Enhancement of mangiferin by fungal endophytes isolated from Salacia chinensis L. and Salacia oblonga Wall.

Microbes residing in the internal tissues of a plant are called endophytes, and are known for producing phytochemicals such as taxol, podophyllotoxin, azadirachtin and vinca alkaloids. In this study, out of five isolates from Salacia species, two fungi Penicillium capsulatum and Aspergillus fumigatus have been evaluated and confirmed by polymerase chain reaction (PCR) amplification for their endophytic action to produce mangiferin. Mangiferin has been reported to possess protective properties, including antioxidant, antidiabetic and immunomodulatory. It has been reported that the content of mangiferin is 7-9% in Mangifera indica, and is also present in other plants like Swertia chirata, Salacia chinensis, and Hypericum aucheri. Therefore, an attempt was made to explore the biotechnological approach and regulation studies to increase the production of mangiferin in S. chinensis and S. oblonga. Endophytes were isolated, screened, and analyzed, to evaluate the mangiferin in fungal extracts in comparison with crude plant extracts. An HPLC analysis was used to determine the mangiferin content present in the fungal extract of S. chinensis stem (74.74 g/mL), followed by fungi extracts of S. oblonga root (33.75 g/mL) and S. chinensis root (30.50 g/mL), compared with the plant extracts. These results were confirmed by FTIR analyses

An encounter with alobar holoprosencephaly: a case report

Alobar holopresencephaly is a rare embryonic condition where there is anomalous fusion of cerebral hemispheres. The key features include neurological impairment and facial dysmorphism like cyclopia, ocular hypertelorism with divided orbits and a proboscis. Obstetric ultrasound and foetal MRI are the diagnostic modalities. Majority of cases are sporadic in origin while a genetic association is also described. A small recurrence risk is noted in cases with sporadic origin. Early diagnosis and pregnancy termination are advisable for the condition since the survival rate is very low.

Parametrial hydatid cyst with cystovesical fistula: a rare presentation

Hydatid disease is a parasitic infestation by a tapeworm of the genus Echinococcus. Theoretically, echinococcosis can involve any organ. The liver is the most common organ involved, followed by the lungs. However, uterus and and adnexa have an incidence of 0.5-1%. Till date, three cases have been reported in which a parametrial hydatid cyst formed a bladder fistula. A 57 year old female was admitted with complaint of burning micturition along with white coloured urine for the last 15-20 days with no other significant history. On examination and evaluation, it was suspected to a neoplastic pelvic mass causing gross right sided hydronephrosis. All biochemical markers were within normal limits. The patient was explored surgically on which a thick-walled lesion was found in right parametrium. The cavity of the lesion was filled with daughter hydatid cyst, along with communication into the bladder via a fistula. Open cystectomy was done after evacuation of daughter cysts and irrigation with scolicidal agents. The fistula was repaired. The patient recovered uneventfully and was doing well on follow-up. The incidence of hydatid cysts in the female reproductive system is very low and constitutes less than 0.5% of all hydatid cysts. However, rare cases have been reported, thus the clinician must be aware of this rare disease and should take precautions while operating, as any spillage may lead to anaphylactic shock.

A study on the awareness and practice of medical education technologies among medical college teachers

Background: Globally there is a move to reorient the medical education to suit the needs of the developing nations. Medical Council of India has made it is mandatory that all faculty need to attend Basic course in Medical Education Technologies (MET) to improve teaching effectiveness. In spite of their efforts in this regard many of the faculty is still unaware of this initiative and those who have already attended the course are not effectively practicing it. This study aimed at assessing level of awareness and practice of medical education technologies among the teaching faculty.Methods: Data was collected from the faculty by personal interviews using a validated semi-structured questionnaire and analysed using SPSS.Results: 219 faculty members participated in the study working in 26 departments. Mean age of faculty was 40.98 (SD: 12.36). 57.1% of them were males and 42.9% were females. The level of awareness among study participants about learning process related medical education technologies ranged from 57% (for psychomotor domain) to 74% (for setting up of educational objectives). The awareness and practice of ‘teaching process’ and assessment process related medical education technologies remained low. No statistically significant association was obtained between awareness and practice of SLO, Microteaching, and MiniCEX.Conclusions: Majority of teachers remain untrained in the medical education technologies at the time of the study. Of the non-clinical compared to the clinical stream of teachers, greater proportion of teachers in non-clinical section have been trained. The awareness and practice of ‘medical education technologies’ remain low among the study participants.

