Analytical Profile of Kanchanara Guggulu Tablets Prepared as per References in Sharangadhara Samhita and Bhaishajya Ratnavali

Marketing of Guggulu, an exudate obtained from the plant Commiphora mukul and its preparations is a great concern of different ayurvedic pharmaceutical houses due to its adulteration, substitution and non-availability of genuine samples. Standardization of raw drugs and formulations with modern analytical tools increase their scope, acceptance and scientific validity. In the present study, an attempt was made for the physicochemical analysis of Kanchanara guggulu tablets (having Guggulu as the major ingredient) prepared as per references in Sharangadhara Samhita and Bhaishajya Ratnavali to develop an analytical profile of the formulation. The study was based on the standard analytical parameters proposed by API and PLIM. Six samples of tablets were prepared as per two references (three for each reference) which were available in market following the same manufacturing procedures. The study comprised of three stages- pharmacognosy of raw drugs, pharmaceutical work and analytical study. The analysis was done using the parameters like organoleptic evaluation, weight variation, hardness, friability, disintegration time, ash values, extractive values, loss on drying, pH, HPTLC and microbial contamination and an analytical profile was developed as per both references.

A study to assess the effectiveness of music therapy in controlling postoperative pain and anxiety among surgical patients (major abdominal surgery) in RMMCH, Annamalai University

Pain is a universal human experience, yet no two individuals experience and respond to pain exactly the same way and also pain is the predominant complaint patients have after surgery. Anxiety is an emotional state characterized by feelings of apprehension, discomfort, restlessness, or worry. Music therapy is one of the non-pharmacological interventions to reduce postoperative pain and anxiety. To assess the effectiveness of music therapy in controllingAIM: postoperative pain and anxiety among surgical patients. Quasi-experimental designMATERIAL AND METHODS: Time series with multiple institutions of treatment) was adopted. A total of 40 patients 20 in experimental and 20 in control group chosen by convenient sampling technique. The instrument consisted of two sections: First section comprises of demographic and clinical variables of the patient. Second section was Speilberger State-Trait Anxiety Scale Form Y-1 and Numerical Pain Rating Scale. Reiki instrumental music was selected for intervention. Music therapy was provided through head phone on second and third postoperative day to the experimental group in two sessions in each day totaling four sessions lasting for 30 minutes each. Assessment was done periodically for two sessions at a interval of 2 hours per day after music therapy. The postoperative pain intensity score of the experimentalRESULTS: group was significantly reduced from severe to mild level, where as in the control group pain intensity score was reduced from moderate to mild level. (p< 0.001).The postoperative anxiety level reduction for experimental group was from moderate to mild level, where as in the control group anxiety level remained constantly at moderate level. (p< 0.001). There was no significant association between preoperative anxiety with previous experience of surgery. CONCLUSION: Music therapy is a simple, safe and effective method for reducing postoperative pain and anxiety.

Unusual Presentation of a Thyroid Malignancy: A Case Report

Medullary thyroid carcinoma is a rare malignancy. We report a case of Medullary thyroid carcinoma in a 56-year-old male patient. Patient presented with lower limb paresis and severe hypokalemia. Cushing’s syndrome is a rare complication of Medullary thyroid carcinoma [MTC] and is due to ectopic Adrenocorticotropic [ACTH] secretion by tumor cells. Cushing’s syndrome presents a challenging diagnostic and management issue in patients with MTC. Entire clinical history, laboratory investigations, microscopic pictures are discussed in detail.

