Evaluation Of Antioxidant And Chemopreventive Potential Of Methanolic Extracts Of Leaf Of Aeglemarmelos Attributes Towards Ductal Carcinoma Studied In Mcf7 Cells

Objective: The objective of the present research work had been made to evaluate the antioxidant potential along with anti-cancer activity of methanolic extracts from the leaf of A. marmelos. Methods: Standard methods for antioxidant potential in terms of DPPH and nitric oxide scavenging assay, and anticancer activity in vitro method (Cytotoxicity/MTT assay and % of cell viability) by using MCF7 cell line. Results: Results of antioxidant efficacy revealed that the IC50 value for DPPH and nitric oxide scavenging assay was considered to be 62.032%, and 20.69% respectively. The methanolic extract of A. marmelos was found to possess enhanced anticancer potential against MCF7 cells. Cytotoxicity activity of MCF7 cells, when treated with methanolic extract of A. marmelos, was found to be 43.42% at 25µg, 52.31% at 50µg, 56.31% at 75µg, 58.38% at 100µg, 62.25% at 125µg. The IC50 value was found as 49.36µg. Toxicity was significantly increased with increased concentration and viability significantly decreased with the increased concentration of methanolic extract of leaf from A. marmelos for MCF7 cell when compared to cyclophosphamide. Conclusion: From the studies, it was postulated that methanolic extract of leaf from A. marmeloshas significant chemopreventive activity. These specific identities will be useful for the identification and authentication of raw drug.

Juvenile nasopharyngeal angiofibroma in our experience

Introduction: Juvenile nasopharyngeal angiofibroma (JNA) is a highly vascular histologically benign, locally aggressive neoplasm of the nasopharynx. It accounts for 0.5% of all head and neck neoplasms with a high incidence of persistence and recurrence. Materials and methods: This was a retrospective observational study whereby the medical records of 32 patients treated for Juvenile angiofibroma between May 2010 and August 2016 were reviewed. Results: This study included patients aged between 13-25 years average was 19 years. More than 10 cases were in 14-18years group. This age group exhibits rapidity of growth high incidence of recurrence and early involvement of neibouring structures such as pterygopalatine fossa and infratemporal region and cheek. In 16 cases out of 32 there were attachments of tumor on the roof of nasopharynx. And 8 cases had attachments on the choana. Nasal obstruction and epistaxis is the most common symptom observed in study. CECT was the most common imaging modality utilized for diagnosis and staging of JNA and it was required in all cases. MRI was utilized as an additional investigation in cases with intracranial extention and was required in 37.5% of cases. Postoperative complications were not serious and only included malar defect, ectropion, epiphora and palatal defect. Total complication rate in all was about 28.2%, seen in 11 out of 32 patients. 7 patients were diagnosed with recurrence, with a recurrence rate of about 30%. These recurrences were diagnosed at varying intervals of follow-up 4 out of 13 cases with Stage IIIa and 3 out of 4 cases with Stage IVb diagnosed with recurrence. Conclusion: Radiologic follow-up is essential in the early identification of residual or recurrent disease.

Biologics and Biosimilars: Differences and Clinical Implications.

Biologics or biopharmaceuticals are drugs derived from living organisms by recombinant technology. Biologics have made a significant contribution to the management of certain chronic diseases such as cancer, rheumatoid, arthritis, ankylosing spondylitis, psoriasis and other immune mediated disorders. Biologics are produced by genetically modifying cells and, are highly complex and expensive to manufacture. Many of them are now facing patent expiry which has paved the way for the development of biosimilars. Biosimilars are biologic medicine that is similar in terms of quality, safety and efficacy but not the same as a registered innovator biologic. The manufacturing of biosimilars has many complexities, such as consistency of manufacturing process, conformation of manufacturing standards and demonstration of product consistency Also, powered clinical trials have to be executed to demonstrate similarity to the innovator biologic. Registration of biosimilars requires a more stringent evaluation than that is required for conventional generics. Biosimilars have the potential to be the molecules of the future as long as they are developed strictly in accordance with comparative procedures mandated by regulatory authorities such as EMA and USFDA. It is believed that the advent of biosimilars will improve patient access to expensive biologics for chronic illnesses. However, it is important that clinicians distinguish between innovator biologics and biosimilars. Physicians should avoid substituting biosimilars for innovators as well as avoid interchangeability as biosimilars are not generics. In addition, pharmacovigilance will be the need of the hour to track down any safety and efficacy problems arising from the use of biosimilars.

