Cardiovascular activity of the n-butanol fraction of the methanol extract of Loranthus ferrugineus Roxb

We investigated the vascular responses and the blood pressure reducing effects of different fractions obtained from the methanol extract of Loranthus ferrugineus Roxb. (F. Loranthaceae). By means of solvent-solvent extraction, L. ferrugineus methanol extract (LFME) was successively fractionated with chloroform, ethyl acetate and n-butanol. The ability of these LFME fractions to relax vascular smooth muscle against phenylephrine (PE)- and KCl-induced contractions in isolated rat aortic rings was determined. In another set of experiments, LFME fractions were tested for blood pressure lowering activity in anesthetized adult male Sprague-Dawley rats (250-300 g, 14-18 weeks). The n-butanol fraction of LFME (NBF-LFME) produced a significant concentration-dependent inhibition of PE- and KCl-induced aortic ring contractions compared to other fractions. Moreover, NBF-LFME had a significantly higher relaxant effect against PE- than against high K+-induced contractions. In anesthetized Sprague-Dawley rats, NBF-LFME significantly lowered blood pressure in a dose-dependent manner and with a relatively longer duration of action compared to the other fractions. HPLC, UV and IR spectra suggested the presence of terpenoid constituents in both LFME and NBF-LFME. Accordingly, we conclude that NBF-LFME is the most potent fraction producing a concentration-dependent relaxation in vascular smooth muscle in vitro and a dose-dependent blood pressure lowering activity in vivo. The cardiovascular effects of NBF-LFME are most likely attributable to its terpenoid content.

Bronchoscopic closure of bronchopleural fistula using gelfoam.

Management of a persistent bronchopleural fistula (BPF) can be a therapeutic challenge. The etiological factors responsible for BPF include pulmonary tuberculosis, post-thoracic resection surgeries, trauma, malignancy, necrotising infections and rupture of lung abscess. The immediate management of BPF is drainage of the pleural cavity with insertion of an intercostal drainage tube. Patients with BPF may also require surgical intervention in the form of a wedge resection or lobectomy or muscle flap surgery. We report a case of a peripheral BPF secondary to a bacterial infection, which was successfully managed by the instillation of gelfoam via flexible bronchoscopy.

Non-invasive respiratory monitoring in paediatric intensive care unit.

Monitoring respiratory function is important in a Paediatrics Intensive Care Unit (PICU), as majority of patients have cardio-respiratory problems. Non-invasive monitoring is convenient, accurate, and has minimal complications. Along with clinical monitoring, oxygen saturation using pulse oximetry, transcutaneous oxygenation (PtcO2) and transcutaneous PCO2 (PtcCO2) using transcutaneous monitors and end-tidal CO2 using capnography are important and routine measurements done in most PICUs. Considering the financial and maintenance constraints pulse oximetry with end tidal CO2 monitoring can be considered as most feasible.

Infantile mediastinal primary endodermal sinus tumour.

Primary extragonadal mediastinal endodermal sinus tumour is rare, and to date very few cases have been reported in the literature. We present here a case of rare extragonadal highly malignant commonest germ cell tumour in an infant who presented with a rapidly progressive mediastinal mass with dry non-productive cough, tachypnea without significant respiratory distress or toxicity.

Three sibs with mild variety of osteopetrosis.

We report three sibs with mild autosomal recessive variety of osteopetrosis. The prominent clinical features were short stature, malocclusion of teeth, hepatosplenomegaly and a typical facial appearance. The only atypical features were microcephaly, a normal upper segment to lower segment ratio and a normal arm span.

Neonatal mydriasis due to effects of atropine used for maternal Tik-20 poisoning.

A neonate was born to a mother who had consumed an organophosphorus(OPC) compound with suicidal intent. The mother was administered atropine and this caused mydriasis in the neonate without any other pharmacological effects. There was no evidence of placental dysfunction. There are no case reports of OPC consumed in pregnancy and its effect on neonates or of effects of massive doses of atropine in the mother and its effects on the fetus or the newborn.

Spectrum of pediatric urolithiasis in western India.

Of 1,211 patients with urolithiasis treated at this institution over a nine years period, there were 77 (6.4%) pediatric cases. The commonest age group was 6-10 years (55.8%). Male:female ratio was 7.6:1. Hindus constituted 72.7% of the patients. There was no significant seasonal variation. The commonest site was urinary bladder (67.5%). The upper: lower urinary tract stone ratio was 1:2.85. Majority belonged to the lower-middle or poor income groups having a cereal based diet with minimal or poor protein intake. The common constituents of stones were calcium (98.7%), oxalate (87%), phosphate (84.4%) and uric acid (76.6%). Of all these, uric acid had the richest concentration (grade of ++ or more) in 93.2%. Only 4 stones (5.2%) were "pure": calcium oxalate--3 and calcium phosphate--1; whereas 73 (94.8%) were mixed stones. Of these, 9 (11.7%) were "predominant" mixed stones, with only one constituent having rich concentration (grade of ++ or more) and all others being either trace or +. The rest 64 (83.1%) were "heterogenous" mixed stones having rich concentration of more than one constituent.