Incidence of Metopic Suture in Adult Human Crania in Uttar Pradesh

Introduction: Failure of ossification in the vertical direction between the two halves of the frontal bone is called a metopic suture; this suture is present in between the superciliary arch and tubers of the frontal bone so it is also called a median frontal suture. At birth, the frontal bone present is two half, in the 1st year they contact each other, and within the 7th to 8th year, they fused together. Sometimes, bones may not be fused completely and it becomes metopic fontanelle. MaterialsandMethods: The goal of the current study was to determine the prevalence of metopic suture in adult human skulls in Uttar Pradesh. One hundred and fifty macerated skulls of undetermined age and sex were used for this. The anatomical departments of Teerthankar Mahaveer Medical College and Research Center (Moradabad), King George Medical College (Lucknow), SRMS Institute of Medical Science (Bareilly), Govt. Medical College Kannauj, and Govt. Medical College Saharanpur provided these skulls. Results: This study has found the incidence of metopic sutures of about 12.90%. The two types of metopic sutures were found in this study, namely complete metopic suture 4.52% and incomplete metopic suture 8.38% in which found 0.64% “V” shape metopic suture. Conclusion: Themorphological study of metopic sutures on adult crania is useful for anatomists, experts in forensic medicine, and neurologists for performing surgical procedures in this area

Assessment of efficacy and safety of daclatasvir, sofusbuvirand ribavirin regimen for 12 weeks as compared to daclatasvir and sofusbuvir combination regimen for 24 weeks in decompensated cirrhotic patients due to hepatitis C virus genotype 3 infection

Background: Assessment of efficacy and safety of daclatasvir+sofosbuvir+ribavirin (DCV+SOF+RBV) for 12 weeks as compare to daclatasvir and sofusbuvirfor 24 weeks in decompensated cirrhotic patients due to hepatitis C virus (HCV) genotype 3 infection. Methods: An observational, prospective, COHORTstudy over 1 year, in decompensated cirrhosis due to G3-HCV infected adult patients. Treatment was a combination of sofosbuvir 400 mg/day+daclatasvir 60 mg/day, with or without a weight-adjusted dosing of ribavirin for 12 or 24 weeks. The primary efficacyendpoint was sustained virologic response rates 12 weeks after therapy (SVR 12). The primary safety endpoint was treatment withdrawal rates secondary to severe adverse events. Results: The32 patients were screened and 2 were excluded, one patient due toassociated HBV+, one patient due to severe anemia. 30 patients were randomized. All 30 randomized patients were divided into two groups. Group 1 was given SOF+DCV+RBV for 12 weeks while group 2 patients were given SOF+DCV for 24 weeks. 81.8% of the participants in the group1 achieved SVR 12. The 90.9% of the participants in the group 2 achieved SVR12 (p=1). No other patient or treatment basal variables influenced the treatment effectiveness. No patient treatment withdrawal secondary to severe adverse events was observed. Conclusions: Both the regimen SOF+DCV with or without RBV are highly efficacious and safe. Addition of RBV can reduce the treatment duration to 12 weeks, and it will further improve compliance and more convenient for the patients.

A study of non-alcoholic fatty liver diseasein patients with type 2 diabetes mellitusand itscorrelation with cardiovascular risk