RECK and TIMP-2 mediate inhibition of MMP-2 and MMP-9 by Annona muricata

Up-regulation of MMP-2 and MMP-9 plays a significant role in promoting cancer progression by degradingthe components of the extracellular matrix, thereby enhancing the migration of tumor cells. Although the antiproliferative and apoptotic effect of Annona muricata is well established, its effect on MMP-2 and MMP-9, amajor target in several types of cancers, has not been studied. Powdered samples of various parts of A.muricata like fruit, stem, seed, and twig extracted using aqueous methanol showed significant dose-dependentinhibition of MMP-2 and MMP-9 in a highly metastatic fibrosarcoma cell line, HT1080. Additionally, theseextracts also up-regulated the expression of several endogenous inhibitors of MMP-2 and MMP-9 likeREversion-inducing Cysteine-rich protein with Kazal motifs (RECK) and Tissue Inhibitor of Metalloproteinase-2 (TIMP-2). Furthermore, primary cells developed from tumor tissues obtained from patients notexposed to chemotherapy, also exhibited similar results. Remarkably, the inhibition of MMP-2 and MMP-9observed was tumor specific, with the A. muricata fruit extract showing only 2% inhibition in cells obtainedfrom normal tissues, when compared to 60% inhibition observed in cells obtained from tumor samples. Thepresent study elucidates a novel mechanism by which A. muricata extracts selectively exhibit their anti-canceractivity in tumor cells by down-regulating MMP-2 and MMP-9 that are important biomarkers in cancer.

Awareness about adverse drug reaction monitoring and pharmacovigilance among final year medical students in tertiary care teaching hospital in Andhra Pradesh: a cross sectional study

Background: Adverse drug reaction (ADR) is an unwanted, undesirable effect of a drug that occurs during clinical use. ADRs will occur daily in health care institutions and can unfavourably affect a patient's quality of life, frequently causing considerable morbidity and mortality. Pharmacovigilance is defined as the science and activities relating to the detection, assessment, understanding and prevention of adverse effects or any other drug-related problem.Methods: It was a non-interventional study was done among hundred final year medical students at Kurnool Medical College, Kurnool, Andhra Pradesh. The study instrument was a predesigned questionnaire was structured by following the precedence, which was set by parallel studies. The participants were given forty-five minutes to answer the questionnaire; the questionnaires were then analyzed by grading the respondents into three categories: poor, unsatisfactory and satisfactory.Results: This study showed satisfactory results about awareness, knowledge and methods of application of pharmacovigilance among final year medical students 55%, 47%, 54% respectively and positive correlation between awareness, knowledge and methods of application of pharmacovigilance among final year medical students significantly (<0.0001) correlated.Conclusions: The present study revealed that the final year medical students were satisfactory in awareness and knowledge and methods of application of pharmacovigilance. The correlations told that the higher the awareness, the more was the knowledge and better were the methods of application. Likewise, the knowledge and practices were significantly and positively related to a correlation.

Prevalence Of Paandu (anaemia) Amongst Patients Reporting At Outpatient Department Of National Institute Of Siddha

Anaemia is the most common nutritional problem in the world .In the outpatient department of National institute of Siddha the significant numbers of anaemia cases are reporting for treatment. As the part of partial completion of 1st year MD degree the investigator select the minor project to determine the data about prevalence of Paandu (Anaemia) in NIS OPD patients. This study includes 500 OPD patients. OPD patients in the age between 13-74 years were randomly selected daily (Systematic random sampling method). A pre-designed self-administrated questionnaire interview method is used for collecting data about the patients. Information on personal characteristics, socio economic status, diet, lab investigations, clinical profiles are obtained. The study results showed that the prevalence of anemia amongst patients reporting at NIS OPD were 45.6%. The mean haemoglobin concentration was 11.4g/dl in female and 12.8g/dl in male. Majority of female in reproductive age (15-49 years) had the highest prevalence of anemia. And the high proportion of microcytic hypochromic anaemia (22.2%) was founded in the selected samples which indicate that Iron deficiency was the main cause of anaemia. Effect of socio economic status on anemic patients reported in NIS also calculated according to ‘Modified Kuppusamy socio economic scale’ which results that patients belongs to the upper lower status (12.2%) are more prone to anemia. Therefore the results of this study can be used to design target interventions aimed at reducing the prevalence of anemia in NIS OPD and to help conduct the interactive educational programs for improve disease awareness in female patients especially. And further studies are needed for clarify prevalence and etiology of anaemia in school going children (Below 13 years) at NIS OPD.

