Perineural low dexamethasone dose as adjuvant in supraclavicular brachial plexus block for arteriovenous fistula creation in end stage renal disease: a randomized controlled trial

Abstract Background and aims: Dexamethasone as adjunct to local anesthetic solution improves the quality of brachial plexus block (BPB). However, evidence for its efficacy at low doses (< 4 mg) is lacking. This study was designed to evaluate the duration of analgesia attained with low dose dexamethasone as adjuvant to local anesthetic for creation of arteriovenous fistula (AVF) under BPB. Methods: Sixty-six patients scheduled for AVF creation were randomly allocated to receive either saline (control) or 2 mg dexamethasone, together with 0.5% ropivacaine and 0.2% lignocaine. The primary outcome was duration of analgesia, defined as time from performing the block to the first analgesic request. The secondary outcomes were time from injection to complete sensory block, time from injection to complete motor block, duration of motor block, postoperative analgesic consumption, and fistula patency at three months. Results: All the blocks were effective. In the group that received dexamethasone, the time to first analgesic request was significantly delayed (432 ± 43.8 minutes vs. 386.4 ± 40.2 minutes; p < 0.01). The onset of sensory and motor blockade occurred faster in dexamethasone group and overall analgesic consumption was also reduced. However, dexamethasone addition did not prolong the duration of motor block. There was no statistically significant difference in the patency of fistulas between the two groups at three months. (p = 0.34). Conclusion: Addition of low-dose perineural dexamethasone to local anesthetic solution significantly prolonged the duration of analgesia. Further trials are warranted to compare the adverse effects between dexamethasone doses of 4 mg and lower.

Management of complex fistula-in-ano by interception of fistula track with application of ksharasutra (IFTAK): a novel technique

Objective: Despite all the technological advances, successful management of complex fistula-in-ano is still a challenge due to recurrence and incontinence. The present study evaluates the outcomes of a novel technique, Interception of Fistula Track with Application of Ksharasutra (IFTAK) in terms of success rate and degree of incontinence. Methods: In the present prospective study, 300 patients with complex fistula-inano were treated by the IFTAK technique, whose surgical steps include: incision at the anterior or posterior midline perianal area, identification and interception of the fistulous track at the level of the external sphincter, rerouting the track (and extensions) at the site of interception, and application of a ksharasutra (medicated seton) in the proximal track (from the site of interception to the internal opening) that is laid open gradually, with the resulting wound healing with minimum scarring. The distal track is allowed to heal spontaneously. Results: There were 227 transsphincteric and 73 intersphincteric varieties of fistula with supralevator extension in 23 cases, of which 130 were recurrent fistulas, 29 had horseshoe track, while 25 had blind fistula with no cutaneous opening. The mean duration of the ksharasutra application was 8.11 ± 3.86 weeks with an overall success rate of 93.33% at the 1-year follow-up. A total of 3.67% of the cases reported with a mild impairment of continence on the Wexner incontinence scoring system. Pre- and postoperative anal manometry evaluation showed minimal reduction in median basal and squeeze pressures. Conclusion: The IFTAK technique is a minimally invasive, daycare surgical procedure for the management of complex fistula-in-ano with low recurrence and minimal sphincter damage. (AU)

Comparison of the efficacy and safety of topical timolol and oral propranolol for the treatment of Superficial Infantile Haemangiomas

Background: Infantile haemangiomas (IHs) are the most common vascular tumours of infancy. In recenttime oral propranolol has achieved great success in treating IHs. To minimize the systemic side events caused by oral propranolol, topical timolol started to be applied in the treatment of IHs, especially for superficial lesions. Methods: We treated 50 children with superficial IHs using oral propranolol on 25 patients and, topical timolol on 25 patients and investigated the efficacy and safety of the two treatment patterns. Results: Both oral propranolol and topical timolol achieved a satisfactory therapeutic outcome, with an effective response rate of 96 and 95.4%, respectively. No significant differences in visual analogy scale (VAS) improvement between the two groups were observed. Systemic adverse events for patients treated with oral propranolol (3.9%) was significantly higher than that for patients treated with topical timolol. Clinical response was not associated with gender, duration of treatment, lesion location, lesion size, and gestational age but closely associated with age at treatment initiation, which indicated that younger age at treatment initiation predicted for a better regression rate. Conclusion: Topical timolol could be the first-line therapy for superficial IHs because of its good efficacy and improved safety profile.

