Spectrum of drug-induced liver injury in a tertiary hospital in southern India

BACKGROUND Anti-tuberculosis drugs are thought to account for about 50% of drugs that cause liver injury in India. We show that the spectrum of drugs is much wider than previously reported. METHODS We evaluated all patients with unexplained acute liver injury presenting during 2006–2016 using a structured proforma for drug-induced liver injury (DILI). The Roussel Uclaf Causality Assessment Method was used to assess causality. RESULTS DILI was found in 143 of 2534 patients with acute liver injury. Nineteen patients had probable ayurvedic DILI. The other common causes of DILI were statins (16 patients) and anti-tuberculosis drugs (11 patients). Eight patients had DILI post-liver transplant. Fluconazole was the most common cause of post-liver transplant DILI. Chronic DILI (abnormal liver function test after 12 months of stopping the suspected drug) was found in 2 patients. CONCLUSION In otherwise unexplained acute liver injury, DILI due to ayurvedic drugs should be sought. DILI should be considered in post-liver transplant patients. Patients with DILI should be monitored for at least 12 months to exclude progression to chronic DILI.

El largo camino de la American Psychological Association hacia la redención / The long road of the American Psychological Association to redemption

En su convención anual de Agosto 2015, la American Psychological Association finalmente comenzó a enfrentar su vergonzosa historia de colusión con la inteligencia y el ejército de los Estados Unidos en el marco de la "guerra contra el terrorismo". De particular interés es la importante, recientemente adoptada política que ahora prohíbe a los psicólogos participar en interrogatorios de seguridad nacional. Pero el daño causado por el fracaso de la APA en defender el principio ético de no dañar es muy amplio, y una reparación significativa requerirá un compromiso integral y permanente con la transparencia, la rendición de cuentas y la reforma. Este breve ensayo ofrece una revisión y evaluación crítica del momento actual, el inquietante pasado y el futuro incierto. Se identifican y discuten algunos retos y obstáculos específicos que enfrenta la APA en su búsqueda de la redención...

At its recent annual convention, the American Psychological Association finally began to confront its shameful history of "war on terror" collusion with the U.S. military and intelligence establishment. Of particular note, an important, newly adopted policy now prohibits psychologists from participating in national security interrogations. But the damage caused by the APA's failure to defend the profession's do-no-harm ethics is extensive, and meaningful repair will require a comprehensive and ongoing commitment to transparency, accountability, and reform. This brief essay offers a review and critical assessment of the current moment, the disturbing past, and the uncertain future. Specific challenges and obstacles the APA faces in pursuing redemption are identified and discussed.

Evaluación de la eficacia de la CEPA MAF1309® de Metarhizium anisopliae en el control biológico de garrapatas adultas de Rhipicephalus microplus en Tunja, Colombia / Evaluation of efficacy of MaF1309® strain of Metarhizium anisopliae in biological control of adult ticks Rhipicephalus microplus in Tunja, Colombia

La garrapata del ganado Rhipicephalus microplus constituye el ectoparásito de mayor importancia en las ganaderías de regiones tropicales y subtropicales, al producir pérdidas directas por reducción de la producción de carne, leche y deterioro de las pieles así como a la transmisión de agentes patógenos para el ganado bovino tales como Babesia bovis, Babesia bigemina y Anaplasma marginale. El tratamiento químico ha sido efectivo para el control de las garrapatas; sin embargo,  su uso excesivo ha propiciado la selección de individuos resistentes y por tal motivo, se hace necesario el desarrollo de nuevas alternativas de control, tales como el uso de hongos entomopatógenos. El objetivo del presente estudio fue evaluar la eficacia in vitro de M. anisopliae para el control de la fase adulta de R. microplus, en Tunja, Colombia. Se usó la prueba de inmersión de adultas para evaluar la eficacia de la cepa MaF1309® de M. anisopliae a las siguientes concentraciones: 1x10(4), 1x10(6) y 1x10(8) conidias/mL. Se observó que en las garrapatas tratadas a una concentración de 1x10(8) conidias/mL se alcanzó el 100% de mortalidad a los 14 d postratamiento (PT), mientras que las concentraciones 1x10(6) y 1x10(4) conidias/mL alcanzaron el 100% de mortalidad a los días 16 y 20 PT, respectivamente. La mortalidad fue directamente proporcional a la concentración empleada del hongo, siendo las garrapatas tratadas con concentraciones mayores aquellas que alcanzaron una mortalidad en menor tiempo. Estos resultados in vitro son considerados el inicio de información de tipo local proyectados al diseño de programas de control para el departamento de Boyacá.

