Evaluation of usage of immunity boosters among the citizens of Pune district during the COVID-19 pandemic

Introduction: Post the coronavirus disease (COVID-19 pandemic), there was a spike in demand for immunity boosters, leading to the irrational use of supplements. To assess the usage of immunity boosters among the citizens of Pune City and correlate the side effects associated with supplements. Material and Methods: A cross-sectional study was conducted from September 2020 to May 2021 in Pune. Data, such as demographic, supplement intake (allopathic, homeopathic, and ayurvedic/home remedies), duration, frequency of supplements, and side effects associated with supplements, were collected through a personal interview and e-form circulation. The correlation of the immunity boosters with the side effects was done using Karl Pearson’s Correlation test in SPSS software version 22.0. Results: Out of 1006, the ayurvedic supplements/home remedies were preferred by 906 (98%) allopathic supplements by 599 (65%) and homeopathic supplements by 256 (28%) participants. The commonly reported side effects were acidity (37%), headache (29.6%), nausea (9%), loss of appetite (8.8%), diarrhea (7%), stomach ache (6%), cough (5.6%), and constipation (4.1%). These side effects had a weak positive linear proportionality with ayurvedic supplements such as amla (r = 0.162), Giloy Vati (r = 0.139), turmeric (r = 0.108), and Kadha (r = 0.102); also, Eupatorium perfoliatum, Vitamin C, and Vitamin D showed a linear proportionality with loss of appetite (r = 0.15), headache (r = 0.12), and cough (r = 0.12), respectively. A higher incidence of side effects such as nausea (r = 0.267), diarrhea (r = 0.243), headache (r = 0.164), and acidity (r = 0.113) was observed when supplements were taken for 6 months. Conclusion: Most participants were on immunity boosters during the COVID-19 pandemic. The study concluded that using immunity boosters in excess or for more than 6 months causes side effects, the most recurrent ones being acidity, headache, nausea, and lack of appetite.

Florid Osseous Dysplasia in Edentulous Maxilla and Mandible: A Rare Case Report

Introduction: Florid osseous dysplasia (FOD) has been described as a reactive fibro-osseous lesion affecting the jaw bones especially the tooth bearing areas. Usually, this lesion is asymptomatic unless accidentally detected during radiographic examination for any other purpose. Although the etiology is unclear, several theories suggests that its origin was related to reactive or dysplastic changes within the periodontal ligament. Case Presentation: Presenting a case of Florid Osseous Dysplasia within the edentulous maxilla and mandible of 65-year-old female patient. Patient reported with a diffuse swelling in the edentulous maxillary and mandibular posterior regions intraorally. Radiographically, multiple radiopaque lesions were noted bilaterally in the posterior mandible and also in the right posterior side of the maxilla. On microscopic examination, the lesion was composed of spicules of bony trabeculae with osteocytes in lacunae and intervening fibro-fatty connective tissue with plump fibroblasts. Management and prognosis: After the incisional biopsy, surgical recontouring was done along with further regular follow up and observation. Conclusion: Diagnosis of the jaw lesions is based on clinical findings, radiographic features, and histological picture, whereas FOD can be diagnosed based on its clinical and radiographical features. Even though the surgical approach may lead to many complications like osteomyelitis, infection, fracture etc., a biopsy may be done to confirm the diagnosis.

Review on Vaidyaka Paribhasha Pradipa- A Comprehensive Treatise of Indian Pharmaceuticals by Govind Sen

Vaidyaka Paribhasha Pradipa was written by Govind Sen, son of Krishna Vallabh Sen. Vidyotini Hindi Tika was written by Indradev Tripathi. The book Vaidyaka Paribhasha Pradipa consists of almost all references collected from various Samhitas regarding the fundamental principles and different Ayurvedic herbal pharmaceutical preparations and descriptions on Panchakarma. The whole content of the book is divided into 4 Khandas. Prathama khanda deals with Mana paribhasha, Dravya samgrahana vidhi, and shelf life of different Kalpana etc. Dwitiya khanda deals with Panchavidha kashaya kalpana and its Upakalpana and dose. Tritiya khanda deals with Sneha kalpana, Sandhana kalpana and Paribhasha of different Gana. Chaturtha khanda deals with Panchakarma procedures and Sneha murchana. The present book review mainly focuses to highlight the framework of Vaidyaka Paribhasha Pradipa, provides information about the author, details of 4 Khandas, a special contribution to the field of pharmaceutical science by the author. Thus, Vaidyaka Paribhasha Pradipa, the compilation book on Bhaishajya Kalpana is a very essential and mandatory book for those who aspire to gain basic, clear, and thorough knowledge in Ayurvedic pharmaceuticals. It is one of the indispensable reference books. The present book is designed to help the young practitioners who prepare medicines and graduates and post-graduate scholars get a clear idea of medicine preparation.

