Choroidal ganglioneuromas in Francois variant neurofibromatosis-1: A rare retinoblastoma mimic

Neurofibromtosis-1 (NF-1) is the commonest oculo-neuro-cutaneous syndrome with multiple ocular manifestations. Reporting three children who presented with unilateral glaucoma (buphthalmos), ipsilateral facial hemihypertrophy, and eyelid plexiform neurofibroma: completing the triad of François syndrome, a rare NF1 variant. Two presented with leukocoria and were referred to as retinoblastoma suspects. Histopathology showed ganglioneuroma, a benign choroidal tumor, associated with NF-1, which does not need treatment. Knowledge of this rare condition avoids misdiagnosis of retinoblastoma, prevents aggressive management, and the associated psychological impact.

Pharmaceutico-Analytical Study of Vanaspati Jarita Marita Yashada Bhasma

Yashada is one of the Sapta dhatu, which is chemically Zn, Yashada bhasma is used therapeutically in many diseases like Prameha, Pandu, Vatavyadi etc., in the form of Bhasma (ZnO). Objectives: To prepare Yashada bhasma and its physico-chemical analysis of Yashada bhasma. Materials and Methods: Yashada was subjected Samanya Shodhana, Vishesha Shodhana and Jarana as per Rasatarangini. Yashada marana was done as per Rasayana sara. Bhasma was subjected to physico-chemical analysis which mainly included classical Bhasma parikshas like Rekhapurnata, Varitara, Unama, Nischandrata etc and modern parameters like Acid Insoluble Ash, pH, Total Ash value etc and advanced analytical techniques like XRD, SEM and AAS. Results: After 1st Puta pale yellow colored Yashada bhasma passed classical Bhasma parikshas. In classical reference two Puta are mentioned so, the 2nd Puta was given. XRD reports shows major peaks which were identified as Zinc oxide (ZnO) compound. Hence indicates complete transformation of metal to Bhasma form. Scanning electron microscopy in Yashada Bhasma after 2nd Puta the particle size ranging from 5-10μm. AAS reports shows zinc percentage of 77.08% after 2nd Puta. Conclusion: Pale yellow coloured Yashada bhasma was prepared after two Gaja putas which passed the classical Bhasma parikshas.

SPECTROSCOPIC ANALYSIS AND ANTI- INFLAMMATORY ACTIVITY OF PLUMERIA RUBRA L.

An investigation was designed for the phytochemical screening by spectroscopic techniques and to determine the anti-in?ammatory activity of Plumeria rubra L. leaves extract. The qualitative UV-VIS spectrum showed the peaks at 333.15 with absorption 0.0731 respectively. The FT-IR spectrum of the Plumeria rubra L. showed the -1 -1 -1 -1 -1 -1 absorption at 1019.79 /cm-1, 1633.07 cm . 2920.54/ cm , 3416.88/ cm ,481.33/ cm , 700.89/ cm , and 2851.70/ cm , 2926 cm-1, 2855 cm-1, 1609 cm-1. Anti-in?ammatory activity of ethanolic leaf extract of Plumeria rubra L. showed that the percentage of inhibition 54.57% at 500?g/ml concentration was evidently higher than the lower concentration of 50 ?g/ml (8.23%). The presence of various bioactive compounds justi?es the use of the leaves for various ailments by traditional practitioners.

Factors and experiences associated with unscheduled 30-day hospital readmission: A mixed method study

