Clinical correlation of retinal nerve fiber layer thickness in multiple sclerosis patients- A North Indian study

Background: Axonal loss is thought to occur early in the course multiple sclerosis (MS) and is supposed to be associated with, and predictive of, neurologic deficits progressing to permanent disability.Axonal loss in the retinal nerve fiber layer (RNFL) is measured by optical coherence tomography (OCT). Material and Methods: A longitudinal observational study, conducted on 30 MS patients. All subjects underwent neurological examination, including expanded disability status scale (EDSS) scoring and OCT on two visits, minimum 2 months apart. Results: Total of 60 eyes of 30 patients were subdivided into 21 eyes having optic neuritis (ON) [‘MS – ON’] and 39 eyes without ON. The RNFL thickness (RNFLt) was found to be significantly reduced in all parameters except in temporal quadrant, as the duration of disease increases. Average RNFLt were found to have negative correlation (r = -0.450) with disease duration. Negative correlation (r=-0.657) was also found between EDSS score change and average RNFLt change. The eyes having ON showed statistically significant RNFL thinning as compared to the non – ON fellow eyes. The baseline EDSS score was found to be negatively correlated (moderate degree, r = -0.348) with baseline average RNFL thickness, with p-value of 0.006. Conclusions: The RNFLt is not only significantly thinner in those with history of ON, but it is also affected remarkably even in absence of prior ON, suggesting subclinical ongoing axonal loss in patients with MS. The EDSS score is inversely correlated with RNFL thickness.

Tot fixation using customized polypropylene mesh – Safe and effective approach for SUI repair

Introduction: Stress urinary incontinence (SUI) is defined as involuntary loss of urine due to increased intraabdominal pressure and intravesical pressure, which exceeds the pressure that the urethral closure mechanism can withstand and urinary loss results. SUI prevalence increases with age and becoming popular day by day. The tot fixation in SUI repair is a common operation done in Gynaecology Department. Hence it is necessary to evaluate this technique in terms of safety and feasibility in our set up and also to evaluate the feasibility, simplicity, cost effectiveness of trans obturator fixation procedure using propylene mesh of adequate size was placed loose at midurethral level, extending from one paraurethral gutter to the other and was fixed with No.1-0 Vicryl on lateral sides in the management of female stress urinary incontinence (SUI). Aim and objectives: The objective was to assess safety, efficacy, complication and cost-effectiveness of polypropylene mesh in patients with SUI undergoing tot fixation and to analyze functional results. Materials and methods: This study included about 25 cases. All of them were examined and investigated after taking their informed consent. This was a retroprospective experimental study to see the outcome measures in patients of SUI treated with transobturator sling. It was an experimental design to assess safety, efficacy, complication, and cost-effectiveness of polypropylene mesh in patients with SUI undergoing tot fixation and study intra-operative parameters like mean operative

Evaluation of Diuretic Activity of Aqueous and Methanol Extracts of Lepidium sativum Garden Cress (Cruciferae) in Rats

Purpose: The present study was undertaken to investigate diuretic effect of aqueous and methanol extracts of the dried seeds of Lepidium sativum in normal rats. Method: Aqueous and methanol extracts of L. sativum seeds were administered to experimental rats orally at doses of 50 and 100 mg/kg p.o. Hydrochlorothiazide (10 mg/kg) was used as positive control in study. The diuretic effect of the extracts was evaluated by measuring urine volume; sodium and potassium content; conductivity and pH. Result: Urine volume was significantly increased by the two doses of aqueous and methanol extracts in comparison to control group. While the excretion of sodium was also increased by both extracts; potassium excretion was only increased by the aqueous extract at a dose of 100 mg/kg. There was no significant change in the conductivity and pH of urine after administration of the L. sativum extracts. The diuretic effect of the extracts was comparable to that of the reference standard (hydrochlorothiazide) and the methanol had the additional advantage of a potassium-conserving effect. Conclusion: We can conclude that aqueous and methanol extracts of L. sativum produced notable diuretic effect which appeared to be comparable to that produced by the reference diuretic HCTZ. The present study provides a quantitative basis for explaining the folkloric use of L. sativum as a diuretic agent in Moroccan population

A prospective study of seroprevalence of Toxoplasmosis in general population, and in HIV/AIDS patients in Bombay, India.