Optimization of Diltiazem hydrochloride osmotic formulation using QBD approach

Abstract Diltiazem hydrochloride (DLH) is a calcium channel blocker useful for the treatment of angina pectoris, arrhythmia, and hypertension. DLH having a short half-life needs frequent administration for successful treatment but this poses a problem of poor patient compliance. These requirements are served by elementary osmotic pump tablets (EOP) based controlled-release (CR) systems. Quality by design (QbD) approach assists in screening various factors with subsequent assessment of critical parameters that can have a major impact on the scalability of EOP. Tablets were formulated using wet granulation method followed by osmotic coating. Factorial design based QbD strategy aided in defining the risk assessment of influential variables such as hydrophilic polymers and osmotic coat component on the in-vitro release kinetics of the designed EOP tablets. These formulated EOP systems followed zero-order kinetics, a characteristic feature of EOPs. EOP tablets were formulated applying a systematic QbD statistical approach. The formulated DLH EOP systems with improved concentration-independent behavior helped to address the challenges of IR formulation. Application of QbD strategy in ascertaining the scalability of DLH EOP formulation would help pharmaceutical industries in the translation of EOP based drug delivery systems from R&D to market.

Evaluation of Relationship of the Methylene Tetrahydrofolate Reductase Enzyme Polymorphisms with Serum Methotrexate Concentration and Toxicity in Acute Lymphoblastic Leukemia Patients Treated with High Dose Methotrexate Infusion

Background: Methotrexate (MTX) blocks MethyleneTetrahydrofolate Reductase (MTHFR) Enzymethereby, interrupt folate metabolism, it is used in thetreatment of cancer and autoimmune disorders. Aimand Objectives: The present study aimed to evaluatethe relationship of the MTHFR polymorphisms withserum MTX concentration and its toxicity in AcuteLymphoblastic Leukemia (ALL) patients treated withhigh dose MTX infusion. Material and Methods: Levelof Serum MTX was measured, along with the detectionof MTHFR polymorphisms viz. C677T and A1298Cby Polymerase Chain Reaction (PCR) followed byDNA sequencing. The percentages of toxicitydeveloped in patients were calculated among the wildtype and carriers for both polymorphisms and werecompared between the groups. Results:The majority ofpatients 36 (72 %) were wild type for the C677Tpolymorphism and 32 (64 %) of patients were carriersfor the A1298C polymorphism [48% heterozygous(AC), and 16 % homozygous (CC)]. Among 50 ALLpatients studied, significant difference was noted in thegenotype and allele frequencies for C677Tpolymorphism, while only allele frequencies differedsignificantly for A1298C polymorphism. The serumMTX level at 48 hours after the start of High DoseMTX (HDMTX) infusion of the C677T variant (CT)was slightly high in all four cycles however, in the firstcycle, there was a significant increase in the level ofMTX. There was no significant difference in the serumMTX level found in all four cycles between patientswild type and carriers for A1298C polymorphism. ForA1298C polymorphism, the mean SGPT level incarriers was significantly high as compared to wildtype. Conclusion: The present study concludes thatpatients with C667T variant had elevated serum MTXconcentration at 48 hours after the start of HDMTXinfusion.