Preparation And Physicochemical Characterisation Of Swarna Makshika Bhasma

Mineral drugs play an important role in Ayurvedic therapeutics. Makshika, Copper pyrite is considered as Maharasa in Rasasastra. It is described as one among best Rasayanas in classical literatures. This study is an attempt to standardize the process of preparation of Swarna Makshika bhasma. The process commences with selection of raw material, which is the prime and crucial step ahead. Ayurveda Pharmacopoeia of India standards and classical methods were used for the same. Swarna Makshika bhasma was prepared as per the reference from Ayurveda Prakasha (Shodhana) and Rasaratna Samucchayam (Marana). Shodhana (purification) was done by open heating in an iron pan by adding Saindhava (rock salt) and lemon juice. Five Varaha puta with 6000C quantum of heat was opted for Marana. The process was performed using an Electric Muffle furnace. During each step classical methods for analyzing the product (Bhasma) was done which ensured the proper Bhasmeekarana. Swarna Makshika bhasma was then subjected to X-ray Diffraction study which reveals the presence of both haematite (58%) and magnetite (40%) in it and the structural representation of them in Bhasma was also noted. XRF study conducted found that the Bhasma posses 75.54% Iron and rest of the elements within its permissible limits which ultimately unwrap its safety. Scanning Electron Microscope study gave the particle size of Bhasma to be 2microns (50000 X magnification. The particle size recorded can be considered as the desired specification of the final Bhasma.

Clinical study of sexually transmitted viral infections in HIV seropositive patients

Human immunodeficiency virus disease (HIV) and sexually transmitted viral infections (STIs) are important cause of increasing morbidity and mortality in sexually active individuals, In our study we the incidence, age, sex distribution, risk factors and prevalence of viral STIs among HIV positive and negative patients who attended the tertiary care hospital and study we found that Herpes Genitalis to be the most common viral infection in HIV seropositive patients. Condylomaaccuminata are second most common viral infection in seropositive HIV patients. Social factors, lack of awareness, multiple sexual partners, poverty also contributed to the spread of HIV. HPV vaccine-based prevention and education programs need to be implemented in this high-risk community and centres providing voluntary counselling and testing (VCT) services for HIV. Introduction Human immunodeficiency virus (HIV) disease and sexually transmitted viral infections (STIs) are important cause of increasing morbidity and mortality in sexually active individuals. Patients suffering with viral STI are more vulnerable to acquire HIV infection in comparison with individuals without STI. HIV-seropositive patients are more vulnerable to acquire viral STI in comparison with HIVseronegative patients. Objectives of the Study To study the incidence, age, sex distribution, risk factors and prevalence of viral STI among HIV-positive and negative patients who attended the tertiary-care hospital. Materials and Methods This is a prospective and descriptive study conducted in STI clinic, Andhra Medical College, Department of Dermatology Venereology and Leprosy, King George Hospital, Visakhapatnam, Andhra Pradesh, for a period of 1 year from February 2017 to January 2018. The study includes 150 HIV-seropositive patients suffering with viral STI like genital herpes, molluscum contagiosum, genital warts, viral hepatitis and 150 HIV-seronegative patients. Results In our observation of 150 HIV-seropositive patients, herpes genitalis 57 cases (38%) was found to be the most common viral STI followed by condyloma accuminata 34 cases (22.7%). The most common age group involved was 20–29 years 68 cases (45.4%) with males most commonly effected 108 (72%) than females 42 (28%). Social factors like illiteracy, multiple sex partners and unprotected sex contributed to the risk of viral STI and HIV. Conclusion In our study, we found that herpes genitalis to be the most common viral infection in HIV-seropositive patients. Warts are second most common viral infection in seropositive HIV patients. Social factors, lack of awareness, multiple sexual practises, poverty also contribute to the spread of HIV.

Association between psychological distress and occlusion among temporomandibular disorder patients – a clinical study.