Supplemental nutrition for retinal health: Evidence based analysis of commercial preparations in India

Purpose: Antioxidants have been lately postulated as supportive and prophylactic supplements for various retinal disorders, especially age?related macular degeneration (AMD). Forty?eight brands of such supplements containing lutein and zeaxanthin are available in India. The aim of the study was to assess the market leaders in supplements for ophthalmology in view of AREDS recommendations. Methods: Descriptive review of top?selling supplements for eye health were compared to the contents of the AREDS?recommended levels. Results: None of the top 10 selling brands had exact or near similar composition as recommended in the AREDS?2 study, which is the most widely accepted level?1 evidence in AMD prevention. Conclusion: Physicians prescribing these antioxidants, especially for the prevention of advanced AMD, should be vigilant and aware of the contents of the prescribed brands.

Endovascular stenting with a drug-eluting stent of transplanted renal artery stenosis in a dual kidney transplanted patient / Tratamento endovascular com stent farmacológico em estenose de artéria renal transplantada de paciente com transplante renal duplo

Abstract Renal transplant remains the preferred therapy for end-stage renal disease (ESRD). Given the shortage of suitable donor kidneys, use of an expanded criteria donor (ECD) allows marginal kidneys to be transplanted; albeit at risk of increased graft failure due to lower nephron mass. To reduce the risk of graft failure, double kidney transplant (DKT) is advocated, with favorable outcomes. Transplant renal artery stenosis (TRAS) is one of the most common vascular complications following renal transplant. Unlike single kidney transplants, where TRAS usually presents with fluid overload, uncontrolled hypertension, and worsening kidney functions; it may be clinically silent in DKT patients since they have two functional transplanted kidneys. We hereby report a case of TRAS in a DKT patient who had 2 years of favorable clinical outcomes following successful endovascular stenting. He however recently died of COVID-19 associated pneumonitis.

Resumo O transplante renal continua sendo a terapia preferida para doenças renais em fase terminal. Dada a escassez de rins de doadores adequados, o doador com critérios expandidos permite que rins marginais sejam transplantados, embora haja um maior risco de falha do enxerto devido à diminuição da massa nefrótica. Para diminuir o risco de falha do enxerto, recomenda-se o transplante renal duplo (TRD), com resultados favoráveis. A estenose de artéria renal transplantada (EART) é uma das complicações vasculares mais comuns após o transplante renal. Ao contrário dos transplantes de rim simples, nos quais a EART geralmente se manifesta como sobrecarga de fluido, hipertensão descontrolada e piora das funções renais, ela pode ser clinicamente silenciosa em pacientes com TRD, pois eles têm dois rins funcionais transplantados. Relatamos aqui um caso de EART em um paciente com TRD que teve resultados clínicos favoráveis por dois anos após o sucesso do implante de stent endovascular. No entanto, ele morreu recentemente de pneumonite associada à covid-19.

Retroperitoneal iliac conduits as an alternative access site for endovascular aortic repair: a tertiary care center experience / Condutos ilíacos retroperitoneais como local de acesso alternativo para reparo endovascular de aneurisma: experiência em centro de atenção terciária

Abstract Background Retroperitoneal open iliac conduits (ROIC) are used in patients with hostile iliac anatomy undergoing endovascular aortic repair (EVAR). Objectives We hereby report our experience of ROIC in patients subjected to EVAR. Methods This was a retrospective evaluation of 8 patients out of a total of 75 patients (11%) who underwent EVAR in the last 10 years. Pre-procedure computed tomography angiography was used to assess the dimensions of iliac and femoral arteries. Patients who had small arterial dimensions (i.e. smaller than the recommended access size for the aortic endograft device) were subjected to ROIC. Results The mean age of the 3 males and 5 females studied was 45.7 ± 15.2 years. The indication for ROIC was the small caliber ilio-femoral access site in 7 patients and atherosclerotic disease in 1 patient. All external grafts were anastomosed to the right common iliac artery except one which was anastomosed to the aortic bifurcation site because of a small common iliac artery. The procedural success rate was 100%. Local access site complications included infection (n=1), retroperitoneal hematoma (n=1), and need for blood transfusion (n=3). The median post-intervention hospital stay was 10 days. All patients had favorable long-term outcomes at a median follow-up of 18 months. Conclusions Female patients require ROIC during EVAR more frequently. Adjunctive use of iliac conduit for EVAR was associated with favorable perioperative and short-term outcomes.