INTRODUCTION@#Analysis of risk factors can pave the way for reducing unscheduled hospital readmissions and improve resource utilisation.@*METHODS@#This was a concurrent nested, mixed method study. Factors associated with patients readmitted within 30 days between 2011 and 2015 at the National University Hospital, Singapore (N=104,496) were examined. Fifty patients were sampled in 2016 to inform an embedded qualitative study. Narrative interviews explored the periods of readmissions and related experiences, contrasted against those of non-readmitted patients.@*RESULTS@#Neoplastic disease (odds ratio [OR] 1.91, 95% confidence interval [CI] 1.70-2.15), number of discharged medications (5 to 10 medications OR 1.21, 95% CI 1.14-1.29; ≥11 medications OR 1.80, 95% CI 1.66-1.95) and length of stay >7 days (OR 1.46, 95% CI 1.36-1.58) were most significantly associated with readmissions. Other factors including number of surgical operations, subvention class, number of emergency department visits in the previous year, hospital bill size, gender, age, Charlson comorbidity index and ethnicity were also independently associated with hospital readmissions. Although readmitted and non-readmitted patients shared some common experiences, they reported different psychological reactions to their illnesses and viewed hospital care differently. Negative emotions, feeling of being left out by the healthcare team and perception of ineffective or inappropriate treatment were expressed by readmitted patients.@*CONCLUSION@#Patient, hospital and system-related factors were associated with readmissions, which may allow early identification of at-risk patients. Qualitative analysis suggested several areas of improvement in care including greater empowerment and involvement of patients in care and decision making.

Analysis of spontaneous individual case safety reports reported at adverse drug reaction monitoring centre: tertiary care teaching hospital in South India

Background: Drugs are double edged weapons, they are used in treatment of the patients but in return can harm as well. The safety of drug prescribing has become a need of the hour topic in medicine. Safety monitoring of patients via Pharmacovigilance tool has become an integral part of pharmacotherapy. This study has been undertaken to analyze the various individual case safety reports including the Special situation cases of medicational error and over dose and to promote the reporting of adverse drug reactions (ADRs) among the healthcare professionals (HCPs).Methods: A retrospective non-interventional observational study was done for indexed period of six months at AMC-PvPI under Osmania Medical College and General Hospital. The reported individual case safety reports (ICSRs) are evaluated on basis of demographics of age and gender, seriousness criteria, outcome parameters and causality assessment of suspected drug (s) and suspected ADR/AE (s) as per the ICH guidelines and WHO causality assessment scale.Results: A total of 177 ICSRs are reported out of that 137 were ADRs, 36-medication error cases and 4-cases of over dose. The incidence of ADRs in females are high compared with males was identical. The occurrence of ADRs in adult patients (61%) was significantly higher than other age groups. Of total ADRs, most of them were with analgesics (26%) and highly reported system organ classification was CNS. Overall, 79% patients were recovered from ADRs.Conclusions: The results depicted an insight to the HCPs on the importance of monitoring and reporting of ICSRs. Our study results emphasized need to roll out a pharmacovigilance practice tool to ensure the safe use of drugs for better Pharmacotherapy and development of pharmacogenomic studies.

Modafinil and Learning and Memory- Is there a Connection? Evaluation of the Effect of Modafinil on Learning and Memory in Wistar Rats

Background: Modafinil, a drug approved for use innarcolepsy, has shown conflicting effects on cognition.This study was conducted to observe the effects ofModafinil on learning and memory following acute andchronic administration in Wistar rats. Aim andObjectives: To observe the effects of Modafinil onlearning and memory following acute and chronicadministration. Material and Methods: The studyconducted in 42 male Wistar rats, had seven groups:Group I: Control, Group II: Negative Control(Vehicle), Group III: Standard Control (Donepezil),Group IV: Chronic Modafinil 10 mg/kg, Group V:Chronic Modafinil 20 mg/kg, Group VI: AcuteModafinil 10 mg/kg, Group VII: Acute Modafinil 10mg/kg. All drugs were administered for 15 days.th Scopolamine was used to induce amnesia on the 15day in all groups except Group I. Using the HebbWilliam maze, baseline learning score was recorded onday 1, and post-treatment learning scores wererecorded on days 15 and 16. Results: On days 15 and16, the learning scores significantly decreased in GroupI, while it significantly increased in group II, comparedto baseline, indicating induction of amnesia byscopolamine. In Group III the learning scores on days15 and 16 (8.66 ± 2.63, 9.66 ± 2.75, in seconds) weredecreased significantly compared to baseline (18.83 ±2.65), indicating a reversal of scopolamine-inducedamnesia. All doses of Modafinil (Acute 10 mg and 20mg/kg, Chronic 10 mg and 20 mg/kg) showed astatistically significant increase in learning scores ondays 15 and 16, compared to baseline, indicating noreversal of scopolamine-induced amnesia. Conclusion:Modafinil in doses of 10 mg/kg and 20 mg/kg, giveneither as a single dose or over a period of time, does notreverse amnesia induced by scopolamine in rats.