Background:NAFLD(non-alcoholic fatty liver disease) encompasses a variety of disorders of lipid metabolism ranging from NAFL, NASH to cirrhosis and rarely HCC. A great deal of evidence suggests that the metabolic syndrome predicts incident cardiovascular disease (CVD), so it is possible to hypothesize that NAFLD patients might portend a greater CVD risk and that NAFLD itself might confer a CVD risk above that associated with individual metabolic syndrome risk factors.Methods:55 T2DM patients were included in current study conducted fromAugust 2019 to September 2021 for assessment of NAFLD using USGabdomen, NAFLD fibrosis score and FIBROSCAN. ASCVD score was used for correlation between CVD risk and NAFLD.Results:Out of 55 patients 42 (76.4%) were having fatty liver based on USG abdomen while 13 (23.4%) patients were having no fatty liver. As far as steatosis is concerned mean CAP (dB/m) was 245±50.89 out of which 24 (43.6%) were having no or minimal steatosis (S0), while 31(56.4%) were having significant steatosis with 11 (20%), 9 (16.4%) and 11 (20%) having S1, S2 and S3 grade of steatosis respectively.15 patients out of 55 were of F0 grade while 19 (34.5%), 9 (16.4%), 7 (12.7%) and 5 (9.1%) were of grade F1, F2, F3 and F4 respectively. There was a positive statistically significant (p?0.001) association of ASCVD risk score with NAFLD fibrosis score and fibroscan: E (KPa). Conclusions:Our study found that the prevalence of NAFLD was quite higher in patients with T2DM based on both USG abdomen (76.4%) and transient elastography (steatosis-56.4% and fibrosis-65.5%) and a statistically significantassociation between fibrosis and ASCVD score with higher fibrosis associated with higher 10 years ASCVD score.

A study on the association of Mental Disorders and Physical Illness in the Geriatric Population

Background: Growth of elderly people in the general population in recent years is termed as "graying of the world” where there is a shift from high mortality & fertility to low mortality & fertility, resulting in an increased proportion of older people as seen in India. Improved health care promises longevity but socio- economic factors like poverty, joint families and poor services pose a psychological threat. Epidemiological data regarding the prevalence of mental disorders in geriatric population with physical illness is required for proper health planning. The aim of the study is to study the association of mental disorders and physical illness in geriatric population. Methodology: Sixty consecutive elderly patients aged 60 years or above of both sexes, reporting with physical illness to general outpatient registration counter of Navodaya Medical College Hospital & Research Centre, Raichur, India, were considered for the Study. With informed consent, they were screened with General Health Questionnaire (GHQ-12) and were further evaluated for diagnosing mental disorders according to WHO International Classification of Diseases (ICD-10) criteria. Descriptive statistics and percentage were used to describe the data. Results: Mental disorders were detected in 48.3%, predominantly depressive disorders, nicotine dependence, generalized anxiety disorder, alcohol dependence and least was dementia. Most common physical illness was cardiovascular disease followed by metabolic, respiratory and other diseases. Depressive disorders, substance dependence and dementia were more associated with cardiovascular disease compared to metabolic disease and respiratory diseases were more associated with nicotine dependence. Conclusions: Depression and Substance use disorders among elderly population is of concern, which needs to be further studied with larger population. Psychiatric morbidity will adversely have an impact on physical illness which needs proper assessment and management. This will enhance our understanding and prioritize our planning for future.

Biocompatible silver nanoparticles:An investigation into their protein binding efficacies,anti-bacterial effects and cell cytotoxicity studies / 药物分析学报

Green synthesis of silver nanoparticles (AgNPs) has garnered tremendous interest as conventional methods include the use and production of toxic chemicals,products,by-products and reagents.In this regard,the synthesis of AgNPs using green tea (GT) extract and two of its components,(-)-epi-gallocatechin gallate (EGCG) and (+)-catechin (Ct) as capping/stabilizing agents,is reported.The syn-thesized AgNPs showed antibacterial activity against the bacterial strains Staphylococcus aureus and Escherichia coli,along with anticancer activity against HeLa cells.After administering nanoparticles to the body,they come in contact with proteins and results in the formation of a protein corona;hence we studied the interactions of these biocompatible AgNPs with hen egg white lysozyme (HEWL) as a carrier protein.Static quenching mechanism was accountable for the quenching of HEWL fluorescence by the AgNPs.The binding constant (Kb) was found to be higher for EGCG-AgNPs ((2.309 ± 0.018) × 104 M-1)than for GT-AgNPs and Ct-AgNPs towards HEWL.EGCG-AgNPs increased the polarity near the binding site while Ct-AgNPs caused the opposite effect,but GT-AgNPs had no such observable effects.Circular dichroism studies indicated that the AgNPs had no such appreciable impact on the secondary structure of HEWL.The key findings of this research included the synthesis of AgNPs using GT extract and its con-stituent polyphenols,and showed significant antibacterial,anticancer and protein-binding properties.The-OH groups of the polyphenols drive the in situ capping/stabilization of the AgNPs during synthesis,which might offer new opportunities having implications for nanomedicine and nanodiagnostics.