Resumo Contexto Os condutos ilíacos abertos retroperitoneais são utilizados em pacientes submetidos a reparo endovascular de aneurisma (REVA) com anatomia ilíaca hostil. Objetivos Relatamos a nossa experiência com os condutos ilíacos em pacientes submetidos a REVA. Métodos Trata-se de uma avaliação retrospectiva de oito pacientes, de um total de 75 (11%), os quais foram submetidos a REVA nos últimos 10 anos. Foi realizada angiotomografia computadorizada antes do procedimento para avaliar as dimensões das artérias ilíaca e femoral. Os pacientes com dimensões arteriais menores, abaixo do tamanho de acesso recomendado para o dispositivo de endoprótese aórtica, foram submetidos a condutos ilíacos. Resultados A média de idade dos participantes foi de 45,7±15,2 anos, sendo três do sexo masculino e cinco do sexo feminino. As indicações para condutos ilíacos foram local de acesso ilíaco femoral de pequeno calibre, para sete pacientes, e doença aterosclerótica, para um paciente. Todas as próteses externas foram anastomosadas na artéria ilíaca comum direita, com exceção de uma, que foi anastomosada no local da bifurcação aórtica por apresentar artéria ilíaca comum menor. A taxa de sucesso do procedimento foi de 100%. As complicações no local de acesso incluíram infecção (n = 1), hematoma retroperitoneal (n = 1) e necessidade de transfusão de sangue (n = 3). O tempo mediano de internação hospitalar pós-intervenção foi de 10 dias. Todos os pacientes apresentaram desfechos de longo prazo favoráveis no seguimento mediano de 18 meses. Conclusões As pacientes do sexo feminino necessitaram de condutos ilíacos durante REVA com maior frequência. O uso adjuvante de condutos ilíacos com REVA foi associado a desfechos perioperatórios e de curto prazo favoráveis.

Simultaneous endovascular revascularization of external iliac artery dissection and transplant renal artery stenosis in a recent renal allograft recipient / Revascularização endovascular simultânea de dissecção da artéria ilíaca externa e de estenose da artéria renal transplantada em receptor recente de aloenxerto renal

Abstract Various vascular complications following renal transplantation include renal artery and vein thrombosis, renal artery stenosis, pseudoaneurysm, and iliac artery dissection. Transplant renal artery stenosis (TRAS) is the most common, while iliac artery dissection is the rarest of these various vascular complications. We describe an elderly male, who had both external iliac artery dissection and TRAS at 2 months following renal transplantation. He underwent successful percutaneous endovascular intervention of both complications. The post-intervention course was uneventful, with improvement in graft renal functions and left lower limb perfusion.

Resumo As diversas complicações vasculares possíveis após um transplante renal incluem trombose da veia e artéria renais, estenose da artéria renal, pseudoaneurisma e dissecção da artéria ilíaca. Entre essas diversas complicações, a estenose da artéria renal transplantada é a mais comum, enquanto a dissecção da artéria ilíaca é a mais rara. Relatamos o caso de um homem idoso que desenvolveu tanto dissecção da artéria ilíaca quanto estenose da artéria renal transplantada 2 meses após transplante renal. As intervenções endovasculares percutâneas foram bem-sucedidas em ambas as complicações. O período pós-intervenção cursou sem complicações, com melhora na função renal do enxerto e na perfusão do membro inferior esquerdo.

Special emphasis on bone health management in prostate cancer patients: a prospective longitudinal study