A rare case of endometriosis to clear cell ovarian carcinoma: a case report

Clear cell carcinoma of ovary is a rare tumour with a very low incidence in pregnancy. It is attributed to develop from an existing background of endometriosis. There are very few case reports of the above combination tumours in pregnancy. It is a very aggressive tumour with a worse prognosis and low survival rate because of its peculiar chemo resistant nature. Early detection and effective treatment are the best approach. The treatment options for advanced stages are still under research.

Decision to delivery interval in emergency LSCS and its impact on fetal outcome

Background: Emergency LSCS can be categorized based on RCOG guidelines into category I and II which indicates maternal or fetal compromise. Here an urgent delivery and the DDI (decision to delivery interval) within 30 and 45 minutes respectively is needed.Methods: This is a retrospective cross-sectional analysis conducted on a sample of 630 patients who underwent caesarean section over a year, from June 2016 to June 2017. The DDI were further classified into ≤30 and >30 minutes for category I, ≤45 and >45 minutes for category II LSCS. The primary objective is to determine whether DDI in Category I and II emergency LSCS has an impact on fetal outcome and secondary objective is to ensure that DDI is within the standard criterion as per RCOG protocol.Results: Out of 630 samples of caesareans, it was found that 173 falls in Category I and 189 falls in Category II. Out of 87 (50.29%) patients delivered within 30 minutes in Category I, 29 babies required NICU admission. DDI was more than 30 minutes in 86 (49.71%) cases in Category I out of which 38 babies got admitted in NICU with low APGAR scores. Out of 176 (93.12%) patients who delivered within 45 minutes in Category II, 56 babies required NICU admission. DDI was more than 45 minutes in 13 (6.88%) cases in Category II and all these babies got admitted in NICU.Conclusions: Decision -delivery interval has a significant impact on fetal outcome.

Prevalence of primary drug resistance to rifampicin and isoniazid in newly diagnosed sputum smear positive pulmonary Tuberculosis

Background: To determine the prevalence of primary drug resistance to either rifampicin or isoniazid alone or both in newly diagnosed sputum smear positive pulmonary tuberculosis patients.Method: A prospective study 100 newly diagnosed sputum smear positive pulmonary TB patients was conducted. The patients with an age of ≥15 years and who had either not taken anti TB treatment or who had taken ATT for less than 1 month were enrolled in this study. Two sputum samples (5ml each), including one early morning sample as per the RNTCP guidelines were collected and subjected to line probe assay (LPA).Results: Out of 100 cases 6 were having resistance to both rifampicin and isoniazid, 9 has resistance to INH alone and 1 had resistance to rifampicin alone.Conclusion: The prevalence of primary drug resistance is high. For early and rapid detection of DR-TB newer modality should be used  for the detection of primary drug resistance in sputum smear positive TB patients.

Analysis of physicochemical and sensory parameters of wine produced from Carica papaya

Wine is one of the most ancient beverages and it consists of a complex mixture of alcohol, sugars, aldehydes,tannins, pectins, vitamins, minerals, and organic acids formed by the action of Saccharomyces cerevisiae onfruit juices. Papaya (Carica papaya) is a common plant originally from South America and grown mainly inAsian and African countries. In the present study, C. papaya fruit pulp was used for the production of wineunder controlled fermentation using S. cerevisiae. The physicochemical parameters such as pH, yeast cellcount, specific gravity, carotenoid content, and alcohol content were observed during the study. The analysiswas done once every 5 days. Fourier Transform Infrared Spectroscopy analyses of wine and unfermented fruitjuice samples also were carried out. During fermentation, the pH was changed from 5.1 to 4.4. The initial valueof yeast cell count during the fermentation process was 8.5×106 cells/ml, later it attained the maximum valueof 9.53×106 cells per ml on the 5th day. It then gradually decreased to a final value of 2.92×106 cells/ml on the20th day. The specific gravity was initially 1.1573 and it decreased to 1.1483. Carotenoid content was 0.034mg/ml on the first day and it increased to 0.279 mg/ml. Alcohol content of papaya was found to be increasedduring the course of fermentation. It was estimated as 3.01% on the 5th day and it increased to 10.11% on the20th day. The overall point for the sensory analysis was 4.8.

