) mouse model compared to their wild-type counterparts. This demonstrates that MRP7 is a key contributor in developing drug resistance. Recently our group reported that PD173074, a specific fibroblast growth factor receptor (FGFR) inhibitor, could significantly reverse P-glycoprotein-mediated MDR. However, whether PD173074 can interact with and inhibit other MRP members is unknown. In the present study, we investigated the ability of PD173074 to reverse MRP7-mediated MDR. We found that PD173074, at non-toxic concentration, could significantly increase the cellular sensitivity to MRP7 substrates. Mechanistic studies indicated that PD173074 (1 μmol/L) significantly increased the intracellular accumulation and in-turn decreased the efflux of paclitaxel by inhibiting the transport activity without altering expression levels of the MRP7 protein, thereby representing a promising therapeutic agent in the clinical treatment of chemoresistant cancer patients.

Preliminary pharmacological investigation of the ischuretic property and safety of a hydro-ethanolic extract of Amaranthus spinosis (Fam: Amaranthaceae).

Background: Ischuria is a health and social problem, having a negative impact on sufferers. This study therefore was a preliminary investigation of the ischuretic property and safety for use of a hydro-ethanolic extract of Amaranthus spinosus used traditionally in managing ischuria. Methods: Phytochemical screening, thin layer chromatography and high performance liquid chromatography were performed on the extract to establish fingerprints for identification. Acetylcholine, Nicotine, and the extract were applied to an isolated rat urinary bladder to ascertain contractile response. The possible receptor site(s) of action was also investigated using isolated rabbit jejunum, and guinea-pig ileum preparations. In-house observation, hematological analysis, and liver and kidney function tests were performed on Sprague-Dawley rats, in acute and sub-acute toxicity studies. Results: The extract had contractile effects on the rat urinary bladder (similar to acetylcholine and nicotine) and rabbit jejunum. Its contractile effect of the guinea-pig ileum was significantly inhibited by hexamethonium (77.50 ± 8.50 %; P ≤ 0.001) and to a lesser extent by mepyramine (49.2 ± 6.80 %; P ≤ 0.001) and Atropine (22.45 ± 5.22 %; P ≤ 0.01). The extract (80-800 mg kg-1) was not lethal and a 160 and 240 mg kg-1 dose had no adverse effect on blood, liver, kidney metabolic function. Conclusions: The hydro-ethanolic extract of Amaranthus spinosus has ischuretic activity possibly mediated via nicotinic, histaminic and muscarinic receptor stimulation and is safety to use in ischuria.

Rol de la evidencia científica en las decisiones políticas relacionadas con los sistemas de salud / The role of research-based evidence in health system policy decision-making

RESUMEN Existen diferentes modelos para explicar cómo la evidencia de la investigación se utiliza en los procesos de formulación de políticas sobre los sistemas de salud. En este artículo argumentamos que los modelos que se desarrollaron desde el contexto clínico, como el de políticas basadas en la evidencia, pueden ser útiles en algunas decisiones políticas. Sin embargo, debido a su "silencio" sobre el contexto político, estos modelos son incompatibles con las decisiones relacionadas con la modificación de los arreglos de los sistemas de salud. Otros modelos, generados desde las ciencias políticas, son más útiles para entender que la investigación es uno solo de los factores que afecta la toma de decisiones y que diferentes tipos de evidencia científica pueden ser utilizados de manera instrumental, conceptual o estratégica en diferentes etapas del proceso de formulación de políticas.

ABSTRACT Different models may be used for explaining how research-based evidence is used in healthcare system policy-making. It is argued that models arising from a clinical setting (i.e. evidence-based policy-making model) could be useful regarding some types of healthcare system decision-making. However, such models are "silent" concerning the influence of political contextual factors on healthcare policy-making and are thus inconsistent with decision-making regarding the modification of healthcare system arrangements. Other political science-based models would seem to be more useful for understanding that research is just one factor affecting decision-making and that different types of research-based evidence can be used instrumentally, conceptual or strategically during different policy-making stages.