ABSTRACT Introduction: Use of androgen deprivation therapy (ADT) in carcinoma prostate (CaP) has deleterious effect on bone mineral density (BMD) leading to increase incidence of osteoporosis and skeletal-related events. We evaluated bone health status and impact of bone-directed therapy (BDT) and ADT on BMD in these patients from Jan 2015-Dec 2018. Materials and Method: Baseline bone health was assessed using Tc-99 MDP Bone scan/ DEXA scan for patients on ADT. Monthly zoledronic acid (ZA) was given to high-risk candidates (T-score ≤2.5 or previous hip/vertebral fracture) or Skel et al. metastatic patients who were receiving ADT. Baseline and follow-up (at 12-months) BMD using DEXA scan at various sites (spine, femur total, femur neck and radius) and subjective improvement in bony pain using Numeric Pain Rating Score after administration of ZA were compared. Results: A total of 96-patients of locally advanced and metastatic prostate cancer receiving ADT with or without BDT were included in the study cohort. Mean age of presentation was 68.4±15.61 years. Median serum PSA was 32.2±13.1ng/mL. There was significant improvement in mean BMD (T-score) in 64-patients post ZA therapy at 12-months (at femoral total, femoral neck and spine; 0.95, 0.79 and 0.68, respectively) (p <0.05) while there was significant deterioration in mean BMD at 12-months (at spine, femoral neck and femoral total; −0.77, −0.55 and −0.66, respectively) in 32 patients who did not receive ZA and were on ADT (p <0.05). Pain scores significantly decreased in patients after 12-months of ZA use (−2.92±2.16, p <0.01). Conclusion: Bone-directed therapy (Zoledronic acid) leads to both subjective and objective improvement in bone health of prostate cancer patients on ADT.

Role of serum Vitamin-C and lipid profile in cardiovascular diseases patients of Southern Rajasthan

Background: Vitamin C's functions as an antioxidant and as an enzyme cofactor are well established, but the ways in which these functions may modify chronic disease risk are less well established. The belief that vitamin C may benefit heart health has stemmed from multiple pieces of evidence and lines of reasoning. Thus, we took the objective of this study to evaluate the correlations of serum concentrations of trace elements including vitamin-C with lipid profile parameters of adult men in Southern Rajasthan.Methods: Present study was conducted in Cardiology and Biochemistry Department in GMCH, Udaipur during the year 2019. A total of 150 MI cases/controls were selected. Blood sample was collected by vein puncture using an aseptic technique. The blood was allowed to settle at 37ºC and then centrifuged at 3000 rpm for 15 min. Serum was then separated and stored at -20ºC until analysis. Vitamin C by NATELSON method on colorimeter.Results: The study cases had significantly higher lipid values than those of controls (p<0.001). In cases the vitamin-C levels were significantly low than the controls. There was significant difference in lipid levels among smokers and nonsmokers. When vitamin C levels were compared there was no statistically significant difference in their levels. There was no significant correlation between serum vitamin C levels and Lipids.Conclusions: The physical characteristics such as diet, residence, smokers, non-smokers, showed significant difference in the controls and cases. Women seemed to have higher proportion of lipid abnormality than men. It is concluded from this study that lower levels of ascorbic acid definitely increase the risk of cardiovascular disease and inclusion of ascorbic acid in the normal diet will control the level of lipids.

Role of serum copper and lipid profile in cardiovascular diseases patients of Southern Rajasthan

Background: It is clear that deficiencies of some trace elements cause marked alterations in lipid and lipoprotein metabolism. The mechanisms of their effects are not completely obvious and inspite of intense research, the role of these microelements need further elucidation. Thus, the objective of this study is to evaluate the correlations of serum concentrations of trace elements including copper with lipid profile parameters of adult men in Southern Rajasthan.Methods: Present study was conducted in Cardiology and Biochemistry Department in GMCH, Udaipur during the year 2019. A total of 150 MI cases/controls were selected. Blood sample was collected by vein puncture using an aseptic technique. The blood was allowed to settle at 37ºC and then centrifuged at 3000 rpm for 15 min. Serum was then separated and stored at -20ºC until analysis.Results: The study cases had significantly higher lipid values than those of controls (p<0.001). In cases the copper levels are higher than the controls. Copper levels were more in males 95.40±18.93 than in females 86.93±14.54 (p<0.05). Lipid levels were higher in urban population related to rural, TC (238.47 V/s 266.59), TG (219.83 V/s 202.40), HDL (64.39 V/s 54.19) and LDL (131.28 V/s 139.48) (p<0.05). Significant negative correlation was seen in study group between serum copper levels and TC (r=-0.288, p<0.05), TG (r =-0.236, p<0.05), HDL (r=-0.946, p<0.05) and VLDL levels (r=0.102, p<0.05). This indicates that as copper level reduces lipids increases.Conclusions:Our findings indicate the possible effect of Cu level in serum lipid profile and this effect may be due to the role of Cu as an antioxidant. The correlations between the serum concentrations of trace elements with lipid profile in physiological concentrations may not be the same as the changes observed during deficiencies of the trace elements as in hyperlipidemic patients

Knowledge, Awareness And Perception Of Fluorosis Among Families Residing In Fluorotic Endemic Areas In North Gujarat After Receiving Dharoi Water Supply As Mitigation Measure To Curb Fluorosis.