Analyzing the Effect of Single Intraoperative Intravitreal Bevacizumab on Central Macular Thickness in Diabetes Mellitus Patients Undergoing Phacoemulsification Under Local Anesthesia

Aim: The aim of the study was to assess the effect of combined phacoemulsification and single intraoperative intravitrealinjection of bevacizumab on the central macular thickness (CMT) in diabetic patients.Materials and Methods: A prospective observational study was conducted on 30 eyes with diabetic retinopathy from February2018 to February 2019. All patients underwent thorough ophthalmic evaluation. Phacoemulsification performed by a singlesurgeon using either 0.5% topical proparacaine eye drops or sub-tenon local anesthesia as per the preference of the surgeonin individual case. Bevacizumab 0.05 ml (1.25 mg) was injected intravitreal using a 30-gauge needle through the pars planainto the vitreous cavity after intraocular lens implantation. Patients were followed postoperatively at day 1 then at 1 week and1 month, respectively, for recording the CMT and best corrected visual acuity at 1 month postoperatively.Results: The mean CMT for all the patients at post-operative day 1 and month 1 was 277.96 ± 142.40 μm and 289.50 ± 155.74 μm,respectively. Patients with <10 years of diabetes had mean CMT of 329.09 μm and 318.90 μm, at post-operative day 1 and at1 month, respectively, while those with diabetes more than 10 years had mean CMT of 248.36 μm and 272.47 μm, respectively.In mild non-proliferative diabetic retinopathy (NPDR) and stable proliferative diabetic retinopathy group no significant worseningoccurred in CMT thickness, while in moderate NPDR, four out of 13 cases showed significant increase in CMT (>10%) at 1 month. Insevere NPDR, out of 4 cases 1 case showed significant increase in CMT while other three cases showed modest reduction of CMT.Conclusion: Intravitreal administration of 1.25 mg bevacizumab at the time of cataract surgery is a safe and effective way inavoiding new onset maculopathy in diabetic retinopathy patients. It is also effective to treat pre-existing clinically significantmacular edema and prevent its progression to some extent in few cases.

A study of knowledge, attitude and practice on use of antibiotics and its resistance among the doctors and interns at urban tertiary care hospital: an interventional study

Background: Infections due to resistant micro-organisms considerably increase the mortality rate, treatment cost, disease spread and duration of illness. The development of antibiotic resistance (AMR) is increasing steadily increasing over the last 10-15 years, which is a real threat to disease management. Many studies states that about 20-50% of antibiotic use unnecessary so decreasing the use of antibiotics is the first step to curb the AMR.Methods: A questionnaire based prospective interventional study among the doctors. Systemic random sampling was applied. The pre tested structured questionnaire was used. Data抯 were summarised in the excel sheet, analysed by proportions, percentages and other statistical methods like Student t test, Fisher test and Chi square test were used to check the association. The p>0.05 was considered as significant.Results: Out of 200 doctors, preliminary screening of 170 was included in the study and finally 156 participants were actively selected for analysis of results. Out of 156 participants, 55.1% were MBBS Intern and 44.9% were doctors. High significance (p=0.0001) were found between pre and post knowledge, attitude and practice of doctors.Conclusions: Further modes of studies have to perform to identify the determinants of attitude behaviour and motivation that lead people to use and misuse antibiotics. For effective outcome many more qualitative and quantitative studies are required. In addition, health care system should follow proper regulation and prescription policy as well as controls for prescription of antibiotic drugs.

Are we operating unnecessarily?: caesarean audit in a single unit of a private tertiary care hospital in North India

Background: Caesarean section emerged as a lifesaving surgery in situations where vaginal delivery could put the mother and fetus at risk. Over the years global rise in caesarean delivery rate has been alarming and may be attributed to changes in medical practice and societal expectations, especially in urban areas and developing countries. Rising caesarean rate is worrisome as it increases maternal morbidity, exposes the mother to future obstetric risks, besides increasing financial burden on the health care system. Caesarean audits could be an effective tool to analyse, understand and propose solutions to reduce caesarean rates. Hence, this retrospective study was conducted to audit caesarean sections done over a period of 5 years (2011 to 2015) in a single unit of a tertiary care private hospital in North India.Methods: The case records of all caesarean deliveries from January 2011 to December 2015 were analysed retrospectively for demographic profile, clinical parameters and recorded indication of caesarean section on the basis of Robson’s classification.Results: The caesarean section rate in the study was 61.8%. According to Robson’s 10 system classification, Group 2, 5 and 10 were the largest contributors. The commonest indication was previous LSCS (18.7%) followed closely by fetal distress (15.4%) and prolonged labor/failed induction (13.3%). Maternal request contributed 10.6% of the Caesarean deliveries.Conclusions: The caesarean section rate in our study is way higher than the national average. We need to re-duce caesareans in primigravidae and consider VBAC where appropriate. Use of Electronic fetal monitoring during labor needs to be optimized. Appropriate use of oxytocics, proper monitoring and using robust criterion to infer non progress of labor are important. Appropriate counselling and assured pain management during labor may help reduce caesareans on maternal request.