Study the association between platelets count and grades of oesophageal varies in patients of cirrhosis of liver with portal hypertension

Background: cirrhosis of liver is a diffuse process of fibrosis that converts the liver architecture into structurally abnormal nodules Portal hypertension leads to dilatation of portal vein, splenomegaly, and formation of portal systemic collaterals at different sites. Screening endoscopy is recommended for early detection of esophageal varices (EVs) in cirrhotic patients with portal hypertension. However, this approach is limited by its invasiveness and cost. The aim of the study was to determine if platelet count can predict the presence of EVs, especially large (grade III, IV) EVs in need of prophylactic therapy.Methods: Statistically 100 patients previously or newly diagnosed with cirrhosis of liver with portal hypertension without history of hepatic encephalopathy, variceal bleeding, EVL, use of beta blockers, were selected for the study. Ultrasonography was performed in all cases to note the spleen size. Routine blood testing including platelet count was done and UGI-Endoscopy was done to detect presence of varices with grades. Statistical Analysis: Statistical analysis was done using Statistical Package for Social Survey (SPSS) for Windows version 17.0. The data obtained was analysed using mean, SD, Student’s t-test and chi square correlation coefficient, p value <0.05 was considered significant.Results: Among 100 patients studied ,90% patients were found to have esophageal varices. Based on endoscopic grading, incidence of grade 2 and grade 3 esophageal varices predominated, accounting to 48% and 23 % respectively. On correlation of platelet count with grades of esophageal varices it was evident that 44 patients had their platelet count less than 1 lac out of which 24 patients had grade 2 varices followed by 14 patients with grade 3 varices, p value <0.001 and was highly significant.Conclusions: The study depicts that with decrease in platelets count the chances of formation of higher grades of oesophageal varices increases and also a positive association exists.

An adaptive clinical trial on patients with non variceal upper gastrointestinal bleed with the help of endoscopy

Background: Acute upper gastrointestinal hemorrhage (UGIH) is a common condition worldwide frequently leads to hospital admission also has a significant associated morbidity and mortality, especially in the elderly. A systematic diagnostic and definite therapeutic approach is essential to establish a diagnosis, relevant to specific investigations for appropriate treatment in tertiary medical care center.Methods: A comparative trial was done on n=109 cases with an objective to find out the different causes of UGI bleed in population, to assess the requirement of blood transfusion in patients with massive GI Bleed and to compare the treatment outcome of Proton pump inhibitors over Tranexamic acid and Octreotide in non-variceal UGI bleed. The cases were assigned to three different groups by lottery system. Proton pump inhibitors (Omeprazole), Somatostatin (Octreotide), Anti-fibrinolytic (Tranexamic acid), outcome was assessed after complete treatment and follow up.Results: Out of 150 cases, 109 were diagnosed with non-variceal GI bleed, 35 cases were treated with Omeprazole out of which 11.42% cases received blood transfusion, and 4 had history of re bleeding, Mean Duration of stay in hospital was 4.4±1.75, when compared to the other two group the duration of hospitalization was least as the P value was <0.0001.Conclusions: In this study it was demonstrated the use of PPI in case of Non-Variceal Bleeding significantly reduces the need of blood transfusion. Even it reduces the cases of re bleeding and duration of hospital stay.