Introduction:Endemic fluorosis remains a challenging and extensively studied national health problem in India. It not only affects the body of a person but also renders them socially, economically and culturally crippled.Objectives:The purpose of this study was to assess the awareness, knowledge and perception regarding water quality, socioeconomic and clinical aspect of Dental and skeletal fluorosis among families residing in endemic areas for Fluorosis in North Gujarat after receiving Dharoi water supply as mitigation measure to curb fluorosis. Methods:Apopulation based survey was done in hundred families of the ten villages of North Gujarat which were selected through Random Sampling techniqueResults:Around 100 families including 473 members were surveyed. Only 8 families have awareness about Fluorosis and 53% of families strongly agree that the water causes ugly teeth and joint pain. Nearly 89% and about 80% of families had agreed that skeletal Fluorosis severely reduced the capacity for work and earning income and Dental Fluorosis reduces self-confidence, especially in girls respectively. Around 70% of families responded that, there is no relief in joint and back pain at all after using Dharoi water supply. Conclusion:It can be concluded that Fluorosis is a major Public Health problem in these ten villages of North Gujarat affecting people physically, socially and economically, even after the introduction of Dharoi water supply. It can be attributed to irregular and insufficient utilization of Dharoi water supply along with various myths and ostentations attached to usage of this water.

A prospective study on tubercular fistula in ano and its management / Estudo prospectivo sobre a fístula anal tuberculosa e seu tratamento

Abstract Objective Tuberculosis fistula in ano, though less encountered, is an important clinical entity in developing countries like India. Diagnosis of TB fistula is a challenge despite of advances in diagnostic modalities and it depends upon both local and systemic clinical presentation. This prospective study aimed at to substantiate the importance of clinical diagnosis as well as medical management of tubercular fistula by antitubercular drugs. Methods and results 25 patients of fistula in ano suspected to be of tubercular origin underwent histopathology of fistulous tracks and an 8 week therapeutic trial of antitubercular treatment after getting an informed consent. Though biopsy showed positive evidence of tubercular pathology only in 52% cases, therapeutic trial showed improvement in local and systemic features in 23 (92%) cases. Of these 23 cases, 3 were cured after 18 months of anti tubercular treatment and 18 showed cure after 24 months of anti tubercular treatment while 2 cases withdrew from the study at 12 and 14 months respectively due to adverse drug reactions though their fistulous symptoms were relieved. Conclusion Meticulous clinical evaluation plays a vital role in diagnosis of tubercular fistula in addition to other diagnostic methods. Anti tubercular treatment is the mainstay of treatment in tubercular fistula with a minimum duration of 18-24 months owing to the recurrent and relapsing nature of disease.

Resumo Objetivo A fístula anal da tuberculose (TB), embora menos observada, constitui entidade clínica importante em países em desenvolvimento, como a Índia. O diagnóstico de fístula TB é tarefa desafiadora, apesar dos avanços nas modalidades diagnósticas; seu estabelecimento depende tanto da apresentação clínica local, como da apresentação sistêmica. Esse estudo prospectivo teve por objetivo consubstanciar a importância do diagnóstico clínico e também do tratamento clínico da fístula TB com medicamentos contra tuberculose. Métodos e resultados Foi realizado estudo histopatológico de tratos fistulosos em 25 pacientes com fístula anal com suspeita de origem tuberculosa; depois de obtido o consentimento livre e informado, esses pacientes foram submetidos a tratamento anti-tuberculose (TAT) durante 8 semanas. Embora a biópsia tenha revelado evidência positiva de patologia tuberculosa em apenas 52% dos casos, o curso terapêutico resultou em melhora nos aspectos local e sistêmico em 23 (92%) pacientes. Desses 23 casos, 3 e 18 casos estavam curados após 18 e 24 meses de TAT, respectivamente, enquanto que 2 pacientes desistiram do estudo após 12 e 14 meses, respectivamente, em decorrência de reações farmacológicas adversas, mesmo diante do alívio de seus sintomas fistulosos. Conclusão Juntamente com outros métodos diagnósticos, uma avaliação clínica meticulosa desempenha papel vital no diagnóstico da fístula TB. TAT é o principal procedimento terapêutico em pacientes com fístula TB, com duração mínima de 18-24 meses devido à natureza recorrente e recidivante da doença.