Oral squamous cell carcinoma in patients with and without predisposing habits in glossal and extra‑glossal site: An institutional experience in South India.

INTRODUCTION: We report our cohort of oral squamous cell carcinoma (OSCC) patients with or without predisposing habits in glossal and extraglossal sites. MATERIALS AND METHODS: A retrospective analysis of OSCC cases over a period of 13.75 years from the archives of Ragas Dental College and Hospital, Chennai, India. Demographic details, site, details of habits, and grade of OSCC were retrieved. Social Package for Social Service version 17.0 was used to analyze the data. Descriptive statistics, Chi‑square test, and comparison of mean were employed appropriately. RESULTS: There were 151 OSCC cases, of which 60.9% (92/151) were males, 21.2% (32/151) were aged ≤40 years and 27.82% (42/151) occurred in the tongue. The glossal to extraglossal site ratio was 1:2.6. Predisposing habits were present in 52.4% of glossal OSCC and 82.6% with extra‑glossal sites (P = 0.000). Besides tobacco, exclusive areca nut chewing was observed in 15.23% (23/151) patients. Thirty‑nine (25.8%) belonged to non‑tobacco, non‑areca nut, non‑alcohol (NTND) group with male to female ratio was1:3. DISCUSSION: In our cohort, 112 of 151 OSCC (74.8%) had at least one predisposing habit. Chewing of areca nut alone was a predisposing habit by itself. In addition, there was a small, subset of cases that were not associated with history of any habits. This study brings to focus the subsets of OSCC predisposed by areca nut and NTND, that needs to be studied further.

Surveillance of Pseudomonas in COPD patients in a tertiary care hospital.

Background: Chronic pulmonary disease is increasing day by day due to lifestyle of general population. Smoking and air pollution are important factors. The present study was carried out to know the bacteriological profile of such cases. Methods: A total of 64 patients suffering with COPD were included in this study. Purulent sputum was collected from all the patients and subjected to routine bacteriological study. Culture positive were identified by routine bacteriological methods and antimicrobial susceptibility tests were performed using Kirby-Bauer disk diffusion method, MIC were determined following CLSI guidelines. Results: Out of 64 samples, 51 showed culture positive. Among aerobic bacteria, Pseudomonas was found to be predominant (54.05%) which was immediately followed by Klebsiella (45.94%). Amikacin was found to be effective (90%), followed by imipenim (85%) and trimethoprim (85%). The ureidopenicillin, piperacillin showed 70% sensitivity. All the strains were resistant to ampicillin and co-trimoxazole (100%). Conclusion: Antipseudomonal agents, imipenim and piperacillin were effective though slight resistance was noted. Therefore continuous monitoring of antipseudomonal agents is necessary to combat the development of resistance. Health education regarding smoking and air pollution needs to be strongly implemented.

Reviews on Calcium Mediated Secondary Messengers in Chronic Opioids Exposure/Addiction.

Addiction and withdrawal are problems disturbing the health of the individual and also causes difficulties for society, raising the rates of divorce, unemployment and government spending on legal and medical systems. Opioids show an important pharmacological effect in the treatment of pain, with extremely addictive potential. Chronic opioid exposure is known to produce the complex behaviors of tolerance and dependence, a state exposed by opioid abstinence leading to withdrawal syndrome, as well as oxidative stress. Studies show that calcium mediated secondary messengers play a crucial role in the mechanism of addictive process and oxidative stress induced by chronic opioid usage. Calcium/calmodulin-dependent protein kinase II (CaMKII), is a major calcium regulated signal transducer that controls many neuronal systems and play important role in neuronal plasticity and can act as a key and direct promoting opioid tolerance and dependence and identifying such a direct mechanism may be useful for designing a pharmacology treatment for these conditions, recent studies, has been shown that calcium channels antagonist can be used in the treatment of withdrawal syndrome. Chronic opioid exposure associated with tolerance, dependence withdrawal syndrome and oxidative stress. Studies has shown that calcium mediated secondary messengers involved in the genesis of these conditions, better understanding of biological mechanisms underlie reduction in neuronal cell excitability could help in the identification of pharmacological targets for treatment.