A study to assess the knowledge and attitude of adolescents towards obesity in a private school in Thrissur district Kerala, India

Background: Overweight and obesity are 5th leading risks for global deaths. Adolescence is a transitional period, which requires special attention. Prevalence of overweight and obesity among children and adolescents has widely increased world-wide, making it one of the most common chronic disorders in this age group. To assess knowledge and attitude of adolescents towards obesity and to assess its associated factors.Methods: This was a descriptive cross sectional study conducted among students of classes 9, 10, 11 and 12 in Devamatha public school, Thrissur from May to November 2018. In total there were 179 students. A pretested self administered questionnaire was used to collect data.Results: 46.4% of adolescents had low knowledge on obesity, 46.9 have moderate knowledge, and only 6.7% of them had high knowledge on obesity. 24.6% of adolescents have negative attitude towards obese individuals, 68.2% had neutral attitude and only 7.3% had positive attitude towards obesity. As the age increases, there is increase in knowledge about obesity and positive attitude towards obese individuals. Both knowledge and attitude is better in children belonging to Christian families. Better knowledge and attitude is seen among students who are hostlers than day scholars. Children with better marks in annual exam had better knowledge and attitude towards obesity. Children who had positive family history for obesity have better knowledge and attitude towards obesity.Conclusions: There is a need for targeted activities to improve the knowledge and attitude of the students towards obesity.

Study of placental location and pregnancy outcome

Background: Placental location can be estimated easily using ultrasonogram by 16 weeks. It can be classified based on its location into central and lateral. Central can be anterior or posterior. Lateral can be left lateral or right lateral. Placental location has been attributed to both normal and abnormal pregnancy and neonatal outcomes.Methods: This is a prospective cohort study conducted in the department of Obstetrics and Gynecology which comprised of 450 singleton gestations between 18 and 24 weeks. The primary objective is to determine the association between placental location and pregnancy outcome and secondary objective is to find out the association between placental location and neonatal outcome. The study population was divided into two groups – central and lateral. Results were analyzed using SPSS version 20, Chi square test and independent two sample t-test.Results: The frequency of central placenta was 377 (83.8%) and lateral placenta in 73 (16.2%). Central placentation had an abnormal outcome in 182(48.3%), lateral placentas with abnormal outcome were 44(60.3%). Abnormal maternal outcomes like hypertensive disorders (33.3%), Intra Uterine Growth Restriction (10.2%), Antepartum haemorrhage (25%), Preterm birth (16.3%) were more in lateral placentation. The number of central placentas having NICU admissions were 62(16.4%) and lateral placenta with NICU admissions were 19(26%).Conclusions: There is a significant association between lateral placentation and abnormal pregnancy and neonatal outcomes. Second trimester ultrasound can be used as non-invasive predictor of adverse pregnancy and neonatal outcomes.

Perceived stress and coping strategies among post graduate students of a medical college in Thrissur, Kerala

Background: Medical education is inherently demanding and stressful. Stress is an external constraint which upsets an individual both mentally and physically. The postgraduate students suffer from higher stress that definitely affects the mental wellbeing of these students. Stressors faced by post graduate students include time pressure to meet deadlines, large amount of content to be learnt, work overload, unfair assessment by superior, fears of making mistakes that can lead to serious consequences, work demands affecting personal and home life. Objectives of the study were to assess the perception of stress amongst post graduate medical students and to assess various coping strategies employed by them.Methods: Predesigned, pretested, validated, self-administered, structured questionnaires were used for data collection over a period of two months. The Perceived Stress Scale (PSS) was used for measuring the perception of stress. Brief COPE inventory was used to assess the various coping strategies medical students use to deal with the stresses in their life.Results: One fourths of the study subjects (25%) were under high stress while 68.3% of the students were under moderate stress. Use of emotional support, self-distraction and venting were the common coping strategies employed.Conclusions: The prevalence of perceived stress seems to be high among post graduate medical students. Review of academics and exam schedules, more leisure time activities, advisory services and peer counseling at the campus could do a lot to reduce the stress.