To Study the Association between Splenic Size and Grades of Oesophageal Varices in Patients of Cirrhosis of Liver with Portal Hypertension.

Chronic liver disease develops when the functional capacity of the liver is deranged, and it is not able to maintain normal physiological conditions. This study was carried to find out the association of portal vein size with gastro-oesophageal varices in diagnosed cases of cirrhosis of liver, so that this parameters can be used in predicting propensity to oesophageal varices non-invasively, and thus help in starting prophylactic therapy earlier to prevent bleeding and other complications of varices.METHODS100 patients previously or newly diagnosed with cirrhosis of liver with portal hypertension without history of hepatic encephalopathy, variceal bleeding, EVL, use of beta blockers, were included for the study. Ultrasonography was done in all cases to find out the spleen size. Routine blood testing including platelet count was done and UGI-Endoscopy was performed to see the presence of oesophageal varices of different grades. The data obtained was analysed using mean, SD, Student’s t-test and chi square correlation coefficient. p Value of <0.05 was considered for significant.RESULTSAmong 100 patients studied, 90% patients were found to have oesophageal varices. Based on endoscopic grading, incidence of grade 2 and grade 3 oesophageal varices predominated, accounting to 48% and 23 % respectively. On correlation of splenic diameter with grades of oesophageal varices, it was found that patients with splenic diameter >13 cm had higher grades of oesophageal varices i.e. 32 patients were grade 2 and 18 patients were grade 3, with p<0.001 and was found highly significant.CONCLUSIONSIn this study, we found that with increasing spleen size there are chances of formation of higher grades of oesophageal varices and both are also having positive association.

Self-administration of MTP Pills and its Complications: An Observational Study

Background: Medical termination of pregnancy (MTP) has been legalized in India since 1971. MTP pills are well effective inthe early weeks of gestation and safe only when used under medical supervision.Aims and Objectives: The aim of the study was to find out the clinical presentations and complications following selfadministration of MTP pills.Materials and Methods: This was a retrospective observational study conducted at SMGS Hospital, Government MedicalCollege Jammu from July 2018 to June 2019. Hundred patients were included in the study. Following factors were studied suchas chief complaints, complications, treatment given, and blood transfusion.Results: Majority (57%) of patients were aged between 30 and 39 years. About 66% were gravid three or more. Only 28% hadtaken the pill within prescribed gestational age limit for MTP, i.e., <7 weeks. Mid-trimester pill intake was encountered in 14%patients. About 41% presented with incomplete abortion. Anemia was present in majority of patients and blood transfusion wasdone in 38% patients. About 24% patients presented with life-threatening shock. Sepsis was present in 5% patients. Emergencylaparotomy was required in 4% cases. Hysterotomy was done in 2% cases. Continuation of pregnancy was noted in 6% patients.Unintended pregnancy and limiting family size were main reasons for abortion 62% and 32%, respectively.Conclusions: Unauthorized over-the-counter availability despite legal ban and ignorance of women have led to increasednumber of unsafe abortions. Increasing awareness among women regarding complications of unsupervised pill intake andeasily availability of safe contraceptive methods can help control this health hazard.

TLH versus TAH: a 2 year retrospective comparative study

Background: Laparoscopic hysterectomy has become a widely accepted technique worldwide, since its introduction by Reich in 1989. The aim of the study was to compare the surgical results and intra- operative and post-operative complications between total laparoscopic hysterectomy (TLH) and total abdominal hysterectomy (TAH).Methods: Authors conducted a retrospective study at SMGS hospital, GMC Jammu between October 2016 to September 2018, 126 patients who underwent TLH and 126 patients who underwent TAH, were included.Results: Authors observed that there was no significant difference between the two groups in respect to patient’s age, parity and indication of surgery. Duration of surgery was found to be longer in TLH than TAH. The length of hospital stay was less in TLH than TAH. Hb drop was more in TAH group. 25 patients of TAH were given post op blood transfusion but only 9 patients of TLH were given post op blood transfusion. The time to ambulation in patients of TLH was much shorter than TAH. Wound infection was more common in TAH as compared to TLH, 5 patients had wound infection and in 4 patients resuturing was done for wound dehiscence. In 8 patients laparoscopy was converted to laparotomy because of adhesions, vascular injury and in one case because of bowel injury.Conclusions: This study showed that TLH can be safely performed by the experienced surgeon as an alternative to abdominal hysterectomy. It offers several benefits over TAH such as smaller incision, earlier ambulation, shorter hospital stay, faster recovery time and does not increase more serious complications than TAH.