Comparative analysis of the antibacterial, antifungal, antiproliferative and cyclic response element (CRE) induced expression of downstream luc gene activities of Monopterus albus and Channa straitus extracts.

In Malaysia, Monopterus albus is commonly found in rice fields, muddy ponds and swamp areas. Channa striatus have been widely used as a source of traditional medicines. The extracts of Malaysian local Monopterus albus and Channa straitus have been reported to have different bioactive properties and these properties can be used at molecular level as alternative tool for different disorders. The comparative analysis of antibacterial, antifungal, antiproliferative and CRE induced expression of downstream luc gene activities of both the extracts were performed. The bacteriostatic and antibacterial effects of both extracts were revealed beside higher antifungal activity of Channa straitus. The extracts from Monopterus albus showed higher levels of antiproliferative activity as compare to Channastraitus. The results were found supportive towards up regulation of hrluc by Monopterus albus extracts and down regulation by Channa striatus extracts. This is the first report on comparing the bioactive properties of Monopterus albus and Channa straitus. The results from this study demands a further research on identifying the bioactive molecules involve in these actions at a molecular level.

Biochemical evaluation of anti-diabetic phytomolecule through bioactivity guided solvent fractionation and subfractionation from hydromethanolic (2:3) extract of Alligator pear Fruit in streptozotocin induced diabetic rats.

The study was to evaluate the most effective fraction and subfraction having hypoglycemic activity from the hydro-methanolic (2:3) extract of the fruit of Persea americana Mil. through bioactivity guided investigation in streptozotocin induced diabetic rats. Out of different solvent fractions and subfractions, the effective fraction and subfraction of Persea americana Mill. were subjected to antidiabetic study in streptozotocin-induced diabetic rat. Serum insulin, glycosylated hemoglobin, transaminases, carbohydrate metabolic enzymes in liver, kidney, cardiac and skeletal muscle, were also assessed after 8 weeks of treatment and compared to the vehicle control. A significant recovery was noted in the level of serum insulin, glycosylated hemoglobin, activities of carbohydrate metabolic enzymes and serum transaminases after n-hexane fraction treatment in respect with other treated groups. Two sub fractions A and B were obtained using petroleum ether sub fractionation of which sub fraction B was more bioactive considering the above biosensors and was comparable with glibenclamide. HPTLC study focused four and two components (P1 and P2) in sub fraction A and B respectively where P1 is major, confirmed by HPLC study. The dose of sub fraction B was 1/4th of the n-hexane fractions dose. It has been concluded that sub fraction B (P1 and P2) which was obtained from nhexane fraction had the antidiabetic activities in the streptozotocin-induced diabetic model.

Effect of NR-ANX-C (a polyherbal formulation) on haloperidol induced catalepsy in albino mice.

BACKGROUND & OBJECTIVE: Use of typical antipsychotics like haloperidol in treatment of schizophrenia is associated with a high incidence of extrapyramidal side effects. In rodents, administration of haloperidol leads to the development of a behavioural state called catalepsy, in which the animal is not able to correct an externally imposed posture. In the present study we evaluated the anticataleptic efficacy of NR-ANX-C, a polyherbal formulation containing bioactives of Withania somnifera, Ocimum sanctum, Camellia sinensis, triphala and shilajit in haloperidol induced catalepsy in mice. METHODS: Five groups (n = 6) of male albino mice were used in the study. Catalepsy was induced by ip administration of haloperidol (1mg/kg). The degree of catalepsy (cataleptic score) was measured as the time the animal maintained an imposed posture. We compared the anticataleptic efficacy of NR-ANX-C (10, 25 and 50 mg/kg) with scopolamine (1 mg/kg). The superoxide dismutase (SOD) level in brain tissue was also estimated to correlate the levels of oxidative stress and degree of catalepsy in the animal. RESULTS: Significant (P<0.01) reduction in the cataleptic scores was observed in all NR-ANX-C treated groups and maximum reduction was observed in the NR-ANX-C (25 mg/kg) treated group. Significant (P<0.05) reduction in SOD activity was observed in NR-ANX-C (25 and 50 mg/kg) treated groups and maximum reduction was observed in NR-ANX-C (25mg/kg) treated group. INTERPRETATION & CONCLUSION: In our study, maximum reduction in cataleptic score was observed in NR-ANX-C (25 mg/kg) treated group. The maximum reduction in SOD activity was also observed in the same group. These findings suggest a possible involvement of the antioxidant potential of NRANX- C in alleviating haloperidol induced catalepsy.