The livestock tick Rhipicephalus microplus is a high importance ectoparasite in cattle raised at tropical and sub-tropical regions producing direct losses since reduce meat and milk production and cause leather injury besides transmission of pathogenic agents such as Babesia bovis, Babesia bigemina y Anaplasma marginale. The chemical treatment has been effective to control tick  however the excessive use has selected resistant individuals; for that reason is important to develop new alternatives such as entomopathogen fungi to keep controlled those individuals. The objective of this research was to evaluate in vitro efficacy of M. anisopliae to control adult stage of R. microplus in Tunja, Colombia. The immersion test was used to evaluate efficacy of MaF1309® strain of M. anisopliae at concentrations of 1x10(4), 1x10(6) y 1x10(8) conidia/mL. The group of ticks treated with 1x10(8) conidia had 100% of mortality 14 post-treatment days (PT), otherwise 1x10(6) y 1x10(4) conidia/mL concentrations have 100% of mortality at 16 and 20 PT days, respectively. Mortality was directly proportional to fungus concentration used, the ticks treated with high concentrations reach high mortality in less time. Those in vitro results start in local information projected to design control programs for the department of Boyacá.

Evaluation of phytoconstituents and assessment of adaptogenic activity in vivo in various extracts of Rhododendron arboreum (leaves).

Natural products particularly of plant origin with antistress property and nutraceutical value have become the focus of scores of scientific investigation in recent times. Against this background the present study was carried out to analyse the phytochemical components and adaptogenic activity of Rhododendron arboreum which grow in high altitudes. Adaptogenic activity of the plant extract was evaluated in vivo in rat and mice animal models. Methanol, hydroethanol and aqueous extract of the leaves were prepared and preliminary screening of the phytochemical constiteunts was carried out. The important phytoconstituents viz. flavonoids and phenolics were estimated and amount of gallic acid and quercetin were evaluated by HPTLC. Adaptogenic activity of the extract was studied in vivo using rat and mice as test animals. The criteria taken were forced swimming test in rat and mice and tail suspension test in mice. Methanol extract showed the presence of diterpenes, triterpenes, flavonoids, steroids, tannin, phenolics. Hydroethanol extract showed the presence of diterpenes, triterpenes, saponin, glycosides, alkaloids, tannin and aqueous extract showed the presence of tannin, glycosides, triterpenes, flavonoids, diterpenes. Quantitative analysis exhibited that the methanol extract have the highest amount of flavonoid and phenolics. The HPTLC profile of methanol extract showed the presence of highest amount of quercetin. Gallic acid was detected only in methanol extract. In vivo study in test animals revealed that the methanol extract of R. arboreum exhibited potent anti stress activity. Hence, presence of these compounds which are known to have strong anti-oxidant activity in high quantity might be responsible for adaptogenic activity.

Association between muscle strength and the cardiopulmonary status of individuals living with HIV/AIDS

OBJECTIVE: The purpose of this study was to compare aerobic function [anaerobic threshold (%VO2-AT), respiratory compensation point (%VO2-RCP) and peak oxygen uptake (VO2peak)] between physically active patients with HIV/AIDS and matched controls and to examine associations between disease status, poor muscle strength, depression (as estimated by the profile of mood states questionnaire) and the aerobic performance of patients. METHODS: Progressive treadmill test data for %VO2-AT (V-slope method), RCP and (VO2peak) were compared between 39 male patients with HIV/AIDS (age 40.6±1.4 years) and 28 male controls (age 44.4±2.1 years) drawn from the same community and matched for habitual physical activity. Within-patient data were also examined in relation to CD4+ counts (nadir and current data) and peak isokinetic knee torque. RESULTS: AT, RCP and (VO2peak) values were generally similar for patients and controls.Within the patient sample, binary classification suggested that AT, RCP and (VO2peak) values were not associated with either the nadir or current CD4+ count, but treadmill test variables were positively associated with peak isokinetic knee torque. CONCLUSION: The aerobic performance of physically active patients with HIV/AIDS is generally well conserved. Nevertheless, poor muscle strength is observed in some HIV/AIDS patients, which is associated with lower anaerobic power and (VO2peak), suggesting the possibility of enhancing the aerobic performance of patients with weak muscles through appropriate muscle-strengthening activities.