Study of eosinophil count in nasal smear and peripheral blood smear in children with allergic rhinitis

Background: Allergic respiratory disorders are the common cases seen in Pediatrics OPD. With an appropriate history and detailed examination, the diagnosis usually may not be problematic and routine investigations may not contribute much for the final diagnosis but may help in ruling other possibilities. The objectives of this study were done to know the eosinophil counts in nasal and blood smear and to assess the feasibility of nasal cytogram which is simple, economical and reliable investigation in patients of allergic respiratory disorders.Methods: A prospective clinical correlation study conducted in outpatient visiting Mysore Medical College and Research Institute, Cheluvamba hospital Department of Pediatrics and ENT Department KR hospital. 60 children of age group between 2 to 18 years were selected to estimate the eosinophil count in nasal and peripheral smear in allergic rhinitis. All allergic rhinitis cases based on clinical signs and symptoms were selected and investigated for nasal and blood eosinophilia. The nasal and blood eosinophilia were compared with each other and the clinical findings of allergic rhinitis were studied.Results: In this study peak age incidence is between 6-10 years and there is equal gender distribution. Seasonal variation and pollen allergens were the most common risk factors for allergic rhinitis. Running nose and the nasal obstruction were the most common symptoms in children with allergic rhinitis followed by sneezing and itching. One tenth of the children with allergic rhinitis had bronchial asthma. Nasal eosinophilia contributes to the diagnosis of allergic rhinitis as compared blood eosinophilia. Mild intermittent variety of allergic rhinitis was the most common form of allergic rhinitis.Conclusions: Among various risk factors for allergic rhinitis, seasonal variation and pollen allergens have significant association with the severity of allergic rhinitis. Among various symptomology, only itching had a significant relation to the severity of allergic rhinitis.

Protective effect of pioglitazone on cardiomyocyte apoptosis in low-dose streptozotocin & high-fat diet-induced type-2 diabetes in rats.

Background & objectives: Cardiomyocyte apoptosis is one of the pathologic phenomena associated with diabetes and related conditions including obesity, insulin resistance and hyperlipidaemia. In the present study, the protective effects of pioglitazone on cardiomyocyte apoptosis was evaluated in experimental diabetes induced by low dose of streptozoticin (STZ) combined with high fat diet (HFD) in rats. Methods: Male Wistar rats (150-200 g) were injected with low-dose STZ (45 mg/kg, i.v., single dose) and orally fed with a HFD (20 g/day/rat) for a period of 28 days and simultaneously treated with pioglitazone (20 mg/kg/p.o.) for a period of 21 days (from 8th day to 28th day). On 29th day blood was collected, serum separated and used for biochemical parameters. Heart tissue was used for cardiomyocyte apoptosis measurement and also for histopathological examination. Results: Pioglitazone treatment resulted in a decrease in cardiomyocyte apoptosis as revealed by a decrease in cardiac caspase-3, lactate dehydrogenase (LDH) levels and DNA fragmentation, and an increase in Na+K+ATPase levels in diabetic rats. Cardiac histology of diabetic control rats showed dense focal fatty infiltration in the myocardial cells whereas normal architecture with regular morphology and well preserved cytoplasm was observed with pioglitazone treatment. Pioglitazone treatment significantly reduced the heart rate, mean arterial blood pressure, body mass index (BMI) and levels of serum glucose, leptin, insulin, HOMA-IR, total cholesterol (TC) and triglycerides (TGs), apoliproprotein-B glycosylated haemoglobin (HbA1c) levels and atherogenic index, and increased the levels of serum high density lipoprotein cholesterol (HDL-C) and cardiac antioxidant enzymes. Interpretation & conclusions: The present study results suggest that pioglitazone possesses cardiac anti-apoptotic potential in diabetic rat model and can be further explored for its use for treatment of diabetic cardiomyopathy.