A study on mosquito density in rural Kerala before and after floods

Background: Mosquito borne diseases are a major public health problem in Kerala. Mosquito density assessed by larval surveys is easier and quicker to perform. The larval indices are an important practical predictor of outbreaks of mosquito borne disease and are valuable in taking preventive measures. This study is done to calculate standardized larval indices namely house index, container index and Breteau index and to identify the major breeding sources of mosquitoes in the residential environment in a rural of Thrissur, Kerala.Methods: A cross-sectional study selecting 80 houses from 1 wards of Konnikara village under Thrikkur Panchayath under the field practice area of rural training centre, Amala Institute of Medical Sciences Thrissur. Every water holding container indoors and outdoors was counted and searched for larval presence and noted on a pretested format.Results: In this study, 80 houses were surveyed in 2 days initially in June and in September. All the entomological indices were found to be above the critical level in the initial survey in June. House index=36% container index=44%; Breteau index=143% showing high chances for outbreaks of mosquito borne diseases. In September though the indices were very low house index 1.25% container index 2.77% and Breteau index.Conclusions: The area is prone for mosquito borne disease outbreaks like dengue fever and after interventions the vector indices and potential risks came down

Swyer-James-Macleod Syndrome: A Rare Entity.

Swyer-James-MacLeod syndrome is a radiological entity characterised by hyperlucency of one or more lobes or of the entire lung associated with decreased number and diameter of ipsilateral peripheral pulmonary vessels resulting in difficult visibility of the arterial network, and unobstructed bronchial system. We report the case of a 12-year-old girl who presented with chief complaint of pain in the chest. Chest radiograph (postero-anterior view) showed hyperlucent left lung field with increased lung volume and shift of the mediastinum to the right side. Contrast-enhanced computed tomography (CECT) of the chest showed hyperlucency and diminished vascularity in the upper lobe and lingula of left lung with hyperinflation of the pulmonary parenchyma. On the basis of clinical and radiological findings, the patient was diagnosed to have Swyer-James-MacLeod syndrome.

Mannitol versus hypertonic saline for brain relaxation in patients undergoing craniotomy

BACKGROUND: Patients with brain tumour usually suffer from increased pressure in the skull due to swelling of brain tissue. A swollen brain renders surgical removal of the brain tumour difficult. To ease surgical tumour removal, measures are taken to reduce brain swelling, often referred to as brain relaxation. Brain relaxation can be achieved with intravenous fluids such as mannitol or hypertonic saline. This review was conducted to find out which of the two fluids may have a greater impact on brain relaxation. OBJECTIVES: To compare the effects of mannitol versus those of hypertonic saline on intraoperative brain relaxation in patients undergoing craniotomy. METHODS: Search methods: We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (2013, Issue 10), Medline via Ovid SP (1966 to October 2013) and Embase via Ovid SP (1980 to October 2013). We also searched specific websites, such as www.indmed.nic.in, www.cochrane-sadcct.org and www.Clinicaltrials.gov. Selection criteria: We included randomized controlled trials (RCTs) that compared the use of hypertonic saline versus mannitol for brain relaxation. We also included studies in which any other method used for intraoperative brain relaxation was compared with mannitol or hypertonic saline. Primary outcomes were longest follow-up mortality, Glasgow Outcome Scale score at three months and any adverse events related to mannitol or hypertonic saline. Secondary outcomes were intraoperative brain relaxation, intensive care unit (ICU) stay, hospital stay and quality of life. Data collection and analysis: We used standardized methods for conducting a systematic review, as described by the Cochrane Handbook for Systematic Reviews of Interventions. Two review authors independently extracted details of trial methodology and outcome data from reports of all trials considered eligible for inclusion. All analyses were made on an intention-to-treat basis. We used a fixed-effect ...

Establishment of an in vitro plantlet regeneration protocol for unique varieties of brinjal (Solanum melongena L.) var. Mattu Gulla and Perampalli Gulla.

Brinjal (Solanum melongena L.) var. Mattu Gulla (MG) and var. Perampalli Gulla (PG) are unique varieties with distinct flavour cultivated in Udupi, Karnataka State, and are exposed to several biotic and abiotic stresses. An efficient and reproducible in vitro regeneration method is required to expedite the manipulation of these brinjal varieties to cope up with stress by tissue culture and gene transfer methods. The present study, reports a rapid and efficient in vitro regeneration protocol for these two varieties. The in vitro growth response was studied on Murashige and Skoog (MS) medium supplemented with 2, 4-D, BAP and IAA, and the plantlets were regenerated efficiently from callus cultures of leaf, cotyledon and hypocotyl explants. Among the three explants, the hypocotyl explants were found to have better callus induction and multiple shoot regeneration. High frequency of shoot initiation was achieved from hypocotyl derived calluses in MS media with 2.0 mg/L BAP and 0.5 mg/L IAA in MG and PG. Efficient and rapid shoot proliferation, and elongation were noted in MS medium with 1.0 mg/L BAP and 0.3 mg/L GA3. The in vitro regenerated shoots produced healthy roots when they were cultured on MS medium supplemented with 0.5 mg/L IBA. A significant difference was observed in percentage of callus induction, number of shoots per callus, shoot elongation and number of hardened plantlets of MG and PG. MG showed maximum response in all stages of culture than PG. Hardening of plantlets in tissue culture was achieved in three weeks. The hardened plantlets were grown in pots for further acclimatization in green house and finally transplanted to experimental garden where they developed into flowering plants and produced mature fruits with viable seeds.