Prevalence of major neurological disorders among geriatric population in the metropolitan city of Kolkata.

Well-conducted neuroepidemiological studies for the geriatric population are rare in India. In view of the growing aging population, we planned to determine the prevalence of common neurological disorders among the elderly population in the city of Kolkata. This was a cross-sectional study of a stratified random sample of the city population and carried in two stages through house to house survey. Initially, trained non-medical workers screened the cases with a validated family questionnaire and then a neurologist examined all the screened positive cases. A validated neuropsychological screening test was also applied among the elderly population with cognitive complaints. Results showed prevalence rates (per 1000 elderly population--> or = 60 years) of following disorders in decreasing order: stroke--33.93, essential tremor--13.76, dementia--7.89, Parkinsonism--3.30 and epilepsy--2.57. Sex-specific prevalence showed that stroke was commoner among men and that of other disorders among women. Age-specific prevalence recorded progressive increase in the rates of all disorders among both genders, though not uniformly among women. Overall the crude prevalence of neurological disorders was 60.9 per 1000. The present study shows higher rate of stroke as compared to other neurological disorders among elderly population in India, which needs urgent attention.

Envelhecimento, atividade física e saúde / Aging, physical activity and health

Neste livro Roy J. Shephard, uma das autoridades mundiais em ciência do exercício, revisa e sintetiza a literatura científica nas mudanças fisiológicas com o envelhecimento, e o quanto a atividade regular afeta o processo de envelhecimento. A análise crítica de Shephard caracteriza as últimas teorias de como o envelhecimento e o exercício afetam as condições médicas, tais como doenças respiratórias, doenças muscoloesqueléticas, saúde metabólica, função mental e bem-estar geral. Fornece evidências fisiológicas conclusivas de que o exercício é eficaz na redução do risco de muitas doenças, maximizando a independência e melhorando a qualidade de vida para os idosos. O autor também discute as conseqüências econômicas e sociais de uma sociedade em envelhecimento. Mais de 1.700 referências torna este livro uma excelente fonte para aqueles que querem investigar áreas específicas do envelhecimento e da atividade

Cultural requirements for in vitro seed germination, protocorm growth and seedling development of Geodorum densiflorum (Lam.) Schltr.

Effects of different nutrient solutions, organic supplements and plant growth regulators on in vitro seed germination and protocorm development of Geodorum densiflorum (Lam.) Schltr. were studied. Seed germination was very high (up to 96%) in all the basal media, with Knudson's C and half-strength Murashige & Skoog being slightly more productive than Vacin & Went. Application of organic supplements and NAA had little effect on germination, but BAP proved inhibitory. After germination, protocorms exhibited a clear preference for peptone and NAA for much faster growth, while BAP resulted in stunted growth. Beside normal development, disorganisation of protocorms, followed by callusing occurred in presence of peptone and NAA. The calli were compact with limited growth and frequently regenerated protocorm like bodies. Development of seedlings was preceded by an intermediary rhizome phase. Growth of rhizomes was slow in the plant growth regulator free medium and about 15 months of culture was required for seedling formation. However, it was possible to hasten the process by 8-10 months with the employment of NAA, which also enhanced the number of seedlings per protocorm through axillary branching. Combined application of high BAP and low NAA was also useful for high rate of seedling formation.

Mutations in tumour suppressor genes, l(2)gl and l(2)gd, alter the expression of wingless in Drosophila.