Early neonatal morbidities in late preterm compared to term neonates born in a tertiary care private hospital

Background: Late preterm babies, born between 34 completed weeks of gestation through 36 weeks 6/7 gestation, tend to be physiologically less mature than term infants, subjecting them to an increased risk of developing various morbidities. Limited information is available regarding the current scenario in India. Therefore, the objective of this study was to understand and compare the early morbidities in late preterm newborns with those in full term babies in a tertiary hospital in India.Methods: The current prospective, observational study consisted of total 150 babies divided into two groups equally; late preterm neonates born between 34 and 36 weeks of gestation and full-term neonates. Weight (at birth, at 72 hours), heart rate, temperature and respiratory parameters were noted of all babies. The newborns were examined for respiratory morbidities, ability to breastfeed, hypoglycemia, hypothermia, neonatal jaundice and signs of sepsis. The need for resuscitation, admission to neonatal intensive care unit (NICU) and parenteral nutrition was also assessed. Data was expressed as mean'SD and was analyzed using the Student 't' and Mann Whitney U tests.Results: The mean length and weight at birth in late preterm babies was significantly lesser than term newborns. Late preterm babies were found to have significantly higher incidence of complications like hyperbilirubinemia (62.7% vs 13.3%), respiratory morbidities (16% vs 4%), poor feeding, hypothermia, hypoglycemia, and sepsis compared to term newborns (p<0.01).Conclusions: Late preterm infants are at a higher risk than term infants for a number of neonatal complications. Initiatives imparting special care to late preterm infants are required in order to lower the morbidities endured by this population.

Epidemiological determinants of road traffic accidents: a cross sectional study in Amravati, Maharashtra, India

Background: Road traffic accidents (RTAs) represents a major epidemic of non-communicable disease in the present century affecting families, community and nation as a whole. Objectives was to study the epidemiological determinants of RTAs.Methods: A hospital based study of RTA victims was conducted for a period of one year at the District General Hospital and Medical College hospital of Amravati, Maharashtra. A total of 1394 patients were studied. Descriptive statistics like percentage and proportions were calculated. Proportions were compared using Chi square test of significance.Results: 86.7% were males and the maximum affected age group was 21 to 30 years. Majority of accidents were seen in summer season and on Monday of the week. Accidents were highest from 12 noon to 6 pm. Alcohol consumption was seen in 27% of the drivers. Two-wheelers were the commonest vehicle involved in RTAs. A total of 481 (34.5%) victims had fractures at various sites of the body, out of this 52.8% was of lower limbs. Right sided bony injuries were more common.Conclusions: There are multiple factors associated with RTAs which due to the lack of road safety measures in the country are playing their role. It is the need of the hour to address this issue and formulate rules and regulations and evaluate its enforcement.

Correlation of Thyroid Disorders with Abnormal Uterine Bleeding (AUB).