Cementoblastoma a Rare Odontogenic Tumor - A Case Report and Differential Diagnosis.

Cementoblastoma is a rare odontogenic tumor derived from the odontogenic mesenchymal tissues. It has distinct clinical, radiographical, and histological features that aid in correct diagnosis. This article presented a case of 35-year-old female patient with pain and swelling in the right cheek region. Radiographic examination was suggestive of benign cementoblastoma in relation to unerupted right maxillary third molar. The tumor was surgically removed along with tooth, and the diagnosis of cementoblastoma was confirmed by histopathology examination.

Assessment of health-related activities of non-governmental organizations in Rajasthan, India.

Public–private partnerships are being encouraged as a part of the comprehensive development framework. We assessed the work profiles of registered non-governmental organizations (NGO) working on health-related activities in Udaipur district, Rajasthan, India by conducting a 16-item pretested questionnaire study. The questions related to various facets of their activities, their scope and process of evaluation. Of the 66 NGOs selected, most (28 [42%]) were working among the general population and had a partnership with a public entity (43 [65.1%]). The running capital of most NGOs (27 [41%]) was `100 000–2 000 000. Only 25 (38%) had a monitoring system to evaluate their progress. There are immense opportunities for NGOs in the health sector in Udaipur. The need of the hour is to encourage various public and private institutions to work together to achieve excellence in healthcare and service delivery. Natl Med J India 2016;29:163–5

A study of correlation between iron deficiency anaemia and serum lipid profile in Indian adults in BRIMS, Bidar.

Both iron deficiency anemia and dyslipidaemia are widely prevalent public health problems, especially in the Indian population. Some link has been suggested between the two potentially morbid conditions but a sufficient Indian study could not be found in this regard. Methods: This study was planned to find the changes in serum lipid profile in adult Indian patients with iron deficiency anemia and the effect of oral iron therapy on them. 100 iron deficiency anemia and 70 age and sex matched healthy controls, in the age group 18-35 years were investigated for any possible changes in serum lipid profile i.e., triglycerides, total cholesterol, high density lipoprotein cholesterol, very low density lipoprotein cholesterol. The patients were followed up after 3 months of oral iron therapy. Results: The results are shown as mean± standard deviation. Triglycerides and very low density lipoprotein cholesterol levels were found to be significantly (P <0.001) elevated in the iron deficiency anemia group (151.87 ± 48.06 mg/dl and 30.40 ± 9.71 mg/dl) as compared to controls (109.99 ± 30.81 mg/dl and 21.96 ± 6.69 mg/dl), whereas level of low density lipoprotein cholesterol were found to be significantly (P = 0.02) lower in patients (90.96 ± 41.55 mg/dl) as compared to controls (105.24 ± 26.45 mg/dl). However, after treatment (in 43 patients) there was significant (P <0.001) reduction in the levels of triglycerides and very low density lipoprotein cholesterol (111.56 ± 26.87 mg/dl and 22.30 ± 5.36 mg/dl) when compared to their pretreatment level (154.70 ± 53.89 mg/dl and 30.93 ± 10.84 mg/dl), whereas low density lipoprotein cholesterol levels did not show any significant change. Conclusion: These findings indicate that iron deficiency anemia in Indian adults is attended by abnormal serum lipid profile, which responds significantly to iron therapy.

Effects of triamcinolone acetonide on human trabecular meshwork cells in vitro.