Intensive care management of head injury patients without routine intracranial pressure monitoring.

Background: Head injury contributes significantly to mortality and morbidity in India. Evaluation of the available trauma care facilities may help improve outcome. Aim: To evaluate the factors influencing the mortality of patients with head injury who had intensive care management and evolve strategies to improve outcome. Setting and Design: Retrospective study in a tertiary hospital where intracranial pressure monitoring (ICPM) is not routinely practiced. Materials and Methods: All patients with head injury managed in the intensive care unit in a two-year period were included. The factors evaluated were age, vital signs, Glasgow Coma scale score (GCS) at admission, pupillary light reflex (PR), oculocephalic reflex (OCR), hemodynamic stability, computerized tomography (CT) findings, diabetes mellitus, anemia, infections and abnormalities of serum sodium. Results: We analyzed 208 patients (202 without ICPM). In-hospital mortality was 64 (31%). Only 24 (11.5%) patients were admitted within one hour of injury, while one-third arrived after six hours. The clinical factors (at admission) that influenced mortality included age, GCS, PR, OCR and diastolic blood pressure (DBP). Effacement of the basal cisterns in the initial and repeat CT scans, hyperglycemia, hemodynamic instability and serum sodium imbalances were associated with higher mortality. The independent predictors of mortality by logistic regression were initial GCS, DBP, hemodynamic instability and effacement of cisterns on repeat CT. Conclusions: Mortality following head injury is high. Pre-hospital emergency medical services are disorganized. The key to reducing mortality within the limitations of our current trauma system is maintenance of DBP>70 mmHg and SBP> 90 mmHg from the time of first contact.

Relationship of plasmid profile with the antibiotic sensitivity pattern of helicobacter pylori isolates from peptic ulcer disease patients in Chennai.

PURPOSE: One hundred and ten Helicobacter pylori isolates from peptic ulcer disease patients and matched controls were analysed for any possible relationship between the presence of cryptic plasmids and their antibiotic sensitivity pattern. METHODS: Antral biopsies of patients with gastric and duodenal ulcer, gastric cancer, non ulcer dyspepsia and matched controls were cultured for H.pylori. Antibiotic susceptibility and MIC analysis of the clinical isolates was done by E-test. Plasmid profiles of the isolates were analysed using mini ultra prep plasmid kit. RESULTS: Out of the 110 isolates tested, 89.1% isolates were resistant to metronidazole, 10.9 % were resistant to clarithromycin and 0.9% were resistant to multiple drugs. Isolates harbouring plasmids were seen in all the groups and constituted 5.4% of total isolates. CONCLUSIONS: The presence of plasmids in the clinical isolates of H.pylori did not have any correlation with their antibiotic resistance pattern.

Soft tissue rheumatism.

Soft tissue rheumatism includes disorders of tendons and their sheaths, ligaments, bursae, joint capsules, muscles, fasciae and others. Inflammatory signs or systemic manifestations may be lacking in these disorders. Fibrositis, bursitis, tenosynovitis, myositis are some of the common types of soft tissue rheumatism. The disorders can be classified broadly into two groups ie, diffuse and local. Proper history taking and performing detailed examination are very important in arriving at diagnosis. Management includes pain relief by suitable measures. In fibromyalgia diffuse musculoskeletal pain is observed having at least 11 or 18 tender points involving upper and lower body bilaterally.

Identification of Pneumocystis carinii in induced sputum of AIDS patients in Chennai (Madras).

Induced sputum samples were collected from 32 AIDS patients with respiratory ailments. Pneumcystis carinii was demonstrated in 9 out of 32 AIDS cases by Indirect Immunofluorescence technique (HF). Four cases were positive by all the three techniques namely Giemsa staining, Toluidine blue staining and IIF, three were positive by both toluidine blue and IIF, and two were positive only by IIF. Among other microbial pathogens, acid fast bacilli was demonstrated in all the P carinii positive cases and Candida albicans in 53% AIDS cases from the induced sputum sample.