Family biosocial variables influencing the use of insecticide treated nets for children in Eastern Nigeria

Effective reduction of malaria morbidity and mortality in Nigerian children under the age of five depends to a large extent on family biosocial factors. Although, the awareness of insecticide treated bed nets [ITNs] is reportedly high and increasing in Nigeria there remain large gaps between awareness, possession and use by families with children under the age of five in Nigeria. To determine the family biosocial variables that influence the use of insecticide treated nets for children in Eastern Nigeria. A descriptive hospital-based study was carried out from June 2008-June 2011 on a cross-section of 415 mothers with children under the age of five, who were treated for confirmed malaria, and met the selection criteria were interviewed using a pretested, structured researcher-administered questionnaire. The questionnaire tool elicited information on family socio-demographic variables, inter-spousal discussion, communication, concurrence and participation in the use of insecticide treated bed nets; and reasons for non-utilization. The period of usage in the previous 6 months was assessed and graded using a scoring system of 0-4. Scores of 1-4 indicated usage while score of 0 meant non use. The rate of ITNs use was 53.0%. The family variables that significantly influenced utilization were secondary education and above of parents [mother: P = 0.009; father: P = 0.001], monogamy [P value = 0.024], family size of 1-4 [P value = 0.016] and parents living together [P = 0.001]; others included parents' occupation [mother: P = 0.003; father: P = 0.04] and inter-spousal discussion [P value = 0.001], communication [P value = 0.001], concurrence [P = 0.000] and participation [P = 0.000]. The commonest reason for non-use was inconvenience during sleep [P = 0.04]. This study shows that the rate of ITN use was marginally good. Specifically, this rate was significantly influenced by some family variables. The families of children under the age of five should, therefore, be the focus of intensive health promotion campaign to influence the use of ITNs to produce ITN family friendly communities

Anti-inflammatory activity of Talinum fruticosum L. on formalin induced paw edema in albino rats.

Inflammation is a reaction of a living vascularised tissue to an injury. Conventional or synthetic drugs used in the treatment of inflammatory diseases are inadequate, it sometimes have serious side effects. So, number of herbal medicines is recommended for the treatment of inflammation that has no side effects. The present study is aimed to evaluate the anti inflammatory activity of Talinum fruticosum L on formalin induced paw edema in rats as for controlling inflammatory disorders. The objectives of the present study are to carry out phytochemical screening of selected plant drug , to prepare an aqueous extract from Talinum fruticosum L and to screen the in vivo anti inflammatory effect of Talinum fruticosum L. For phytochemical screening, the secondary metabolites like alkaloid, flavonoid, tannin, saponin, quinine were tested using qualitative spot tests. For anti inflammatory activity, wistar albino rats were used and divided into 6 groups and treated accordingly:Normal control, formalin induced group (0.1ml/kg bw), formalin+ Talinum fruticosum L (100mg/kg bw), formalin+ Talinum fruticosum L (200mg/kg bw), formalin+ Talinum fruticosum L (300mg/kg bw), and plant treated (300mg/kg bw).After the experimental period of 15 days, the blood and tissue samples were collected and biochemical parameter and histpathological studies were carried out.The phytochemical screening suggests the standardization, identity, purity and of presence of phytochemicals like saponins, tannins, flavonoids, terpenoids and cardiac glycosides. Oral administration of formalin to the experimental animals produced reduction in the levels of SOD,GSH,GPX ,GR, serum protein and total RBC and Hb. The animals pretreated with Talinum fruticosum L extract at dose levels of 100,200,300mg/kg bw were significantly increased the levels of the above parameters. A significant increase in the length of the paw thickness, in the level of serum enzymes (SGOT, SGPT, ALP, CK) and Lipid peroxide (LPO), in the level of hydroxy proline, hexosamine and leucocytes was noted in the rats induced with formalin, while these levels were normalized by pretreatment with Talinum fruticosum L extract. The histopathological studies of edematous sections of formalin induced rat paw showed loss of cartilage, osteoblast hyperplasia. Talinum fruticosum L treated formalin induced rats showed moderate reduction in the cartilage and osteoblast. From the present observation, it is evidenced that Talinum fruticosum L would be an effective drug for the treatment of inflammatory reactions.

HIV testing in developing countries: What is required.

HIV diagnostic and follow up testing are usually done in laboratory settings. However, in developing countries there is a need to decentralize testing as the majority of the population lives in rural settings. In developing countries stringent quality assurance (QA) practices, which include appropriate training, development of standard operating procedures, maintenance of operator proficiency, routine use of quality control (QC) specimens, standardized data management, equipment calibration and maintenance, and biohazard safety with proper disinfection/disposal procedures are not routinely followed to ensure reliability of results and a safe work environment. The introduction of point-of-care testing technologies involving the use of non-laboratorians in routine testing has further increased the complexity of QA. Therefore, a careful approach towards improvement of laboratories that encourages best practices, coupled with incentives, and review of government policies in point-of-care testing is needed to improve quality of testing as decentralization takes place. Development of a functional laboratory tiered network that facilitates communication, referral, training and problem solving could further enhance confidence in laboratory testing. There is also a need for special considerations in implementing a stepwise approach towards quality improvement, strengthening of the supply chain management, human capacity development, infrastructure upgrade, and strong public private partnerships to ensure long term sustainability of these efforts.