Role of Prostaglandins in Pathogenesis of Dysmenorrhea and Place of Mefenamic Acid and Dicyclomine in its Management

Despite being one of the most common gynecological issues faced by women of reproductive age, dysmenorrhea largely remains an ignored, underdiagnosed and untreated condition. It continues to be a public health issue and has a significant impact on the quality of life of the affected women in terms of inability to lead routine activities, absenteeism from academic activities or work and reduced social activities. Currently, existing evidence correlates and implicates the excessive synthesis of prostaglandins with the menstrual pain. Hence, treatment approaches that can inhibit prostaglandins' production or already formed prostaglandins can provide relief in dysmenorrhea. In this review, the impact of dysmenorrhea on the quality of life of women, the role of prostaglandins in the pathogenesis of dysmenorrhea, and how nonsteroidal anti-inflammatory drugs (NSAIDs) like mefenamic acid can be safe and effective in managing dysmenorrhea are discussed.

Dapagliflozin in the Landscape of Type 2 Diabetes Management

As per current statistics, India accounts for more than 74 million individuals living with diabetes. Many of these individuals have associated cardiovascular disease (CVD) and chronic kidney disease (CKD) comorbidities. Optimal glycemic management is important because uncontrolled glycemia may accelerate the macrovascular and microvascular complications, further aggravating the comorbid conditions. Metformin is used as the first-line therapy in most persons. However, there are some who do not tolerate metformin, are unable to achieve required glycemic targets or require greater efforts for cardiovascular (CV) risk reduction. These patients require an alternative hypoglycemic agent to be used as either monotherapy or as combination treatment with metformin, respectively. Sodium-glucose cotransporter-2 (SGLT2) inhibitors are one such novel class of drugs that can be used as either monotherapy or as part of two drug (dual) or three drug (triple) combinations with other oral hypoglycemic agents or insulin. Dapagliflozin is a promising option for managing type 2 diabetes with CV and renal benefits, weight and blood pressure reducing properties. A low risk of hypoglycemia and drug-drug interactions are the added advantages. In this article, the authors have reviewed the existing clinical evidences on dapagliflozin and highlighted its place in the diabetes management landscape

Management of Methicillin Resistant Staphylococcus aureus Infection of Endogenous Origin in an Electrical Burns Patient - A Case Report.

Methicillin Resistant Staphylococcus aureus (MRSA) poses a major problem and plays a vital role in nosocomial infections. Management of MRSA infection becomes cumbersome in healthcare settings due to its extension of resistance towards much class of antibiotics and it is purely based on antibiotic susceptibility. Nasal carriage of MRSA is a recognized risk factor for subsequent endogenous infection. We hereby report a case of MRSA infection in burns patient of endogenous origin and recovered by antibiotic therapy with 2% mupirocin. MRSA is frequent confront in the burn’s ward where the patients have more colonized and infected than other group of patients. Disturbances in the skin barrier and immunological variations are recorded among burn patients. Surveillance of microbial entities, its epidemiology and following the strict infection control practices lessen the frequency of such infection but very dangerous to control the outbreak situations.

Efficacy and Tolerability of Trandolapril in Mildto- moderate Hypertension: A Double-blind Comparison with Enalapril.

Objective: To compare the efficacy and tolerability between trandolapril and enalapril in mild-to-moderate hypertension. Material and Methods: This was a prospective, double-blind, parallel, comparative clinical trial involving 120 patients with mild-to-moderate hypertension. Patients were randomized to receive trandolapril 2-4 mg once-daily and enalapril 5-10 mg once-daily. The participants were followed for eight weeks. Results: Both the drugs achieved effective control of blood pressure (BP) at the end of eight weeks. The mean reduction in systolic BP (SBP) was 22.17 mmHg with trandolapril and 21.47 mmHg with enalapril group; the mean reduction of diastolic BP (DBP) was 9.57 mmHg with trandolapril and 11.13 mmHg with enalapril. Adverse events developed in 11 (18.3%) and 12 (20%) patients in trandolapril and enalapril group, respectively. Conclusion: The efficacy and tolerability of trandolapril was comparable to enalapril in mild-to-moderate hypertension with minor adverse events.

Assessment of haematotoxic potential of mercuric chloride in rat.

The blood is an important liquid connective tissue flow in body and performs the role of distribution of oxygen to various tissues, taken out carbon dioxide and maintains the health status of an organism. Any change in the blood components can cause adverse effects on the body. The effect of mercuric chloride has been evaluated on blood in albino rats (Rattus norvegicus). The albino rats were treated with mercuric chloride 0.926 mg kg-1 body wt. for acute (1 day) and 0.044 mg kg-1 body wt. for sub-acute (7, 14 and 21 day) sets after calculating LD50 (9.26 mg kg-1 body wt.). Major changes have been observed in the form of enhanced clotting time (CT) and bleeding time (BT) due to toxic effect of mercuric chloride on haemopoietic system along with decrease in the total erythrocyte count (TEC) and haemoglobin concentration (Hb. conc.). The changes in erythrocyte count and haemoglobin concentration have been correlated with cytotoxic effect of mercuric chloride on erythropoiesis. However, the intoxication of mercuric chloride on total leukocyte count (TLC) and erythrocyte sedimentation rate (ESR) has been observed to be significantly increased after acute and sub-acute treatments due to leucocytosis and rouleux formation. Moreover, the present observations highlight dose dependent toxicity.

Effect of arsenic trioxide on renal functions and its modulation by Curcuma aromatica leaf extract in albino rat.