Aim: To study the effects of triamcinolone acetonide (TA) on cultured human trabecular meshwork (HTM) cells. Materials and Methods: HTM cells were cultured and treated with 125, 250, 500 and 1000 μg/mL concentration of TA for 24 h. The cells were treated with both crystalline TA (TA‑C) (commercial preparation) and solubilized TA (TA‑S). Cell viability was measured by a trypan blue dye exclusion test. The activity of caspse‑3/7 was measured by a fluorescence caspase kit and DNA laddering was evaluated by electrophoresis on 3% agarose gel. Levels of lactate dehydrogenase (LDH) were assessed with LDH cytotoxicity assay kit‑II. Results: Mean cell viabilities of HTM cells after 24 h exposure to TA‑C 125, 250, 500, and 1000 μg/mL were 75.4 ±2.45% (P < 0.0001), 49.43 ± 1.85% (P < 0.0001), 17.07 ± 2.39% (P < 0.0001), and 3.7 ± 0.9% (P < 0.0001), respectively, compared with the untreated HTM cells 92.49 ± 1.21%. The mean cell viabilities with 125, 250, 500, and 1000 μg/mL of TA‑S were 94.47 ± 1.60% (P > 0.05), 90.13 ± 0.40% (P < 0.01), 85.57 ± 0.47% (P < 0.001), and 71.67 ± 3.30% (P < 0.0001), respectively, compared to DMSO‑equivalent cultures. Untreated HTM control had a cell viability of 96.57 ± 1.98%. DMSO‑treated controls of 125, 250, 500, and 1000 μg/mL had a cell viability of 94.73 ± 0.57%, 96.97 ± 1.08%, 93.97 ± 1.85%, and 97.27 ± 1.15%, respectively. There was no increase of caspase‑3/7 activity in cultures treated with either TA‑C or TA‑S. DNA laddering showed no bands in the TA‑C or TA‑S treated cultures. There were significantly higher LDH release rates at all concentrations of TA‑C compared to TA‑S. Conclusions: Results show that the effect of TA‑C and TA‑S on HTM cells is due to cell death by necrosis at all concentrations except 125 μg/mL of TA‑S. Elevated levels of LDH confirmed necrotic cell death. Our study also infers the relative safety of TA‑S over TA‑C.

Effect of bevacizumab (Avastin™) on mitochondrial function of in vitro retinal pigment epithelial, neurosensory retinal and microvascular endothelial cells.

Purpose: To evaluate the effect of bevacizumab on the mitochondrial function of human retinal pigment epithelial (ARPE‑19), rat neurosensory retinal (R28) and human microvascular endothelial (HMVEC) cells in culture. Materials and Methods: ARPE‑19 and R28 cells were treated with 0.125, 0.25, 0.50 and 1 mg/ml of bevacizumab. The HMVEC cultures were treated with 0.125, 0.25, 0.50 and 1 mg/ml of bevacizumab or 1 mg/ml of immunoglobulin G (control). Mitochondrial function assessed by mitochondrial dehydrogenase activity (MDA) was determined using the WST‑1 assay. Results: Bevacizumab doses of 0.125 to 1 mg/ml for 5 days did not significantly affect the MDA of ARPE‑19 cells. Bevacizumab treatment at 0.125 and 0.25 mg/ml (clinical dose) did not significantly affect the MDA of R28 cells; however, 0.50 and 1 mg/ml doses significantly reduced the R28 cell mitochondrial function. All doses of bevacizumab significantly reduced the MDA of proliferating and non‑proliferating HMVEC. Conclusion: Bevacizumab exposure for 5 days was safe at clinical doses in both ARPE‑19 and R28 retinal neurosensory cells in culture. By contrast, bevacizumab exposure at all doses show a significant dose‑dependent decrease in mitochondrial activity in both the proliferating and non‑proliferating HMVEC in vitro. This suggests a selective action of bevacizumab on endothelial cells at clinical doses.

Evaluation of Cardioprotective Activity of Aqueous and Ethanolic Extract of Bauhinia Variegata in Cacl2 Induced Arrhythmia in Albino Rats.

The aim of present study was to evaluate cardioprotective activity of ethanolic and aqueous extracts of Bauhinia variegata Linn in CaCl2 induced arrhythmia in albino rats.In present study, i.v injection of 5% CaCl2 solution (25 mg/kg b.w.) that induce arrhythmia without causing mortality and heart rates were monitored throughout the study by a lead II electrocardiogram. CaCl2 reduced heart rate and exhibited alteration in the PQRST waves. Arrhythmia induced by CaCl2 in experimental animals, which is confirmed by change in ECG pattern and sodium, potassium and calcium level in plasma. Pretreatment of extracts prevent the CaCl2 induced arrhythmia by virtue of the potent active constituents. Bauhinia variegata Linn. root extracts produced significantly (P<0.05) antiarrhythmic activity. These finding might be helpful to understand the beneficial effect of extracts against CaCl2 induced arrhythmia. Further study is need to confirm their mechanisms.