Anthelmintic, antimicrobial, antioxidant and cytotoxic activity of Caltha palustris var. alba Kashmir, India / 中国天然药物

The methanolic extract obtained from the root portion of Caltha palustris var. alba was evaluated for its anthelmintic efficacy against gastrointestinal nematodes of sheep under both in vitro and in vivo conditions using worm motility inhibition (WMI) assay and fecal egg count reduction (FECR) assay, respectively. The extract was subjected to antimicrobial activity using agar-well diffusion method against different bacterial strains. In addition the extract was evaluated for cytotoxic and antioxidant activity against cultured THP-1(Leukemia), A-549 (Lung), HCT-15 (Colon), Cervix (HeLa) and PC-3(Prostrate) cell lines by SRB and DPPH radical scavenging assays. The extract used resulted in mean %WMI of 94.44%, as observed when the worms were put in lukewarm buffer for 30 min after exposure to different treatments. The mean mortality index of the sample was 0.95. The lethal concentration (LC50) was 0.11 mg·mL(-1). Cell lines were exposed to concentration of 100 μg·mL(-1) of extract for 48 h, which reduced the viability of these cell lines. The same plant extract also showed 55.58% DPPH radical scavenging activity.

Immunodiagnosis of Haemonchus contortus infection in sheep by indirect enzyme linked immunosorbent assay [ELISA]

Indirect plate enzyme-linked immunosorbent assay was standardized and evaluated for its effectiveness in immunodiagnosis of haemonchosis in experimental and clinical cases in sheep by using somatic whole adult antigen of H. contortus. Plate ELISA was standardized using 5 mg/well antigen concentration with 1:100 and 1:1000 of sera and conjugate dilution. Indirect plate ELISA was able to demonstrate the antibody titre at different weeks post infection in experimental sheep. A comparison of plate ELISA on suspected field sera and faecal sample examination by floatation method revealed that 74 samples were found to be positive by ELISA but only ten by faecal examination. Sensitivity of plate ELISA was found to be 80.0%, whereas specificity was 21.42% indicating that this test is quite sensitive for clinical cases; an early diagnosis, however, lacks specificity

Thoracic injuries in Indian Kashmir during earthquake, 2005

Earthquakes cause horrendous devastation with lots of deaths. This study was conducted to determine the patterns of thoracic injuries in the 2005 earthquake victims of Indian Kashmir referred to the CVTS Dept. of Sher-i-Kashmir Institute of Medical Sciences [SKIMS], Soura, India. Of the 468 patients received by SKIMS, 87 patients had either isolated chest injuries or multiple organ trauma. Chest injuries were identified and categorized for appropriate management to be instituted. The patients were followed up for next four years for functional outcome. There were 51 females and 36 males. Their mean age was 35 years. 83.91% had isolated chest injuries while 16.09% had associated injuries. For patients with isolated chest trauma, the Mean Injury Severity Score [MISS] was 8.79 and for multiple organ trauma it was 36.42. 27.59% were treated conservatively, and 41.38% had only chest tube. 31.03% were operated; 37 surgeries were done. 87.36% of the patients showed excellent recovery in functional outcomes. Females have shown more long term PTSD than males. Massive calamities like earthquakes cause multiple types of injuries in the affected population. Categorization of the victims in different groups so as to provide specialized and multi-specialty integrated care is imperative. In accordance with earlier studies, we found that high MISS is associated with high mortality

Role of intraoperative sentinel lymph node mapping in the management of carcinoma of the esophagus