The protective effects of Curcuma aromatica leaf extract were studied on nehrotoxicity induced by arsenic trioxide in albino rats. LD50 estimated for arsenic trioxide was 14.98 mg kg-1 body weight. Nephrotoxicity was assessed by estimating the serum levels of urea, uric acid and creatinine, the markers of renal dysfunctioning. The applied doses of arsenic trioxide administered orally were 0.007 , 0.01 , 0.02 and 0.15 mg 100 g-1 body weight for sub acute (21,14 and 7 days) and acute (1 day) treatments respectively. Arsenic trioxide intoxication significantly increased the serum level of urea, uric acid and creatinine in comparison to control due to renal dysfunctioning. Pretreatment with dose of 50 mg kg-1 body weight of leaf extract of Curcuma aromatica restored the increased serum levels of urea, uric acid and creatinine to normal. The results reveal that Curcuma aromatica leaf extract has a potential to modulate the renal dysfunctioning caused by arsenic trioxide.

Cybil induced hepatobiochemical changes in wistar rats.

Cybil, 25%EC formulation of Cypermethrin, induces biochemical changes in the liver of wistar rats after oral intubation of the same at acute (one day) and subacute (7, 14 and 21 days) levels. The changes were tallied with the controls run simultaneously. LD50 of Cybil was estimated to be 622mg/kg body weight The acute dose is 80mg/kg body weight exposed for one day i.e. 24 hours and subacute dose is 4mg/kg body weight exposed for 7, 14 and 21 days. When compared with the control values, both the doses enhanced the level of glycogen, cholesterol, total lipid and acid phosphatase activities, while decreased activity of alkaline phosphatase. Alterations in glycogen, cholesterol, total lipid, acid phosphatase and alkaline phosphatase resulted in the impairement in liver physiology.

Effects of beta-cyfluthrin on white and sepia mutants of Drosophila melanogaster.

The effects of sublethal concentrations of a synthetic pyrethroid, beta-cyfluthrin (Bulldock 025 SC) were investigated in the F1 generations of white and sepia mutants of Drosophila melanogaster after various cross combinations of the parents which were exposed separately to the insecticide mixed diet for 24 hours. The experiment was carried out under the laboratory conditions at a temperature of 25+/-5 degrees C and 60+/-5% relative humidity. The insecticide had deleterious effect on the growth and development of both the mutant flies. Larval, pupal and total developmental periods were found to be increased as compared to controls, whereas the number of adult emerged decreased in all the treatment sets. Larval period index (LPI), pupal period index (PPI) and growth index (GI) were observed to be decreased in the entire cross combinations. Maximum effects were observed in those sets where both the sexes were treated, crossed and F1 generation was studied on the treated food having sublethal concentration of the insecticide, followed by similar treatment sets but on the fresh untreated food. Females were found to be resistant as compared to the males, whereas white mutant files were more susceptible to the test insecticide beta-cyfluthrin as compared to sepia mutant flies.

Ruptured idiopathic pulmonary artery aneurysm: unusual case of hemothorax treated by selective embolization.

Aneurysm of the peripheral pulmonary arteries is rare. Rupture of pulmonary artery aneurysms manifesting as recurrent hemoptysis with exsanguination is well recognized. We report the case of a young woman who presented with massive hemothorax and shock at the sixth month of pregnancy due to a ruptured lingular artery aneurysm. She was treated with selective coil embolization of the lingular artery to achieve hemostasis. Subsequently, clot evacuation from the pleural space was done. This case is reported for its unsuspected presentation, rarity and to highlight the use of catheter coil embolization to achieve control of bleeding and exclusion of the aneurysm from the pulmonary circulation.

Mesiodens in the primary dentition--a case report.

Supernumerary teeth are among the most significant dental anomalies affecting the primary and the permanent dentitions. Mesiodens is a supernumerary tooth with a cone shaped crown and a short root. Though it occurs frequently in the permanent dentition, it is extremely rare in the primary dentition. The exact etiology is still obscure and not well understood. Supernumerary teeth occur as isolated dental findings or as part of a syndrome. The frequency with which supernumerary teeth occur and the effects they have on development of normal occlusion justify the radiographic examination of preschool children. Early removal of such teeth is recommended if they impede the eruption of adjacent permanent teeth, appear inverted or rudimentary, associated with certain pathologic conditions or are symptomatic.

Reattachment of a fractured maxillary incisor crown--case report.

Management of traumatic injuries to the teeth is a challenge to the practising dentist. It has no prescriptive method for occurring, possesses no significant predictable pattern of intensity or extensiveness and occurring at times when dentists are least prepared for it. It may not only leave physical scars but also a psychological impact on its victim. Yet, more than half of all children traumatize either their primary or permanent teeth before leaving the school, coupled with the dynamic panorama of sporting activity worldwide and the significant increase in violence among the populations. Tooth trauma and its management loom as a major challenge to the dental practitioner. A case of a 11 year old boy with Ellis Class 3 traumatic injury to the maxillary left central incisor is reported. A pulpectomy was performed followed by reinforcement and reattachment of the crown fragment and restoration with composite resin.

Bilaterally fused primary mandibular incisors--a case report.

Fusion of teeth results from abnormal events in the embryologic development of teeth. In most cases the clinical and radiological findings allow only a presumptive diagnosis to be established since the specific terminology described refers to the etiology of the process, which often cannot be established. An unusual case of bilateral fusion in primary mandibular incisor region in a four-year-old boy is reported.

Dentigerous cyst with inflammatory etiology from a deciduous predecessor--report of a case.

Dentigerous cysts arising from overlying infected predecessor teeth are very rare. This report describes one such case where extraction of the infected deciduous tooth with marsupialization led to the eruption of the premolar. Periodic radiographic evaluation is required to note and prevent recurrence and other serious complications arising from these cysts.