Assessment of phytochemical and pharmacological activities of Leucas zeylanica [L.] R.Br. [Family: Lamiaceae]

The aim of the present study is to investigate the antioxidant, neuropharmacological, analgesic and antimicrobial activities of the EtOH extract of the whole plant of Leucas zeylanica. Phytochemical screening indicated the presence of gums, carbohydrate, reducing sugar, phenols, tannins [gallic acid], cardiac glycosides and saponins. TLC-based antioxidant assay by DPPH free radical revealed positive activity of the extract and in quantitative assay IC[50] value was 62.9 microg/ml. The extract potentiated the phenobarbitone-induced sleeping time in mice in a dose dependent manner. From the study of analgesic activity using the model of acetic acid-induced writhing in mice it was found that the extract exhibited [***p<0.001] writhing inhibition was dose dependent. The extract showed moderate antimicrobial activity

Pulmonary infiltrates during chemotherapy-induced febrile neutropenia: incidence, patterns and outcome

To analyze the incidence, etiologies, radiographic patterns, and clinical outcomes of adult leukemics with prolonged febrile neutropenia and pneumonia. A retrospective study was conducted at a tertiary care hospital. The medical records of adult patients with acute myeloid leukemia diagnosed between January 1989 and June 2000 and undergoing induction chemotherapy were included. Only the patients who presented with a pulmonary infiltrate, secondary leukemia [e.g., transformed chronic myeloid leukemia underlying myelodysplastic syndrome, or disease following alkylating agent therapy] were included and those developing infiltrates following consolidation chemotherapy were excluded. A total of 124 patients were admitted to the hospital with a diagnosis of AML during the study period. Thirty-one patients were excluded; 93 patients received induction chemotherapy and were included in the study analysis. The median age was 36 years [15 - 70 years]; 58 males and 35 females. Sixty two% patients received Cytosine Arabinoside [Ara-C], 17% received Etoposide, 11% received Ara-C and Mitoxantrone, and 6% received All-trans-retinoic Acid. The mean onset and duration of neutropenia were 5 and 15 days, respectively. Pulmonary infiltrates were identified during 45% of neutropenic episodes. A presumptive causative organism was isolated from 50% of patients with an infiltrate: Gram- positive bacteria were most common [47%] followed by Gram-negative bacilli [33%] and fungi [20%]. Survival data were available for 88 patients; median disease free survival for the entire cohort was 7 months. Male sex [p=0.015], onset of neutropenia [p=0.02] and bilateral distribution of an infiltrate [p=0.03] were statistically significant predictors of early mortality. For patients with and without pneumonia, the median disease-free interval and overall survival were 2.5 and 4.6 months and 9 and 13 months [p=0.038 and p=0.095] respectively. Neutropenia occurred at a mean of 5.0 after initiation of induction chemotherapy. The majority of patients had bilateral pulmonary infiltrates. Male sex, onset of neutropenia and bilateral distribution of an infiltrate were found to be statistically significant predictors of early mortality

use of indomethacin and other methods of management of premature infants with delayed closure of the ductus arteriosus

Patent ductus arteriosus [PDA] is observed much more commonly in premature than in mature infants. In premature infants of weight less than 1500g with respiratory distress syndrome [RDS], the PDA may be silent and yet be the cause of cardiac failure and aggravate the respiratory difficulties. The high incidence of PDA in premature infants is thought to be due to its own immaturity. In the mid 1970s it was suggested that indomethacin, a potent prostaglandin synthetase inhibitor, might have clinical applications in the non-surgical treatment of PDA in sick premature infants with RDS. Several reports have confirmed this drug's effectiveness in successful closure of 80% of PDAs in infants to whom it was administered; fluid restriction and diuretics also play a major role. The risks of indomethacin treatment include gastrointestinal bleeding, nephrotoxicity, liver toxicity, bone marrow depression, intracranial bleeding, necrotizing enterocolitis and retinopathy of prematurity. Fortunately these problems are rare but the drug should be used with caution, especially in infants of under 1000 g birth weight

Use of prostaglandin in newborns with serious congenital heart disease

In a number of cardiac lesions the pulmonary or systemic circulation depends partially or totally on the patency of the ductus arteriosus. Ductal closure after birth could prove fatal in these cases of congenital cardiac lesions. In the early 1970s, research showed the efficacy of E type prostaglandins [PGE] in relaxing the ductus muscle. Clinical trials showed that PGE[1] or PGE[2] were consistently effective in increasing the oxygenation of newborns whose pulmonary blood flow was dependent on patency of the ductus arteriosus. In ductus-dependent systemic-flow lesions, PGE[1] also has shown its effectiveness. It improves acidaemia, oxygenation and provides an improved metabolic state for cardiac catheterization or surgery. Before transferring an infant with these lesions from a peripheral hospital, PGE[1] infusion can be started intravenously, in consultation with the paediatric cardiologist. The most frequent side-effect of PGE[1] or PGE[2] infusion is fever, and the most serious side-effect is apnoea. In general, side-effects diminish with decrease in infusion rate

Immediate management of the newborn in congestive heart failure with serious heart disease

Severe heart disease in the newborn may manifest as cyanosis, respiratory distress congestive heart failure or shock. This can lead to an acute emergency in the newborn infant Optimal, management means early recognition, first line treatment and then prompt referral to a medical centre with paediatric facilities in cardiology and cardiac surgery. Care should be taken to keep the infant warm, in oxygen and under observation. Intravenous fluids should be started serum glucose and calcium should be checked. Electrocardiogram and chest X-rays should be done, together with echocardiogram if available, while the transport is being arranged; the latter should be carried out in properly equipped ambulances, helicopters or aeroplanes. In the presence of severe congestive heart failure, the initial portion of the digitalizing dose together with frusemide, can be given intravenously before moving the infant. In ductal-dependent cardiac lesions, after consulting with the paediatric cardiologist, prostaglandin E[1] should be started in appropriate dosage