Jaw ‑ winking phenomenon: Report of a case with review of literature.

Jaw‑winking or the Marcus Gunn phenomenon (MGP), a congenital uncommon condition characterized by involuntary elevation of a drooping upper eyelid concomitant with various movements of the mandible, is well‑documented in medical literature, but very little information is available in dental literature. This is an interesting case report of a 17‑year‑old female with MGP, who reported for orthodontic treatment of her proclined upper anterior teeth, severe lower crowding, and mandibular micrognathia. Review of the literature revealed only two reported cases of dental anomalies in conjunction with MGP. The patient also gave a positive family history of MGP with a maternal cousin having a similar problem. Dentists and other oral health professionals can play a significant role in detection and diagnosis of this rare condition and should take protective measures during dental and oral surgical procedures.

In vitro regeneration and ploidy level analysis of Eulophia ochreata Lindl.

Various parameters including explant-type, medium compositions, use of phytohormones and additives were optimized for direct and indirect regeneration of E. ochreata, a medicinal orchid under threat. Protocorm-like-bodies (PLBs) proved to be the best explants for shoot initiation, proliferation and callus induction. Murashige and Skoog’s (MS) medium containing 2.5 mg L-1 6-benzylaminopurine (BAP), 1.0 mg L-1 kinetin (Kin) and additives (adenine sulfate, arginine, citric acid, 30 mg L-1 each and 50 mg L-1 ascorbic acid) was optimal for shoot multiplication (12.1 shoots and 7.1 PLBs per explant with synchronized growth), which also produced callus. Shoot number was further increased with three successive subcultures on same media and ~40 shoots per explant were achieved after 3 cycles of 30 days each. Additives and casein hydrolysate (CH) showed advantageous effects on indirect shoot regeneration via protocorm-derived callus. Optimum indirect regeneration was achieved on MS containing additives, 500 mg L-1 CH, 2.5 mg L-1 BAP and 1.0 mg L-1 Kin with 30 PLBs and 6 shoots per callus mass (~5 mm size). The shoots were rooted (70% frequency) on one by fourth-MS medium containing 2.0 mg L-1 indole-3-butyric acid, 200 mg L-1 activated charcoal and additives. The rooted plantlets were hardened and transferred to greenhouse with 63% survival rate. Flow-cytometry based DNA content analysis revealed that the ploidy levels were maintained in in vitro regenerated plants. This is the first report for in vitro plant regeneration in E. ochreata.

Antibiotic resistance reversal of multiple drug resistant bacteria using Piper longum fruit extract.

Present investigation was aimed to identify natural products of plant-origin as novel antibiotic resistance reversal agents. Aqueous and methanol extracts of Piper longum (fruits) were tested against multiple drug resistant (MDR) clinical isolates of Enterococcus faecalis, Staphylococcus aureus, Salmonella typhi, Shigella sonnei, as well as reference-plasmid-harboring strains of Escherichia coli (RP4) and Bacillus subtilis (pUB110). The crude methanol extract showed significant antibacterial activity with a minimal inhibitory concentration of 400 μg/mL against Bacillus subtilis (harboring pUB110 plasmid). Methanol extract could reverse the antibiotic resistance in clinical isolates of Shigella sonnei, with a curing efficiency of 42%. In comparison with methanol extract, aqueous extract showed antibiotic resistance reversal efficiency against wider range of clinical isolates. Aqueous extract showed strong antibiotic resistance reversal activities against R-plasmid harboring strains of clinical origin- Enterococcus faecalis, Staphylococcus aureus, Salmonella typhi with curing efficiencies of 64%, 50% and 32% respectively. This antibiotic resistance reversal may be attributed to the elimination of R-plasmids as the multiple antibiotic resistance genes are usually located on R-plasmids. Active biomolecules from P. longum may prove to be a source to develop MDR reversal agents of natural origin to contain the development and spread of plasmid borne multiple antibiotic resistance.

