Study of efficacy of epidural methylprednisolone acetate and triamcinolone acetate for treatment of low back pain and radiculopathy

Background: Epidural steroids have been proven to be one of the most effective non-operative managements of back pain. The present study entailed evaluation of the efficacy of epidural methylprednisolone acetate and triamcinolone acetate for treatment of low back pain and radiculopathy.Methods: The two groups of 25 participants, formed on the basis of the injectable epidural steroid used {80mg of methylprednisolone acetate (group 1) or 40mg of triamcinolone acetate (group 2)}, were enrolled after following due selection criteria. After detailed history taking, examination and requisite investigations, 15 ml volume of the drug was injected epidurally with the patient lying in lateral position. The patients were followed-up at 3 weeks, 6 weeks and 3 months and pain assessment and percentage of pain relief was noted in comparison with the level of pain before epidural injection. Sleep quality, activity score, days in bed, analgesic requirement, complications and requirement of surgical intervention were all assessed at each follow-up.Results: The mean pain score was significantly less in group 1 after 6 weeks and 3 months period, with 60% in group 1 having “good” pain relief, while 69.56% amongst group 2 participants reported “fair” pain relief. Eighty four percent group 1 participants required 2 injections, while 64% participants in group 2 required 3 injections. There was overall improvement in the activity score, quality of sleep and decrease in bed rest and analgesic requirement.Conclusions: Epidural steroid therapy is highly efficacious and methylprednisolone acetate is more effective than triamcinolone acetate; with negligible complications.

Oral versus intramuscular midazolam for paediatric preanaesthetic medication

Background: The need for effective preanesthetic medication in children is obvious and midazolam has proven to be one reliable choice. The aim of the present study was to compare the efficacy, acceptability and reliability of the oral and intramuscular routes of administration of midazolam towards paediatric preanesthetic medication at various doses.Methods: Hundred eligible patients in the age group of 1 to 10 years undergoing ambulatory or routine planned, minor or major surgery during study period were allocated to one of the four groups of 25 participants each, formed on the basis of premedication they received. Haemodynamic parameters, level of sedation and anxiety and induction score were noted before premedication and after each 15 minutes interval for next 45 minutes in all the four groups. Postoperative assessment included sleep level, anterograde amnesia, picture recall and occurrence of complications.Results: The sedative and anxiolytic effects were observed to be maximum at 45 minutes after premedication in all the four groups and better sedation, anxiolysis and quality of induction were achieved with higher doses for both oral as well as intramuscular routes. Postoperatively, the sleep level did not increase with higher dose and 64% patients were awake with 0.75 mg/kg oral midazolam. The sleep level was more with higher dose with the Intramuscular route, with 60% patients feeling drowsy with 0.1mg/kg dose. 0.75 mg/kg dose showed better anterograde amnesia (64%) than 0.5 mg/kg (28%), while it was present in 64% participants premedicated with 0.8 mg/kg intramuscular does and 72% in 0.1 mg/kg intramuscular dose.Conclusions: Intramuscular midazolam at 0.1 mg/kg dose seems to be the ideal dose and route for paediatric preanesthetic medication, with oral midazolam at 0.75 mg/kg to be considered an effective and acceptable alternative.

Development of species-specific primers for detection of Xanthomonas campestris pv. campestris causing black rot of crucifers

Aim: Black rot of crucifers caused by Xanthomonas campestris pv. campestris (Pammel) Dowson (Xcc) is a major seed-borne disease. The present study aimed to develop a rapid diagnostic protocol for the specific and sensitive detection of this pathogen. Methodology: A specific primer set was designed based on rpf gene and optimization of PCR condition was done for specific detection of Xcc. Sensitivity of PCR for primer set was then determined by diluting the Xcc DNA and cells. Results: Specific primer set was able to amplify a specific band of 304 bp in all 11 isolates of Xcc but failed to amplify other Xanthomonas species and one each of Ralstonia solanacearum, Erwinia caratovora subsp. caratovora, Bacillus subtilis, Pseudomonas fluorescens and P. aeruginosa. The primer set was highly sensitive as it was able to detect 10 pg μl-1 bacterial DNA and up to 3x103 CFU ml-1 corresponding to 12 viable cells of Xcc which were used as template for PCR reaction Interpretation: The results suggest that developed PCR primers are highly specific and sensitive and it can be used to detect the pathogen at an early stage of infection for disease management.