Safety and Tolerability of Nonspecific Antidiarrheals in Children with Acute Diarrhea

Introduction: In clinical practice, nonspecific antidiarrhealsare most commonly used by clinicians along with routinetreatment to hasten the recovery. This study was conductedto to study the safety and tolerability of these nonspecificantidiarrheals in children with acute diarrhea.Material and Methods: This was a prospective, observationalstudy done in clinical settings for a period of 3 years at twopediatric clinics and at a tertiary care hospital. Children weredivided into 5 treatment groups (viz, control, racecadotril,Mebarid, Diarex and loperamide) at the discretion of thepediatrician. One questionnaire was provided to parents torecord the details about the course of diarrhea and parentswere sensitized to report any adverse event.Results: Overall occurrence of adverse events wassignificantly higher in racecadotril group (34.86%) comparedto other groups (C:23.16%, M:21.14%, D:17.95%, L:17.65%).Conclusion: These agents may be safe, effective andinexpensive addition to the routine treatment of acute diarrhea.

Comparative study of analgesic effect of Moringa oleifera leaf extracts with aspirin on experimental animals

Background: Moringa oleifera is highly valued with a wide range of medicinal uses. It is abundantly available in tropical and sub-tropical countries. It has been used as an analgesic and anti-inflammatory in Indian folk medicine since centuries. The mechanism of action of analgesic effect is by the phytochemical components of its leaves which contain alkaloids, glycosides, phenols, saponins and tannin.Methods: This experiment is carried out in mice by using the thermal method of analgesiometer, that is Eddy’s Hot Plate method. Thermostatically controlled electrically heated plate is used in this method. Ethanolic and aqueous extracts of Moringa oleifera leaf extracts are compared with aspirin.Results: When the analgesic properties of the standard drug aspirin were compared to the analgesic properties of ethanolic and aqueous extracts of Moringa oleifera, the ethanolic extract showed a comparable analgesic effect with aspirin at 90min. Among these two extracts, the ethanolic extract showed a higher response than aqueous extract.Conclusions: When the analgesic properties of the standard drug aspirin were compared to the analgesic properties of ethanolic and aqueous extracts of Moringa oleifera, the ethanolic extract showed a comparable analgesic effect with aspirin at 90min. Among these two extracts, the ethanolic extract showed a higher response than aqueous extract.

Cross sectional study on different doses of acenocoumarol with INR in a tertiary care hospital

Background: It is of high value to be assess the relationship between doses of Acenocoumarol and the INR values to offer better patient care. Since Acenocoumarol is a commonly used drug with a narrow therapeutic range it is essential to monitor the variations encountered in response to it to avoid drastic complications and to provide better health care. Aim: The aim of this study is to compare the INR values with different doses of Acenocoumarol, to compare the association of dose of Acenocoumarol with their respective INR and to find out the occurrence of bleeding with different doses of Acenocoumarol.Methods: The study was conducted in a Tertiary care hospital. 40 patients taking Acenocoumarol were recruited in the study. Relevant details like age, weight, dose of Acenocoumarol, INR and other concomitant drugs were obtained in a prospective manner. Correlation of dose of Acenocoumarol with respective INR was done by simple linear regression.Results: The relationship between dose and INR was analyzed using Simple linear regression and the scatter plot revealed no significant correlation between the dose and INR values. There is a lot of inter-individual variability in the dose response and thereafter the INR values.Conclusions: The dose of Acenocoumarol cannot predict INR values. Patient can ideally be started treatment on a low dose of Acenocoumarol and based on the INR values, dose can be titrated. There is a need for consideration of other factors which influence the dose and INR values.