To understand the roles of two well known tumour suppressor genes. l(2)gl and l(2)gd in normal imaginal disc development in Drosophila, we have initiated a study to examine effect of mulations of these genes on the expression of genes involved in the patterning of the imaginal discs. In this study we show that the expression of wingless, the Drosophila orthologue of the mammalian oncogene Wnt, is affected in the imaginal discs of l(2)gl4 and l(2)gd1 mutant individuals. In the tumourous wing imaginal discs from l(2)gl mutant larvae, the pattern of wingless expression was progressively disrupted with an increase in the area of expression, Tumourous wing imaginal discs from l(2)gd homozygous individuals exhibited progressive broadening and extension of the wingless expressing domains. We suggest that l(2)gl and l(2)gd might be involved in regulating post embryonic expression of Wingless.

To understand the roles of two well known tumour suppressor genes. l(2)gl and l(2)gd in normal imaginal disc development in Drosophila, we have initiated a study to examine effect of mulations of these genes on the expression of genes involved in the patterning of the imaginal discs. In this study we show that the expression of wingless, the Drosophila orthologue of the mammalian oncogene Wnt, is affected in the imaginal discs of l(2)gl4 and l(2)gd1 mutant individuals. In the tumourous wing imaginal discs from l(2)gl mutant larvae, the pattern of wingless expression was progressively disrupted with an increase in the area of expression, Tumourous wing imaginal discs from l(2)gd homozygous individuals exhibited progressive broadening and extension of the wingless expressing domains. We suggest that l(2)gl and l(2)gd might be involved in regulating post embryonic expression of Wingless.

Cell cycle and DNA content of mitotic cells in brain ganglia of Drosophila larvae.

The programmes of replication of hetero- and euchromatin regions, mitotic cell cycle and the DNA content in metaphases in brain ganglia from late third instar larvae of Drosophila melanogaster (wild type and a tumour bearing mutant, 1(2)gl, strain) and of Drosophila nasuta were examined by autoradiography of [3H]thymidine labelled (continuous or pulse) cells and by cytophotometry, respectively. Brain ganglia labelled continuously with [3H]thymidine for 24 h in vitro showed a significantly high proportion of cells with incorporation of radioactivity restricted to heterochromatin only. Pulse labelling of brain ganglia from larvae of Drosophila melanogaster and Drosophila nasuta followed by chase for different time intervals showed that (i) the frequency of labelled metaphases was more than 50% within 15 to 30 min of chase and remained higher than 50% in nearly all the chase samples till 24 h, (ii) euchromatin labelled metaphases appeared with a low frequency within 1 to 4 h chase period but the heterochromatin labelled metaphases continued to be more common in the later chase samples also, (iii) single chromatid labelled second cycle metaphases were seen within 1 to 4 h after the pulse, but their frequency did not increase in the later samples. Cytophotometry of feulgen-DNA and Hoechst 33258 stained metaphases in late third instar larval brain ganglia revealed a greater variation in the DNA content of individual metaphases, although the means were close to the expected 4 C content. It appears that in relation to the known asymmetric cell divisions of neuroblast and other neural cells, the mitotically active cells in brain ganglia comprise a heterogenous population with widely varying lengths of the different phases of cell cycle; some of them may not cycle regularly and may possibly have a discontinuous S-phase.

Micro-determination of fluoride by means of metallic sodium fusion and using fluoride-sensitive electrode.

A simple and accurate method to determine the content of fluoride in non-volatile organofluoro compounds or in biological samples has been developed. The method includes the metallic sodium fusion followed by quantitative estimation of fluoride using fluoride-sensitive electrode.

Effect of proteolytic digestion on the function of vesicular stomatitis virus ribonucleoprotein complex.

The nucleocapsid protein (49 Kd) of vesicular stomatitis virus is tightly bound to the genome rendering the latter transcriptionally competent. Controlled digestion with chymotrypsin removed a 12 Kd peptide from the complex. The resulting complex failed to serve as template for genome transcription in vitro when the polymerase components L and NS proteins were added. A template-associated protein kinase activity was also lost upon chymotrypsin treatment. However, the cleaved nucleocapsid protein (37 Kd) was still capable of binding tightly with the genome template and retained the epitope recognized by a monoclonal antibody. These results suggest that the nucleocapsid protein possesses separate domains that mediate binding to polymerase complex and maintain the structural integrity of the template.