A preliminary examination of the phytochemical profile of Azolla microphylla with respect to Seasons

Objective: To evaluate the role of seasons on the phytochemical properties of Azolla microphylla.Methods:Dried and powdered leaves (50g) were extracted with 300 ml of methanol using soxhlet extractor for 16 h at a temperature not exceeding the boiling point of the solvent. Standard methods have been used to screen the phytochemical constituents. Conclusions: From the observations it can be concluded that the plant extracts show the presence of several bioactive compounds which could be exploited further.

Antibacterial and antifungal studies of various extracts of chiorophytum borivilianum leaves

Five different crude extracts viz, petroleum ether, chloroform, ethyl ether, ethanol and aqueous extract of Chiorophytum borivilianum have been studied for both in vitro antibacterial and antifungal activities. The different extracts showed remarkable inhibitory action against various gram positive and gram negative bacteria and two fungal species

Rapid detection and characterization of chikungunya virus by RT-PCR in febrile patients from Kerala, India.

There has been a resurgence and prevalence of fever with symptoms of Chikungunya (CHIK) and increased death toll in Kerala, the southern-most state of India. The objective of this study was to develop a rapid detection method to determine the presence of CHIK- virus in the serum samples collected from febrile patients in Kerala, India. Serum specimens were analyzed for CHIK viral RNA by RT-PCR using primers specific for nsP1 and E1 genes. Five out of twenty clinical samples were positive for CHIK virus. The partial sequences of the E1 and nsP1 genes of the strain, IndKL01 were highly similar to the Reunion strains and the recently isolated Indian strains. A novel substitution, A148V, was detected in the E1 gene of the isolate, IndKL02. The detection procedure used in this study was simple, sensitive and rapid (less than 4 hr). This result suggests that CHIK viruses similar to the Reunion strains, which had resulted in high morbidity and mortality rates, may have caused the recent Chikungunya outbreak in India. The effect of the variant, E1-A148V, in the virulence and the rate of transmission of the virus deserves further investigation.

Quality standards of the leaves of Tylophora indica

Tylophora indica [Asclepiadaceae] is very important medicinal plant, used in Indigenous System of Medicine as an antiasthmatic drug. The plant has been used as bronchodilator, emetic, expectorant and diaphoretic. In the present investigation, morphoanatomical, pharmacognostical and physiochemical characteristics of Tylophora indica were studied. In order to ensure the use of only genuine and uniform material of such herbal remedies, work on standardization assumes vital significance. Pharmacognostical study has, therefore been carried out, covering detailed morphological and anatomical characters; features of the powdered drug include response to U.V. light exposure, some physiochemical constants, phytochemical screening and results of TLC. The morphoanatomical characteristics and results of different chemical protocols would serve as standard reference for identification of Tylophora indica. Tylophora indica [Asclepiadaceae], commonly known as Antamool, is a climbing perennial plant indigenous to India, and has a long-standing reputation as a remedy for asthma[1] [hence the name T. asthmatica]. The plant is commonly known as Indian Ipecac. The drug is official in Bengal Pharmacopoeia[2]. Traditionally Tylophora indica has been used in treatment of asthma[3], dermatitis and rheumatism[4]. The plant has been described as bronchodilator, emetic, expectorant and diaphoretic[5] Various Phenenthroindolizidine alkaloids[6,8], Seco-phenenthroindolizidine alkaloids[9], cc-amyrin, quercetin, kaempferol and unidentified flavonoids, mixture of p-sitosterol and stigmasterol have been isolated from the aerial parts of this plant[10]. Due to the medicinal importance of Tylophora indica in Indigenous.System of Medicine, the morpho-anatomic features of the raw material, physiochemical constants, phytochemical screening of the powder and chromatographic characteristics of different extractives are evaluated in this work to provide diagnostic values for its identification