Advantages, Disadvantages, Indications, Contraindications and Surgical Technique of Laryngeal Airway Mask

The beauty of the laryngeal mask is that it forms an air tight seal enclosing the larynx rather than plugging the pharynx, and avoid airway obstruction in the oropharynx. The goal of its development was to create an intermediate form of airway management face mask and endotracheal tube. Indication for its use includes any procedure that would normally involve the use of a face mask. The laryngeal mask airway was designed as a new concept in airway management and has been gaining a firm position in anesthetic practice. Despite wide spread use the definitive role of the laryngeal mask airway is yet to be established. In some situations, such as after failed tracheal intubation or in oral surgery its use is controversial. There are several unresolved issues, for example the effect of the laryngeal mask on regurgitation and whether or not cricoids pressure prevents placement of mask. We review the techniques of insertion, details of misplacement, and complications associated with use of the laryngeal mask. We then attempt to clarify the role of laryngeal mask in air way management during anesthesia, discussing the advantages and disadvantages as well as indications and contraindications of its use in oral and maxillofacial surgery.

Comparing the effect of conventional method of retinoscopic refraction with computerized automated refraction in various refractive error patients

Introduction: Refractive error is the most common visual impairment seen worldwide. This is one of the main cause for which patients come to ophthalmologist. This can occur at any age of the patient. Automated refractometer has become popularised method for doing refraction because of the busy practise of ophthalmologist and due to heavy patients load in screening camps. It is an easy method to learn, to operate and also time saving procedure. Patients are also very comfortable with it because of this easy procedure done in short time. But Streak retinoscopy which is considered as a Gold standard technique for refraction, has some difficulties like time consuming, dilatation of pupil and discomfort to the patient. Aim: Comparing the effect of the conventional method of refraction with computerized automated refraction in various refractive error patients. Materials and methods: It was an observational, cross-sectional study done in a 50 refractive error patients who attend Department of Ophthalmology OPD. Results: According to the statistical analysis done to compare the refraction values of the auto refractometer and streak retinoscopy with the patient's acceptance value, results came as streak Deepikadevi SN, Sundararajan D, Namitha Bhuvaneshwari K, Murali Krishnan. Comparing the effect of conventional method of retinoscopic refraction with computerized automated refraction in various refractive error patients. IAIM, 2017; 4(10): 105-110. Page 106 retinoscopy values had no significant difference with the patient's acceptance value. This study also shows males were more affected by refractive errors than females and the mean age of affection in myopia was 19- 20 years and hypermetropia is 33-36 years. Conclusion: Since reteak retinoscopy values are accepted well by the patients, it is the better method for refrection than auto refractometer

GC-MS Determination of Organochlorine Pesticides in Bovine Milk from Tiruchirappalli, South India- A Preliminary Assessment.

The study was aimed to determine the concentrations of organochlorine pesticides (OCPs) in bovine milk (both branded and unbranded) collected from in and around Tiruchirappalli city, Southern India. The results of the present investigation indicated that these milk specimens were found to be contaminated with 7 different pesticides. Mirex (higher incidence), Heptachlor, o,p’-DDD, o,p’- DDE, Aldrin, cis and trans-chlordane were detected in the milk samples. The residues were quantitatively determined using Gas Chromatograph-Mass Spectrometer-Quadrupole on electron ionization (EI) mode. The study showed that unbranded milk samples contained higher concentrations of residues than branded. The derived average daily intake of aldrin and DDT has exceeded WHO’s Acceptable Daily Intake.

Microbicidal activity of crude extracts from sargassum wightii against Bacillus cereus.