Background: TMD is a multifactorial disorder significant research efforts have been invested in finding its etiologies and management to improve their quality of life. Objectives: To evaluate and compare digital occlusal parameters, depression, anxiety and serum cortisol level between temporomandibular disorder patients and control group. Material and methods: A sample size of 24 TMD patients and 24 apparently healthy age and sex matched controls were recruited in the study. The patients occlusion time and disclusion time was recorded using T-Scan III, the level of anxiety and depression was evaluated by using Hospital Anxiety and Depression scale questtionaire and serum cortisol was evaluated by collecting fasting blood sample, under aseptic conditions. Results: The incidence of premature contacts (occlusal interferences), clusion time and disclusion time was significantly longer in TMD group than in control subjects. The anxiety and depression scores were statistically significant in TMD group compared to control group, but no statistically significant difference was observed in serum cortisol levels. Conclusion: The present study demonstrated increase in the premature contacts i.e occlusal interferences were high with increase in clusion time, disclusion time, anxiety and depression scores in TMD group, where as no significant increase in serum cortisol levels was seen among TMD group even though their anxiety and depression levels were high. Hence, patients with temporomandibular disorders should always be evaluated for stress and anxiety along with the T- Scan evaluation of occlusal prematurities and correction of the same.

Spectrum of thyroid lesions on fine needle aspiration cytology.

The incidence of thyroid lesions is increasing significantly nowadays. Many a times, differentiation between physiological, inflammatory, autoimmune, hyperfunctioning and hypofunctioning of thyroid gland, benign and malignant tumor poses diagnostic difficulty. Fine needle aspiration cytology (FNAC) with clinical correlation, along with ultrasonography and thyroid function tests are done in relevant cases. Final diagnosis requires morphological examination of the lesions. FNAC is widely accepted and has become the cornerstone in evaluation of the thyroid lesions, as unnecessary surgery can be avoided. We studied a total of 251 cases in the age range of 3 years to 72 years, who presented with thyroid swelling over a period of one year and got a spectrum of thyroid lesions on cytology. Incidence was more in females 230 cases (91.63%) compared to males 21 cases (8.36%). Nodular goiter was the commonest disease constituting 127 cases (50.59%) followed by Hashimoto’s thyroiditis 93 cases (33.05%) and malignancy was reported in 7 cases (2.78%). USG guided FNAC for optimization of results is necessary for the location of target lesion. Careful searching for malignant cells and repeat FNAC are the key to a successful diagnosis and to plan a proper surgical procedure. Follow-up is necessary in case of a benign mass.

Management of pain in cancer patients at a South Indian Hospital.

The main objectives were to study the incidence of cancer in the locality, pattern of drug prescribed and management of pain in cancer patients. In a total of 30 patients, 18 (60%) were male and 12 (40%) were female. Patients between the age group 51 and 60 were found to be more (n=7; 23.33%) to get hospitalized for the treatment of cancer. Right breast cancer (n=3; 10%) is more predominant in the cancer patients as a past medical history, which is followed by Left breast cancer, Penis cancer, Acute myeloid leukemia in 6.66% (n=2) and Non- Hodgkin lymphoma, B-cell acute lymphoblastic leukemia, T-cell lymphoma, Acute lymphocytic leukemia and airway obstruction, Burkett’s lymphoma, Right lung cancer, Carcinoma of mild transverse colon, etc. Diagnosis in the study population shown that Hodgkin lymphoma (n=4; 13.33%) and Right breast cancer (n=4; 13.33%) were predominant cancer, which is followed by B-cell acute lymphoblastic leukemia, left breast cancer, penis cancer, acute myeloid leukemia in each of 2 (6.66%) patients. The most commonly used pain medications were Tramadol and Diazepam, these drugs are prescribed in 8 patients each (26.66%), and it is followed by Morphine, Phenobarbital and Flurazepamwere found in 4 patients each (13.33%).

Immunomodulatory effect of dietary nelumbo nucifera (lotus) in growth and haematology of cirrhinus mrigala challenged with pseudomonas aeruginosa.