Two hundred and seventy nine sera (age group 13-50 years) were tested for antitoxoplasma IgG/IgM antibodies by ELISA techniques; the diagnostic titer for positive test is 10 iu/ml or > 1:100. Sera were obtained from (i) 165 (100 men/65 women) healthy adult voluntary blood donors (HIV, HBsAg, VDRL negative); (ii) 89 consecutive HIV/AIDS patients (82 men/7 women); and (iii) 25 patients (HIV negative: 12 men/13 women) treated for cerebral Tuberculoma or Neurocysticercosis during this study from January 1996-June 1997. The overall seroprevalence was 30.9% (51/165) in the immunocompetent adult (group i) 34% (34/100) men and 26.2% (17/65) in women [range: 10-899 iu/ml; (mean: 376.8)]. In HIV infected hosts the seroprevalence [range: 21-340 iu/ml; (mean; 180)] was 67.8% (56/82 men, 04/07 women). The seroprevalence was 20.5% (8/39), 32.8% (22/67), 34.8% (16/46) and 38.4% (5/13) in the 2nd, 3rd, 4th and 5th decades respectively in healthy adults. In HIV/AIDS patients, 69% (29/42) in the 3rd and 70.6% (24/34) in 4th decade were seropositive. The risk of cerebral Toxoplasmosis (encephalitis-02, granuloma-24) was 43.3% (26/60, mean 250 iu/ml). The seroprevalence was 28% in group iii (range 12-80 iu/ml, mean 21 iu/ml). Anti-toxo IgM was negative in all. Primary Toxoplasma infection appears to be subclinical and prevalent throughout life. T. gondii has emerged as an important opportunistic infection in HIV/AIDS patients in Bombay. Recrudescence of cerebral toxoplasmosis (CTOX) is observed with low IgG response during mid-late stage of the disease, as seen in our patients (mean IgG 250 iu/ml, CD4+ = 283/cmm (range 43-504 in 5 patients). Primary prophylaxis for CTOX seems rationale and can be targeted to asymptomatic HIV/AIDS population at risk who are seropositive for T. gondii (mean IgG 111.5 iu/ml in our study). The very high predictive value of a negative test for TOX remains the best serological parameter for excluding acute episode of TOX.

Isolation of Aeromonas spp. from canal water.

Aeromonas sobria was identified from soil and canal water at the East End of London. There was a correlation between water and faecal isolates from children attending the nearby Children's Hospital. In view of the potential risk of enteric and non-enteric infections due to Aeromonas spp, efforts are needed to ensure that canals, rivers, natural water sources and domestic water supply are free of these organisms.

Evidence for histamine and 5-hydroxytryptamine like effects of MK-212 on guinea pig ileum, taenia coli and rat fundus strip.

MK-212 (1 x 10(-7)M -- 1 x 10(-5)M) produced dose-dependent contractions of guinea pig ileum, taenia coil and rat fundus strip. The responses to MK-212 in all three preparations were blocked competitively by cyproheptadine (1 x 10(-8)M) a 5-HT receptor antagonist. Mepyramine (1 x 10(-8)M)-H1 receptor antagonist also inhibited competitively the responses of guinea pig ileum and taenia coli to MK-212. However, it failed to block significantly the responses of rat fundus strip to MK-212. Metiamide (1 x 10(-6)M), propranolol (1 x 10(-6)M) or atropine (1 x 10(-6)M) did not produce any significant effects on MK-212 induced contractile responses of guinea pig ileum, taenia coli and rat fundus strip. Our findings suggest that MK-212 produces both 5-HT as well as histamine like effects on the guinea-pig ileum, taenia coli and rat fundus strip.