The present study was investigated to explore the antibacterial activity of four different solvent (petroleum ether, chloroform, acetone and ethanol) crude extracts of marine brown seaweed Sargassum wightti. Crude extracts were screened against human pathogen Bacillus cereus. The antibacterial efficiency was performed by agar well diffusion, minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) methods. The results revealed that the crude extract of petroleum ether showed prominent inhibiting activity against B. cereus andother crude extracts showed below detectable level. The highest microbicidal activity (zone of inhibition) 9.0 ± 0.32 mm was obtained at the concentration of 250 μg /ml and the lowest activity was 3 ± 0.20 mm at 31.25 μg /ml concentration. The MIC and MBC values were found to be 125 and 250 μg /ml respectively. Results of this study suggested that the compounds present in the crude extracts of petroleum ether showed high activity against B. cereus and further studies are required to purify the active principles.

Canagliflozin: a novel ‘glucuretic’ approach for the treatment of type 2 diabetes mellitus.

Canagliflozin is the first in a new class of glucose-lowering drugs, an oral inhibitor of sodium glucose cotransporter 2 (SGLT2). SGLT2, the transporter is responsible for reabsorbing the majority of glucose filtered by the kidney. SGLT2 inhibitors are a new class of oral drugs indicated only for the treatment of type 2 diabetes mellitus in conjunction with exercise and a healthy diet. They inhibit glucose re-absorption in the proximal renal tubules providing an insulin independent mechanism to lower blood glucose. Their use in clinical studies is associated with improved glycemic control, weight loss, and a low risk of hypoglycemia. They have been studied alone and with other medications including sulfonylureas, sitagliptin, and insulin.

Microbicidal activity of crude extracts from Sargassum wightii against Bacillus cereus.

The present study was investigated to explore the antibacterial activity of four different solvent (petroleum ether, chloroform, acetone and ethanol) crude extracts of marine brown seaweed Sargassum wightti. Crude extracts were screened against human pathogen Bacillus cereus. The antibacterial efficiency was performed by agar well diffusion, minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) methods. The results revealed that the crude extract of petroleum ether showed prominent inhibiting activity against B. cereus and other crude extracts showed below detectable level. The highest microbicidal activity (zone of inhibition) 9.0 ± 0.32 mm was obtained at the concentration of 250 μg /ml and the lowest activity was 3 ± 0.20 mm at 31.25 μg /ml concentration. The MIC and MBC values were found to be 125 and 250 μg /ml respectively. Results of this study suggested that the compounds present in the crude extracts of petroleum ether showed high activity against B. cereus and further studies are required to purify the active principles.

Therapeutic effect of aqueous extract of cocos nucifera in streptozotocin- doxorubicin induced rat model of diabetic cardiomyopathy

Diabetes is the most common endocrine disorders and poses a serious challenge to healthcare worldwide. The pre-valence of diabetes varies in different parts of the world. During diabetes, metabolic remodeling precedes the cardiomyopathy, these changes may contribute to cardiac function. In the present study the effects of Cocos nucifera flower extract on cardiac dysfunction during diabetes were investigated

Methods: The aqueous flower extract of Cocos nucifera was administered for 30 days to the control and experimental rats. After the experimental period animals were sacrificed and the blood samples were used for the analysis of blood glucose, urea, creatinine, marker enzymes, lipid profiles and the histopathological analysis was also done for pancreatic tissue

Results: The results showed that the induction of diabetic cardiomyopathy with streptozotocin and doxorubicin increased the glucose level, cardiac marker enzyme activity and the lipid levels. Administration of aqueous extract of Cocos nucifera to experimental rats reduced the glucose and lipid levels and restored the enzyme activity to the normal level. The histopathological analysis showed the restoration by flower extract of pancreas ultra structure impaired by streptozotocin-doxorubicin. The athrogenic and coronary risk indices were significantly increased in doxorubicin-treated and streptozotocin-doxorubicin treated diabetic groups and this was reduced in Cocos nucifera treated as well as in aspirin treated group rats [p<0.05]. We conclude that feeding of the Cocos nucifera extract to rats with diabetic cardiomyopathy protect the heart tissue from the complication of diabetes