Precise evaluation of lymph node status is one of the most important factors in determining clinical outcome in treating gastro-intestinal [GI] cancer. Sentinel lymph node [SLN] mapping clearly has become highly feasible and accurate in staging GI cancer. This study aims to investigate the feasibility and accuracy of detection of SLN using methylene blue dye in patients with carcinoma of the esophagus and assess its potential role in determining the rational extent of lymphadenectomy in esophageal cancer surgery. Thirty-two patients of esophageal cancer diagnosed on endoscopic biopsy were enrolled in this prospective study. After laparotomy, patent methylene blue was injected into the subserosal layer adjacent to the tumor. SLNs were defined as blue stained nodes within a period of 5 min. Standard radical esophagogastrectomy with lymphadenectomy was performed in all the patients. All the resected nodes were examined postoperatively by routine hematoxylin and eosin stain for elucidating the presence of metastasis, and the negative SLNs were examined further with cytokeratin immunohistochemical staining. SLNs were detected in 26 [81.25%] patients out of 32 patients who were studied. The number of SLNs ranged from 1 to 4 with a mean value of 1.7 per case. The SLNs of esophageal cancer were only found in N1 area in 21 [80.77%] cases, and in N2 or N3 area in only 19.33%. The overall accuracy of the procedure was 75% in predicting nodal metastasis. SLN had a sensitivity of 85.7% in the case of squamous cell carcinoma and 92.86% in the cases of adenocarcinoma of the esophagus. The accuracy of the procedure for squamous cell carcinoma and adenocarcinoma was 60% and 76.47%, respectively. SLN mapping is an accurate diagnostic procedure for detecting lymph node metastasis in patients with esophageal cancer and may indicate rational extent of lymphadenectomy in these patients. SLN mapping provides [right nodes] to the pathologists for detailed analysis and appropriate staging, thereby helping in individualizing the multi-modal treatment for esophageal cancer

Missile diaphragmatic injuries: Kashmir experience

Importance of repairing a diaphragmatic tear due to a missile injury cannot be overemphasized.Even a small diaphragmatic rent should be repaired because of morbidity and mortality caused by subsequent herniation and strangulation. Fifty-three cases with diaphragmatic injuries caused by penetrating missiles were studied from January 1997 to January 2007. All the patients were primarily explored either for thoracic or abdominal penetrating trauma; the diaphragmatic injury was an associated incidental intraoperative finding. Thoracotomy was performed in 18 patients, Laprotomy in 33 patients and in two patients combined thorocoabdominal approach was utilised for managing associated visceral injuries. Overall mortality was 37.7%. Mortality was dependent on associated injuries of thoracic and abdominal viscera. Most patients died due to associated injuries and septicaemia. None of the patients had any sequelae of diaphragmatic repair. Immediate repair of diaphragmatic injury is of paramount importance to prevent subsequent complications of herniation and strangulation

Prevalence of exfoliative glaucoma among Kashmiri population: a hospital based study

The Prevalence of exfiolative glaucoma has shown extensive variation all over world ranging from 0 to 50%. To know the prevalence of exfoliative glaucoma in Kashmir. A hospital based cross-sectional study was conducted from January 2006 to January 2007 on 300 patients with documented raised intra ocular pressure [IOP], glaucomatous changes in the fundus and open angle of anterior chamber. The study included 236 males and 64 females. Out of 300 patients, 115 had exfiolative glaucoma and among those left eye was involved in 47 patients, right eye in 31 and 37 had bilateral involvement. The patients above 60 years of age were found to have this condition more frequently as compared to those below 60 years of age. Occupation of patients had a strong association with this condition, as the disorder was seen more commonly in patients engaged in outdoor activites. The patients with exfiolative glaucoma were found to be having less Visual acuity; a higher IOP at presentation and a more severe and early optic nerve head involvement as compared to those with open angle glaucoma. The study reveals that prevalence of exfoliative glaucoma as seen in our OPD based cross sectional study was found to be 38.3%. This prevalence was high as compared to prevalence studies conducted in southern parts of the country and low as compared to the studies conducted in the Scandinavian countries. The difference in the prevalence of the condition was probably inpart related to the differences in the climatic conditions, ethnic origin and in part related to genetic factors of the studied population

Atrial myxoma: trends in management

Myxomas are the most common type of cardiac tumours in all age groups accounting for one-third to one-half of cases at postmortem and for about three quarter of tumours treated surgically. Most atrial myxomas, whether left or right, arise from the atrial sptum. About 10% have other sites of origin, particularly posterior wall, anterior wall and the appendages [in order of frequency]. Myxomas are frequently located in left atrium and produce symptoms when they fragment and cause systemic emboli or when they interfere with cardiac valvular function and cause pulmonary congestion. Careful surgical management of these lesions should be curative with minimal early and late morbidity and mortality. Recurrence of atrial myxomas can occur most likely in about 3% of patients. However, extensive resection of the myxoma attached to atrial septum or atrial wall can reduce the likehood of recurrence to a greater extent. Long term clinical and echocardiographic follow-up is mandatory