Ameliorative role of atorvastatin on methionine-induced hyperhomocysteinemia and hematological changes in albino rats.

Methionine (1g/kg, po) administration to pathogenic control rats for 30 days significantly increased the levels of homocysteine, total cholesterol (TC), low density lipoprotein (LDL-C), very low density lipoprotein (VLDL-C) and triglycerides (TGs) and decreased the levels of high density lipoprotein (HDL-C) in serum. Hematological observations of the peripheral blood smears of pathogenic rats fed with methionine also showed crenation of RBCs cell membrane and significant increase in total leukocyte count, differential leukocyte count and platelet counts with significant decrease in the mean hemoglobin levels as compared to vehicle control rats. Administration of atorvastatin (0.2 mg/kg/po) to hyperhomocysteinemic rats significantly decreased the levels of homocysteine, TC, TGs, LDL-C and VLDL-C and increased the levels of HDL-C in serum. The present results provide clear evidence that oral treatment with atorvastatin exhibit homocysteine and lipid lowering activity and also reversal of hematological changes induced by methionine in albino rats.

Antibacterial & antiplasmid activities of Helicteres isora L.

Background & objectives: The multiple drug resistance (MDR) is a serious health problem and major challenge to the global drug discovery programmes. Most of the genetic determinants that confer resistance to antibiotics are located on R-plasmids in bacteria. The present investigation was undertaken to investigate the ability of organic extract of the fruits of Helicteres isora to cure R-plasmids from certain clinical isolates. Methods: Active fractions demonstrating antibacterial and antiplasmid activities were isolated from the acetone extracts of shade dried fruits of H. isora by bioassay guided fractionation. Minimal inhibitory concentration (MIC) of antibiotics and organic extracts was determined by agar dilution method. Plasmid curing activity of organic fractions was determined by evaluating the ability of bacterial colonies (pre treated with organic fraction for 18 h) to grow in the presence of antibiotics. The physical loss of plasmid DNA in the cured derivatives was further confirmed by agarose gel electrophoresis. Results: The active fraction did not inhibit the growth of either the clinical isolates or the strains harbouring reference plasmids even at a concentration of 400 μg/ml. However, the same fraction could cure plasmids from Enterococcus faecalis, Escherichia coli, Bacillus cereus and E. coli (RP4) at curing efficiencies of 14, 26, 22 and 2 per cent respectively. The active fraction mediated plasmid curing resulted in the subsequent loss of antibiotic resistance encoded in the plasmids as revealed by antibiotic resistance profile of cured strains. The physical loss of plasmid was also confirmed by agarose gel electrophoresis. Interpretation & conclusions: The active fraction of acetone extract of H. isora fruits cured R-plasmids from Gram-positive and Gram-negative clinical isolates as well as reference strains. Such plasmid loss reversed the multiple antibiotic resistance in cured derivatives making them sensitive to low concentrations of antibiotics. Acetone fractions of H. isora may be a source to develop antiplasmid agents of natural origin to contain the development and spread of plasmid borne multiple antibiotic resistance.

Mesenteric fibromatosis with involvement of the gastrointestinal tract.

Primary mesenteric fibromatosis is a rare condition. The aggressive nature of these tumors and the potential for major morbidity secondary to resection makes it a challenging disease for the surgeon. We report a case of mesenteric fibromatosis with involvement of small bowel.