The present study was carried out to evaluate the immunostimulant potential of Nelumbo nucifera (Lotus). Formulated diets with different concentrations of ethanolic extract of N.nucifera (D1=0%, D2=1% and D3=2%) were fed to Cirrhinus mrigala for 40 days, the Specific Growth Rate (SGR) and Feed Conversion Ratio (FCR) were calculated significant increase was observed in SGR &FCR. Then the experimental fishes were infected with Pseudomonas aeruginosa and after 5 days the haematological parameters like Total Erythrocyte count (TEC), Haemoglobin (Hb), Total leucocyte count (TLC), Differential leucocyte count (DLC), serum total protein, serum albumin and globulin levels were analyzed. The TEC, Hb, TLC, Lymphocytes and monocyte counts increased significantly in D3 diet fed fishes. Highly significant increase was observed in serum total protein and albumin levels only. Globulin levels remain unchanged. Basophil and Eosinophil counts decreased significantly. Thus N.nucifera in fish feed preparations may be included as growth promoter and immunostimulator.

Studies on the reproductive and pollen biology of Terminalia Arjuna, W&A (Combretaceae).

Terminalia arjuna is a deciduous tree widely distributed in tropical semi-evergreen and moist deciduous forests. Flowers of T. arjuna have ten stamens, which remain inside the bud and anthesis is carried out at different times of the day. Pollen grains are yellow in colour, medium and spherical, aperture is tri zonocolporate and exine is smooth. The pollen: ovule ratio is about 15,400 : 1. Optimum germination was seen in BBM + 12.5% sucrose. After 16 hr of anthesis, the pollen grains lost their viability and there was no fruit set. The current findings will be useful in studying pollen – pistil interactions, gene flow and heterozygosity of the T. arjuna populations.

Isolation and purification of cuticle degrading extra cellular proteases from entomopathogenic fungal species of beauveria bassiana and metarhizium anisopliae.

Enhanced Pr1 and Pr2 activities were observed in entomopathogenic fungi Beauveria bassiana (UB9) and Metarhizium anisopliae (UM4) supplemented with casein. Highest activity was observed at 72 hours of incubation when compared to minimal medium (MM) and colloidal chitin amended media. The extra cellular proteases (Pr1 and Pr2) thus isolated were purified through dialysis and their activities were found to be increased by two-fold. Pr1 and Pr2 were subjected to SDS - PAGE analysis and activity gel electrophoresis. The molecular weight of protease produced by Beauveria bassiana (UB9) is 19 KD and that of Metarhizium anisopliae (UM4) is 21 KD.

Antioxidant and antifungal activities of essential oil of Alpinia calcarata Roscoe rhizomes.

Antioxidant and antifungal activity were determined for the essential oil of Alpinia calcarata Roscoe (Zingiberaceae) rhizomes. Its antioxidant properties were investigated by the 2,2-diphenyl-1-picrylhydrazyl (DPPH) free radical scavenging assay and thiobarbituric acid reactive substances (TBARS) assay. Butylated hydroxy toluene (BHT) and vitamin E served as positive controls. Antifungal activities were investigated against crop pathogens Curvularia spp. and Colletorichum spp. using the agar plate method. Fifty percent effective concentration (EC50) and % antioxidant index of the essential oil were 45 ± 0.4 and 16.1 ± 0.2 for DPPH and TBARS assays, respectively. The degree of, the essential oil's inhibition of the growth of crop pathogens Curvularia spp. and Colletorichum spp. varied with time period its effects were higher than greater than for the positive control, daconil. In conclusion, the essential oil of A. calcarata rhizomes possess moderate antioxidant property and promising antifungal activity.

Oxidative Stress in Cardiovascular Disease.