AUB is a common and complicated clinical entity. Thyroid disorders are the most common endocrine disorders in India with a prevalence of 26% in women and its incidence increases with age.Menstrual disturbances may accompany or may even precede thyroid disorders. We wanted to study the correlation between thyroid disorders and abnormal uterine bleeding in women of reproductive age group.METHODSThis is cross-sectional study conducted on 165 subjects who fulfilled the eligibility criteria in the Department of OBGY, AVBRH, Sawangi for a period of 2 years. Thorough clinical examination, ultrasonography and thyroid function tests of the patients was done. RESULTSIn this study, maximum number of patients were in the age group of 21-30 years. Regarding bleeding patterns, maximum patients had complaints of menorrhagia (46.06%). 77.58% of patients were euthyroid, 12.12% were subclinical hypothyroid, 17.88% were overt hypothyroid and 2.42% patients were hyperthyroid. Among both subclinical and overt hypothyroid patients, the most common menstrual irregularity was menorrhagia in 55% followed by polymenorrhagia, acyclical bleeding, polymenorrhoea, oligomenorrhoea and metrorrhagia. Among hyperthyroidism, the most common menstrual irregularity was oligomenorrhoea in 75% followed by hypomenorrhoea in 25%.CONCLUSIONSOur study concludes that the work up of any patient with AUB should essentially consist of T3 and T4 levels along with TSH levels as a mandatory part otherwise cases of subclinical hypothyroidism may be missed if only TSH levels are measured

Study of sociodemographic factors affecting outcome of babies admitted in neonatal care unit

Background: A country needs sound epidemiological information to prioritize, plan and implement the public health care system effectively. Outcome data from hospitalized patients reflect the causes of major illnesses and care seeking behaviour of the community. Thus, we felt the need to conduct this study at our hospital to assess the socio-demographic factors affecting outcome of babies admitted in neonatal intensive care unit.Methods: The present study was a hospital based observational descriptive study. The study was undertaken in neonatal intensive care unit (NICU) of department of paediatrics of tertiary care centre. The study period was from January 2013 to December 2013 i.e. total period of one year.Results: Among 1050 total neonatal admissions 601 (57.29%), were from rural area and 449 (42.70%) were from urban area. Multinomial regression analysis reveals that socio-demographic factors like age of mother, parental intake of tobacco alcohol in any form, socioeconomic class IV, in born place of delivery, occupation and education of father, low birth weight and male sex of baby affects the outcome of babies.Conclusions: Cure rate in NICU admissions was 69% which may be due to available speciality staff and logistics. Taking this into account, 40 bedded NICU in tertiary care hospital seemed to be essential and sufficient.

Takotsubo cardiomyopathy complicating a twin pregnancy at partum

Takotsubo cardiomyopathy is a rare syndrome characterized by acute left ventricular dysfunction with regional left ventricular ballooning, mimicking myocardial infarction. This condition is often described in post-menopausal women. Authors present a case in an elderly primi with twin gestation immediately after Cesarean surgery. We discussed her presentation, investigations, diagnosis, management and outcome. 35 year female, a primi with twin pregnancy developed chest pain and shortness of breath immediately after Cesarean surgery. Her Electrocardiograph was abnormal, and Echocardiogram demonstrated abnormal apical ballooning of the left ventricle and severe dysfunction. Cardiac enzymes were elevated and chest skiagram showed pulmonary edema. She was managed in the intensive care unit with oxygen supplementation, diuretics and inotropes. She made an excellent recovery with normalization of left ventricular ejection fraction within 8 days. During the six months follow up, she was asymptomatic and left ventricular function remained normal.

A clinico-radiological study of mild traumatic brain injury using the national emergency x-radiation utilization study decision instrument

Background: While traumatic Brain Injury (TBI) is one of the leading causes of morbidity and mortality in the Indian subcontinent, little is known regarding its basic characteristics. While CT scanning plays an important role in primary assessment of TBI, it is not always indicated in cases of mild TBI. Thus, the present study was carried out to describe the characteristics of cases of mild TBI presenting to a tertiary care hospital in India and determine the need for CT scanning in them using the National Emergency X-radiation Utilization Study (NEXUS) decision instrument.Methods: In this prospective study, a detailed history was obtained, and clinical examination performed for each patient, followed by calculation of the NEXUS score. CT scan findings were recorded. Outcome measures were safe discharge, need for neurosurgical intervention or death.Results: Out of the 425 patients, 87.05% were males. Road Traffic Accident (RTA) was the most common mode of injury. 206 patients had significant intracranial injuries, with skull fractures and hemorrhagic contusions being the most common.138 out of these 206 had a positive NEXUS score. ENT bleed and history of loss of consciousness were also found to be important predictors of significant intracranial injuries. 83 patients were discharged safely from the emergency department, 14 required neurosurgical intervention and 2 died during the course of their stay in the hospital. Conclusions: NEXUS decision instrument can be a useful tool to determine the need for CT scanning in patients of mild TBI.