A multicentre pharmacoepidemiological study of dermatological disorders in Wardha district.

Background: Skin diseases are common among the general population and account for a high percentage of all diseases. For considering the increase in the prevalence of specific skin diseases, prevalence data are needed. Appropriate treatment of common diseases and provision of essential drugs are two essential components of the primary health care. The aim in dermatological therapy is to use the safest and least number of drugs in order to obtain the best possible effect in the shortest period at reasonable cost. For that important step is taken to monitor, evaluate and therapeutically analyze the prescribing pattern of dermatological drugs. Methods: 12210 cases were screened for dermatological disorders in the Primary Health Care Centers and Rural Hospital of Wardha district during the time frame 1st January 2006 to 30th September 2010, out of which 1000 patients experienced different variety of dermatological disorders were analyzed. In prescription analysis 800 prescriptions with 1946 drugs were analyzed. Results: The prevalence of dermatological disorders in our study was found 8.19%. Out of 1000 patients, there were 567 females (56.7%) and 433 male (43.3%).1000 cases were divided into five age groups viz. 1-20 yrs, 21-40 yrs, 41-60 yrs, 61-80 yrs and more than 80 yrs. Percentage distribution for the various age ranges were 21%, 48%, 20%, 8% and 3% respectively. In spectrum of dermatological disorders, Acne vulgaris (14.8%) was the most common disorder followed by Tinea infection (13.6%) , Eczema (13.2%), scabies (12.4%) and pyoderma (11.6%), Acute urticaria (6.6%), Melasma (5.8%), Psoriasis (3.8%), Polymorphous light eruption (3.6%), Phytophotodermatitis (2.6%), Leprosy (2%) and other disorders (10%). The total number of drugs prescribed in 800 prescriptions was 1946 i.e. on average 2.43 drugs were prescribed per patient. Out of 1946 drugs, 1054 were topical and 892 were oral preparations. Antifungal was most common topically prescribed drug. Conclusions: The prevalence of dermatological disorders is 8.19 %. Younger age group (21-40 yrs) and Females is most affected by dermatological disorders. The commonest dermatological disorder is Acne and in prescription analysis, antifungals are most commonly prescribed.

Biological activities of Sarcanthus pauciflorus.

Sarcanthus pauciflorus is a pendulous epiphytic orchid belonging to the family Orchidaceae. The present study was conducted to determine antimicrobial, antioxidant, anthelmintic and insecticidal efficacy of methanol extract of S. pauciflorus. Antimicrobial activity of methanol extract was determined against four bacteria and two fungi by Agar well diffusion method. Antioxidant activity was performed by DPPH free radical scavenging and Ferric reducing assay. Anthelmintic activity was studied on the basis of time taken for paralysis and death of adult Indian earthworms by the extract. Insecticidal activity, in terms of larvicidal effect, was evaluated using II instar larvae of Aedes aegypti. Total phenolic content of extract was estimated by Folin-Ciocalteau reagent assay. Phytoconstituents viz., tannins, saponins and glycosides were detected in methanol extract. Content of total phenolics was found to be 258.65 mg GAE/g of extract. All test bacteria and fungi were susceptible to extract of orchid. Bacillus subtilis and Cryptococcus neoformans were susceptible to high extent among bacteria and fungi respectively. Gram positive bacteria have shown greater susceptibility than Gram negative bacteria to extract. The extract exhibited marked dose dependent scavenging of DPPH free radicals. An increase in absorbance at 700nm revealed reducing power of the extract. The extract caused paralysis and death of adult Indian earthworms in a dose dependent manner. The lethal effect of extract on II instar larvae of Aedes aegypti was found to be dose dependent. The results of the present study shows that the methanol extract of S. pauciflorus is found to possess antimicrobial, antioxidant, anthelmintic and insecticidal activities which might be attributed to the presence of secondary metabolites. Further experimentations concerned with isolation of the bioactive components present in the orchid and determination of their biological activities are under progress.

Need of medicines information OPD in tertiary health care settings: A cross sectional study .