Magnesium supplementation and the potential association with mortality rates among critically ill non-cardiac patients

Recent literature showed that development of hypomagnesemia is associated with higher mortality. The objective of this study is to evaluate the impact of magnesium supplementation on mortality rates of critically ill patients. All patients admitted to the Intensive Care Unit [ICU] of King Abdul-Aziz Medical City, Riyadh, Saudi Arabia since September 2003 were included. We recorded the demographics data, APACHE score, daily magnesium levels and magnesium supplementation. We collected the data for 30 days or until discharge from ICU. Statistical analysis was performed using the student t-test for continuous data and the Fischers exact test for categorical data. Nothing was carried out to influence the behavior of intensivists in replacing magnesium. During the study period, 71 patients [45 males and 26 females] were admitted to the ICU, the mean age was 54 +/- 18 years for males and 56 +/- 19.2 years for females. The mean magnesium level on admission was 0.78 +/- 0.2 mmol/L and the majority of the patients were medical admissions. Approximately 39.4% had hypomagnesemia on admission and the overall mortality rate was 31%. In able to standardize the supplementation of magnesium among groups, the daily magnesium supplementation index [DMSI = total magnesium supplement in grams/length of stay in days] was calculated. The mortality rates for DMSI with <1 grm/day [low groups] was statistically significant higher than that of DMSI with >1 grm/day [high group] [43.5% versus 17%, p=0.035]. There was no statistically significant differences between magnesium levels of both groups of DMSI except at admission where DMSI group had higher magnesium levels [<1 grm/day]. Daily magnesium supplementation index higher than 1 grm/day is associated with lower mortality rates for critically ill patients. This effect was not found to be independent and may be related to severity of illness. Given that magnesium levels were similar between the 2 groups of DMSI at almost all points of the study, magnesium supplementation per se may be beneficial in lowering mortality rates. The exact cause of this effect is unknown. An aggressive magnesium supplementation protocol may be warranted. A larger scale randomized study is necessary to evaluate this effect

Retinoblastoma; bone marrow infiltration: a study of 30 cases

Thirty patients of Retinoblastoma presenting in the Haematology Department of King Edward Medical College, Lahore were included in the study to find out the bone marrow involvement. The patients underwent bone marrow aspiration and peripheral blood examination was also done. The aspirates were screened for the presence of tumor cells. Of the patients studied 21[70%] were males while 9[30%] were females giving a male to female ratio of 2.8:1. Maximum number of patients were in the 2-3years age group. Twenty seven patients had unilateral Retinoblastomas while three patients had bilateral disease at presentation. The bone marrow of three patients showed presence of tumor cells

Etiological factors and clinical profile of adhesive capsulitis in patients seen at the rheumatology clinic of a tertiary care hospital in India

This study was conducted to examine the clinical profile of patients with adhesive capsulitis [AC] and evaluate various possible etiological factors. The study was conducted in the Department of Physical Medicine and Rehabilitation, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, Kashmir, India. One hundred patients fulfilling the criteria for the diagnosis of AC were studied for the severity of shoulder pain and the range of shoulder movements. The patients were also examined for the presence of various etiological factors for AC. Age of the subjects ranged from 25-70 years and duration of symptoms averaged 3.66 +/- 2.36 months; left shoulder was more commonly involved [54%], 2% had bilateral involvement and 63% of the subjects were sedentary workers. Disease was seen most commonly in patients with diabetes mellitus [27%]. Other identifiable risk factors included previous myocardial infarction [5%], immobilization [5%], stroke and chronic bronchitis [4% each]. Fifty-six% of patients with AC had radiological evidence of cervical spondylosis. We conclude that AC mostly affects people in the fifth to seventh decade. The majority of the affected individuals are sedentary at the time of the sickness and subjects with diabetes mellitus are at particular risk