Clinico-pathological study of ovarian tumors in Goa medical college: a tertiary care centre in Goa, India

Background: Ovarian neoplasms are a distinct entity in women health care and are increasingly contributing to morbidity and mortality among women. The burden is not only related to the increasing incidence but also to the varied pathological features depending on the tissue of origin and pathogenesis. The study was carried out to find the prevalence and determine the clinical presentation and histo-pathological distribution of ovarian neoplasms. Management options were also noted.Methods: It is a retrospective study carried out at Goa Medical College between January 2013 to December 2015. All patients diagnosed and treated for ovarian neoplasm were included in the study. Data was tabulated using Microsoft Excel and descriptive statistical analysis was carried out using SPSS version 23.Results: A total of 3111 patients were admitted in gynecology at Goa Medical College during the specified time period. Of these 358 cases were diagnosed with ovarian neoplasm. On histopathology 196 were benign tumors and 162 were reported to be malignant. Commonest presenting symptom was abdominal distention seen in 51.1% of the patients, pain in 44.4%, followed by dyspepsia in 26.85%. Epithelial tumors were most common (Benign - 39.3%, Malignant - 41%) followed by sex cord stromal tumors and germ cell tumors in 7.26% of cases.Conclusions: Surface epithelial tumors were most common neoplasm. An alarming high no. of malignant tumors (45.25%) was found in present study. 44.4% tumors presented in 41-50 years age group. Presenting complaints were vague and nonspecific leading to delay in diagnosis. Histological type correlates with prognosis; therefore, preponderance of histological type will guide treatment options and patient education with respect to epidemiology.

Evaluation of antidiabetic efficacy of Murraya koenigii on Streptozotocin induced diabetes in experimental rats

Background: The medicinal plant Murraya koenigii shown to have a wide variety of pharmacological activities (hypoglycemic and hypolipidemic). Objective of this study is the present study was designed to evaluate Antidiabetic and Hypolipidemic property of Murraya koenigii in experimentally induced diabetes in rats.Methods: Experimental diabetes was produced with single dose of Streptozotocin (STZ): 45 mg/kg IP. The rats were randomly allocated in various groups for 37 days. After the confirmation of diabetes on 7th day (>200 mg/dl), hydroalcoholic extract of Murraya koenigii (500 mg/kg) was administered orally to experimental rats from day 7th day and continued for 37 days thereafter. Various antidiabetic (Glucose, HbA1C), metabolic (Lipid profile), safety (pancreatic lipase, Creatinine, SGPT, Histopathology of Liver and Kidney) were evaluated in various group.Results: Efficacy of Murraya koenigii was observed on various parameter of diabetes. Administration of STZ resulted in a significant decrease in diabetic changes (increase in blood glucose, HbA1C), altered lipid profile (p<0.01) in the Control group rats as compared to sham group. Murraya koenigii treatment demonstrated significant antidiabetic indicated by restoration of blood glucose, HbA1C level (p<0.01) compared to Control group. In addition, Murraya koenigii also documented hypolipidemic property of test drug. As per biochemical assessment of Pancreatic lipase, Serum creatinine, SGPT and Histopathological report, the test drug reduce the pancreatic, liver and renal marker and also showed safe to pancreas, Liver and kidney. The histopathological assessment of the liver and kidney confirmed the biochemical findings.Conclusions: The study concluded that the Murraya koenigii possess antidiabetic efficacy.

Spatio-temporal genetic diversity in Indian barley (Hordeum vulgare L.) varieties based on SSR markers