Over the last two decades, it has become increasingly clear that reactive oxygen species (ROS), including free radicals are involved in cardiovascular disease. In recent years, there has been a growing interest in the clinical implications of these oxidants. The ROS are common by-products of many oxidative biochemical and physiological processes. They can be released by xanthine oxidase, NAD(P)H oxidase, lipoxygenases, mitochondria, or the uncoupling of nitric oxide synthase in vascular cells. ROS mediate various signaling pathways that underlie vascular inflammation in atherogenesis. Various animal models of oxidative stress support that ROS have causal role in atherosclerosis and other cardiovascular diseases. They are too reactive to be tolerated in living tissue, and aerobic organisms use sophisticated defense system, both enzymatic and non-enzymatic for prevention of overload of free radicals. In a number of pathophysiological conditions, the delicate equilibrium between free-radical production and antioxidant capability can be altered in favor of the former, thus leading to oxidative stress and increased tissue injury. This review focuses on the biochemical evidences concerning involvement of ROS in several cardiovascular diseases, namely atherosclerosis, heart failure, hypertension and ischemia/reperfusion injury.

Biochemistry of homocysteine in health and diseases.

The amino acid homocysteine (Hcy), formed from methionine has profound importance in health and diseases. In normal circumstances, it is converted to cysteine and partly remethylated to methionine with the help of vit B12 and folate. However, when normal metabolism is disturbed, due to deficiency of cystathionine-beta-synthase, which requires vit B6 for activation, Hcy is accumulated in the blood with an increase of methionine, resulting into mental retardation (homocystinuria type I). A decrease of cysteine may cause eye diseases, due to decrease in the synthesis of glutathione (antioxidant). In homocystinurias type II, III and IV, there is accumulation of Hcy, but a decrease of methionine, thus, there is no mental retardation. Homocysteinemia is found in Marfan syndrome, some cases of type I diabetes and is also linked to smoking and has genetic basis too. In hyperhomocysteinemias (HHcys), clinical manifestations are mental retardation and seizures (type I only), ectopia lentis, secondary glaucoma, optic atrophy, retinal detachment, skeletal abnormalities, osteoporosis, vascular changes, neurological dysfunction and psychiatric symptoms. Thrombotic and cardiovascular diseases may also be encountered. The harmful effects of homocysteinemias are due to (i) production of oxidants (reactive oxygen species) generated during oxidation of Hcy to homocystine and disulphides in the blood. These could oxidize membrane lipids and proteins. (ii) Hcy can react with proteins with their thiols and form disulphides (thiolation), (iii) it can also be converted to highly reactive thiolactone which could react with the proteins forming -NH-CO- adducts, thus affecting the body proteins and enzymes. Homocystinuria type I is very rare (1 in 12 lakhs only) and is treated with supplementation of vit B6 and cystine. Others are more common and are treated with folate, vit B12 and in selected cases as in methionine synthase deficiency, methionine, avoiding excess. In this review, the role of elevated Hcy levels in cardiovascular, ocular, neurologial and other diseases and the possible therapeutic measures, in addition to the molecular mechanisms involved in deleterious manifestations of homocysteinemia, have been discussed.

Studies of some biochemical changes in the tissues of Catla catla (Hamilton), Labeo rohita (Hamilton) and Cirrhinus mrigala (Hamilton) exposed to NH3-N, NO2-N and NO3-N.

Biochemical changes, total proteins, glycogen, aspartate and alanine (AAT and ALAT) amino transferases were studied with exposure of sublethal concentrations of NH3-N, NO2-N and NO3-N to the freshwater fish Catla catla (Hamilton), Labeo rohita (Hamilton) and Cirrhinus mrigala (Hamilton). Depletion in the food reserves and enzyme activity was observed in all the three fish species exposed to these toxicants. Hence, the concentrations of NH3, NO2 and NO3 in water need to be monitored in water quality in aquaculture practices.

The toxicity of ammonia, nitrite and nitrate to the fish, Catla catla (Hamilton).

The acute toxicity of unionized ammonia; nitrite and nitrate to the Indian major carp Catla catla (Hamilton) was determined using static and continuous flow through systems for 24 hours. The median lethal concentration (LC50) values for 24 h of ammonia (NH3-N), nitrite (NO2-N) and nitrate (NO3-N) were 0.045 mg/l, 120.84 mg/l and 1565.43 mg/l in static test respectively and were 0.036 mg/l, 117.43 mg/l and 1484.08 mg/l in continuous flow through test respectively.