Background: Population burden, illiteracy, availability of few doctors for larger group of population all these leads to many unanswered questions left in a patient’s mind. Incomplete information results into noncompliance, therapeutic failure, and adverse drug reactions (ADR). It is very important to establish a system which will provide noncommercial, independent, unbiased source of medicine information. Medicines Info OPD is a concept and step towards safe and appropriate use of medicines. Objective: (1) To assess the present status of knowledge about the medicines in the patients and its correlation with education. (2) To assess the medicine information dispensing modalities, their use and sufficiency from the patients view point. (3) To assess the overall need for Medicines Information OPD in present scenario. Materials and Methods: A pre-validated questionnaire based study was conducted amongst 500 patients of tertiary health care hospital. The questionnaire consisted of specific questions regarding understanding of prescription, knowledge about adverse drug reaction, view about self-medication and opinion regarding the need of Medicines Info OPD. Results: Significantly large proportion of patients opined that doctors do not have sufficient time in current Indian healthcare to explain the prescription and they are not aware of adverse drug reactions, expiry date or use the package inserts etc. Conclusion: Clinically relevant, up to date, user specific, independent, objective and unbiased Medicines Info OPD is essential for appropriate drug use and can help in a big way to common public to address many problems faced by them.

Mural unicystic ameloblastoma crossing the midline: a rare case report / Ameloblastoma uniquístico mural traspasando la línea mediana: reporte de un caso infrecuente

Ameloblastoma is a benign odontogenic neoplasm which frequently affects the mandible. The term ameloblastoma includes several clinico-radiological and histological types. Apart from the most commonly encountered clinico- pathologic models there are few variants, whose biological profile is unknown or not elicited. The reason for lack of understanding is the scarcity of case report published in the literature. Among the types, unicystic ameloblastoma is the least encountered either it presents as unilocular or multilocular radiolucency, but peculiar radiographic presentation of multilocular radiolucency in posterior mandible with unilocular radiographic appearance crossing the midline is extremely rare, which has not been reported yet. Here we report a distinctive case of mural unicystic ameloblastoma of mandible in a 17-year- old- girl with the radiographic presentation as mentioned above.

El ameloblastoma es un tumor odontogénico benigno que frecuentemente afecta a la mandíbula. El término ameloblastoma incluye varias características clínico-radiológicas y tipos histológicos. Aparte de los modelos clínicopatológicos que se encuentran con frecuencia existen algunas variantes, cuyo perfil biológico es desconocido o aún no elucidado. La razón de la falta de comprensión es la escasez de informes de casos publicados en la literatura. Entre los tipos, el ameloblastoma uniquístico es el menos frecuente y puede presentarse como una radiolucidez unilocular o multilocular, pero la peculiar presentación radiográfica de radiolucidez multilocular en el posterior de la mandíbula con aspecto radiográfico unilocular que cruza la línea mediana es extremadamente rara, y aún no se ha reportado. Se presenta un caso de ameloblastoma uniquístico mural de la mandíbula en una paciente de 17 años con la presentación radiográfica anteriormente descrita.

Effect of dietary methionine and inorganic sulfate with and without calcium supplementation, on urinary calcium excretion of guinea pigs (Cavia porcellus).

Supplementation of sodium sulfate and DL-methionine along with the standard diet to guinea pigs nearly doubled the urinary calcium in 6 weeks. This was probably due to decreased tubular reabsorption of calcium which was complexed with sulfate in the tubular lumen. A mild calcium load didn't further enhance calcium excretion in sodium sulfate supplemented group, but did so in methionine supplemented group. It may be due to methionine which might have increased the intestinal absorption of calcium. Both of these compounds increased citric acid excretion and decreased magnesium excretion.

Age related toxic effects of endosulfan on certain enzymes of rat erythrocytes.

The effect of oral administration of endosulfan (12.5 mg/kg body weight), daily for 4 days was investigated on erythrocytes of female rats of 4 different age groups i.e. 15, 30, 70 and 365 days old. Erythrocyte membrane Na+, K(+)-ATPase and Mg2(+)-ATPase activities were significantly inhibited in all the age groups of rats. However, percent inhibition was maximum in the youngest animals. A significant decrease in the activity of erythrocyte glutathione reductase was observed in 30 and 70 days old rats whereas a significant increase in the activity of glucose-6-phosphate dehydrogenase (G-6-PD) was observed in these groups. The increase in G-6-PD activity may be a physiological response to compensate for decrease in the reduced glutathione level which results from decrease in the activity of glutathione reductase.