Barley is a popular cereal crop of nutritious and industrial importance and there is always a scope to improve a particular crop in view of its value and demand. Spatio-temporal studies discuss the diversity level among the existing varieties as well as the trend of genetic variation over a period of time and are useful in designing suitable strategies for genetic enhancement and improvement of a particular crop. Here, we used SSR markers to assess the level of spatio-temporal genetic diversity among fifty diverse released varieties of barley from India. Spatial diversity (0.233±0.16) was higher in varieties having exotic parentage as compared to the indigenous varieties (0.176±0.18) and significant diversity was also observed among the varieties released from different developing centers. There was a rising trend in % polymorphism and other diversity parameters among the barley varieties released before 1960s to 1970s, which may be attributed to the increasing usage of exotic germplasm during these decades. Increase in temporal diversity from 1970s to 1980s and to 1990s was not much as compared to earlier decades, which suggests that more diverse germplasm should be used to widen the genetic base of barley varieties released over the years. Further, structure and AMOVA results revealed strong differentiation among spatial groups, but not between temporal groups. The role of spatio-temporal genetic diversity studies and the importance of periodic monitoring of the varieties released for further crop improvement was emphasized.

Clinicopathological study of testicular lesions

Background: Testis is affected by both neoplastic and non neoplastic conditions. Non neoplastic lesions of the testis include epididymo-orchitis, testicular atrophy, undescended testis, testicular abscess etc. Testicular tumors are relatively rare. They constitute the 4th most common cause of death from neoplasia in the young males. This study was undertaken to study the histopathological spectrum, age wise distribution and clinical symptoms of testicular lesions.Methods: This is a retrospective study of three years conducted in the department of pathology, Aurangabad from June 2015 to May 2018. It included all the orchidectomy specimens received from the department of surgery and excluded the orchidectomy specimens sent for infertility and prostatic carcinoma. A detail clinical history was taken. Histopathological examination was done after routine processing and staining with H and E. The data collected was tabulated, analysed and compared to other similar studies.Results: We studied 70 cases. Non neoplastic testicular lesions were 57 and 13 were neoplastic. Non neoplastic testicular lesions were more common than the neoplastic ones. Non neoplastic testicular lesions presented most commonly in the 2nd decade. Most common non neoplastic lesion was epididymo-orchitis followed by torsion, atrophy and testicular abscess. Most common neoplasm was malignant mixed germ cell tumor. Most of the patients of neoplasms presented in the 3rd decade. The most common complaint was testicular swelling and pain.Conclusions: Majority of testicular lesions are non neoplastic. Neoplastic lesions are rare. Non neoplastic lesions mimic neoplastic ones clinically, as testicular swelling is the most common complaint. So histopathological diagnosis is necessary for an accurate diagnosis of testicular lesions.

DPP-4 inhibitory activity and myocardial salvaging effects of Commiphora mukul in experimental diabetes

Background: Commiphora mukul (Burseraceae) is commonly known as Guggul in Ayurveda. Several studies have reported antidiabetic activity of Commiphora mukul but there are no studies to explore the DPP-4 inhibitory activity and myocardial salvaging effects of Commiphora mukul in setting of diabetes mellitus. The present study was designed to evaluate the cardioprotective efficacy as well as safety of the medicinal plant Commiphora mukul (Guggul) in the experimental model of myocardial infarction co-existing with diabetes.Methods: Diabetes was induced with single dose of streptozotocin (STZ): 45mg/kg ip and myocardial infarction was produced by administering isoproterenol (ISP): (85mg/kg, sc) to rats 24 and 48 h prior to scarification (5th week). After the confirmation of diabetes on 7th day (glucose>200mg/dl), vildagliptin (10 mg/kg) and Commiphora mukul (200 mg/kg) were administered orally from 1st to 5th week (4 weeks). At the end of experimental period, normal control, diabetic-isoproterenol control, vildagliptin and Commiphora mukul group rats were sacrificed for further biochemical investigations as well as histopathological evaluation.Results: Commiphora mukul treatment demonstrated significant antidiabetic as well as myocardial salvaging effects as indicated by restoration of blood glucose, HbA1c and CPK-MB serum DPP-4, hs-CRP levels as compared to diabetic ISP control group. In addition, Commiphora mukul showed significant cardioprotection as indicated by positive correlation between cardiac marker CPK-MB and serum DPP-4. The histopathological assessment of heart, pancreas and biochemical indices of injury confirmed the cardioprotective effects of Commiphora mukul. In addition, Commiphora mukul was found to be safe to the liver and kidney.Conclusions: The natural DPP-4 inhibitor Commiphora mukul demonstrated significant cardioprotective effects in experimental model of myocardial infarction co-existing with diabetes.