Evaluation of efficacy of Carica papaya leaf extracts to increase platelet count in hydroxyurea induced thrombocytopenia in Albino rats

Background: Dengue is an infectious disease associated with high mortality and morbidity. Being a viral disease, there is no specific drug available for treatment. There are some reports that Carica papaya leaf extract may improve the clinical condition of dengue patients. However, to support this, at present, there is no systematically searched and synthesized evidence available. Hence this study was undertaken to compare the efficacy of commercial preparation of Carica papaya leaves with freshly prepared Carica papaya leaf extracted.Methods: 48 albino rats were randomly divided into eight groups of six each. Thrombocytopenia was induced by giving hydroxyurea (15mg/kg) orally. Group I and II served as saline and toxic control group respectively. Other six groups were given two different doses of either commercial extract or fresh extract orally for five days. 1ml of blood was withdrawn at baseline,3rd and 6th day of the study. Platelet, WBC, RBC count, clotting and bleeding time were determined.Results: Mean platelet count increased significantly on day 6 in both low dose (2.06 to 4.93lakh/mm3) and human equivalent dose (2.73 to 7.66lakh/mm3) of commercial extract groups compared to the toxic control group (p<0.05). Similarly, the mean platelet count increased significantly for human equivalent dose in fresh leaf extract group (3.17 to 4.69lakh/mm3) but the increase in low dose fresh extract (3.28 to 3.76lakh/mm3) was not significant. There was no significant rise in mean platelets count, mean RBC count, WBC count, decrease in mean bleeding and clotting time between commercial extract and fresh leaf extract group for both low dose and human equivalent dose.Conclusions: Efficacy of fresh leaf extract of Carica papaya was not inferior to commercial available preparation. Fresh Carica papaya leaf extract no doubt offers a potential therapeutic efficacy which is cost effective, more affordable and accessible treatment in patients with thrombocytopenia.

Study to compare CT and MRI evaluation in cerebral venous thrombosis

Introduction: Cerebral venous thrombosis possible causal factors and clinical manifestations are many and varied; imaging plays a primary role in the diagnosis. Aim: The purpose of study was to compare CT and MRI findings, in evaluation of parenchymal abnormalities, recanalization. Materials and methods: It was prospective study done in 42 patients all patients with clinical suspicion of CVT, intracranial vascular malformation, and/or with intracranial hemorrhage of unclear etiology undergone a standardized MR imaging protocol, including the study protocol sequences. Results: Cerebral venous thrombosis was more common in the females; 24(57.2%) out 42 members. 20(47.6%) members had cerebral venous thrombosis. Staging chart showed majority of cases come to hospital at subacute stage; 33 (78.5%) cases. A total of 32 cases out of 42 underwent both CT and MRI. Cerebral venous thrombosis detected by MRI was 100 % in our study and diagnosed 32 out of 32 cases but CT failed to pick up the lesions in six cases. 11 Sites of thrombosis identified in these patients, Superior sagittal sinus thrombosis was most commonly involved in 78.5% cases (33 out 42). Thrombosis identified with clot on T1WI as hyper intense on 78% cases (33 out 42), Iso intense in 11% (5 out 42) and No signal intensity in 9% (4) cases. On T2 WI, hyper intense in (59%) 25 case out 42 cases, iso intensity in (19%) 8 cases, no signal intensity in 9 cases (21%). On FLAIR, clot appears on hyper signal intensity in 28 % (12 case out 42), iso intensity in 26 % (11 case in 42), no signal intensity in (45%) 19 cases. On DWI clot appears on hyper signal intensity in 26% (11) cases, is intensity in 21% (9) cases, no signal intensity in 52% (22) cases. With follow up 9 cases with complete recanalization, 2 cases with partial recanalization, no change in only one case. Conclusion: MR imaging should be used as routine imaging modality for cerebral venous thrombosis.

Ethics in human resource management: potential for burnout among healthcare workers in ART and community care centres.

This paper examines ethical dilemmas in providing care for people with HIV/AIDS. Healthcare providers in this sector are overworked, particularly in the high prevalence states. They are faced with the dual burden of the physical and the emotional risks of providing this care. The emotional risks result from their inability to control their work environment, while having to deal with the social and cultural dimensions of patients’ experiences. The physical risk is addressed to some extent by post exposure prophylaxis. But the emotional risk is largely left to the individual and there is little by way of institutional responsibility for minimising this. The guidelines for training workers in care and support programmes do not include any detailed institutional mechanisms for reducing workplace stress. This aspect of the programme needs to be examined for its ethical justification. The omission of institutional mechanisms to reduce the emotional risks experienced by healthcare providers in the HIV/AIDS sector could be a function of lack of coordination across different stakeholders in programme development. This can be addressed in further formulations of the programme. Whatever the reasons may be for overlooking these needs, the ethics of this choice need to be carefully reviewed.