Protective effect of Tribulus terrestris linn on liver and kidney in cadmium intoxicated rats.

Administration of cadmium (Cd) significantly increased the peroxidation markers such as malondialdehyde and protein carbonyls along with significant decrease in antioxidant markers such as super oxide dismutase and reduced glutathione in liver and kidney tissues. Cadmium also caused a significant alteration in hepatic and renal functional markers in serum viz. total protein, albumin, alanine transaminase, blood urea nitrogen and creatinine. Prominent pathological changes observed in liver were severe vascular and sinusoidal congestion with diffuse degenerative changes and mononuclear infiltration into peripheral areas, while the kidney showed vascular and glomerular congestion, cloudy swelling of tubular epithelium. Co-administration of ethonolic extract of T. terrestris or vitamin E along with Cd significantly reversed the Cd induced changes along with significant reduction in Cd load.

Protective effect of α-tocopheral on biochemical and histological alterations induced by cadmium in rat testes.

Cadmium (Cd) is a potential environmental pollutant and causes severe damage to reproductive organs in adults including ovary and testes. Of all antioxidants α-tocopheral is considered to be most potent chain breaking antioxidant. Our aim was to study the effect of α-tocopheral on biochemical and histological alterations induced by Cd in testes of rats. Group 1 served as control, while groups 2 and 3 received subcutaneous injections of CdCl2 (3 mg/kg b.wt) once a week for four weeks. Group 3 in addition received α-tocopheral (75 mg/kg b.wt.) orally, daily for six weeks. Cadmium caused testicular tissue biochemical alterations such as significant increase in MDA, a peroxidation marker, decrease in antioxidant markers viz SOD, CAT and GSH and functional markers viz ALP and LDH. Histological alteration induced by Cd consisted of desquamation of basal lamina, shrunken tubules, generalized germ cell depletion with multinucleated gaint cells, degenerating Leydig cells, vascular congestion, interstitial edema and significant reduction in spermatodynamic count. α- tocopheral significantly reversed all the Cd induced alterations. These results indicate that α-tocopheral has a protective effect against Cd indced biochemical and histological alterations in rat testes.

Investigation of an outbreak of device-related postoperative ventriculitis: a lesson learnt.

Pseudomonas aeruginosa (P aeruginosa) is one of the most common nosocomial pathogens. We report our experience of a device-related outbreak of postoperative ventriculitis caused by P aeruginosa thus initiating investigation of the unusual occurrence. Five neurosurgical patients were affected, postoperatively. The investigations entailed extensive screening of the common sources of contamination for colonization of P aeruginosa. Sterilized instruments used for surgery, including the ultrasonic aspirator (USA) sets and other hollow devices, were randomly sampled and cultured. Conventional culture methods yielded P aeruginosa, with almost similar antibiotic sensitivity pattern in all the patients and the ultrasonic aspirator, clinching the source of contamination. Routine surveillance, identification of unusual patterns, molecular epidemiological typing would be helpful in quick control of outbreaks of postoperative infections.

Cerebral blood flow velocity changes under nitrous oxide halothane anesthesia in patients with frontotemporal gliomas: a comparison of the normal and abnormal cerebral hemispheres.

BACKGROUND: Regional differences in vascular response to anesthetic agents in brain areas with and without tumors have not been investigated till now. The existence of such differences may influence the regional distribution of cerebral blood flow under anesthesia. MATERIAL AND METHODS: In 8 patients with frontotemporal gliomas, middle cerebral artery blood flow velocity (VMCA), pulsatality index (PI) and resistance index (RI) were determined in the normal and pathological cerebral hemispheres before and after stable nitrous oxide-halothane anesthesia. RESULTS: During halothane anesthesia, there was an increase in VMCA both in the normal cerebral hemisphere (69 +/- 11 to 100 +/- 38 cm/s; P = 0.05) and the hemisphere with tumor (65 +/- 17 to 83 +/- 28 cm/s; P = 0.04). A significant decrease in the pulsatality index and the resistance index was also observed in both the hemispheres (P < 0.05). The percentage changes of VMCA, PI and RI in both the hemispheres after anesthesia were not significantly different. CONCLUSIONS: In patients with cerebral tumors, nitrous oxide-halothane anesthesia causes comparable changes of cerebral blood flow velocities in the hemisphere with tumor and the normal hemisphere.

Cutaneous changes in chronic alcoholics.

BACKGROUND: Alcohol consumption can have a variety of cutaneous manifestations. Awareness of the cutaneous changes of alcohol abuse can allow early detection and intervention in an attempt to limit the adverse medical consequences. Hence a study was planned to determine the cutaneous changes in chronic alcoholics. AIMS: To determine the cutaneous changes in chronic alcoholics. METHODS: All the patients attending alcohol de-addiction camps were examined for cutaneous changes. The results were analyzed using Gausian test and compared with other reports. RESULTS: Out of 200 alcoholics examined for cutaneous changes, 182 (91%) had cutaneous, nail, hair or oral cavity changes. Nail changes were found in 51 (25.5%) alcoholics, koilonychia being the commonest (16%). Oral changes were present in 107 (53.5%) alcoholics and changes due to nutritional deficiency in 20 (10%). Diseases due to poor hygiene were seen in 55 (27.5%) alcoholics. Tinea versicolor (14%) and seborrheic dermatitis (11.5%) were the commonest cutaneous changes noted. CONCLUSION: Even though alcohol abuse has a variety of cutaneous manifestations and perhaps aggravates many diseases, there are no specific cutaneous signs of alcoholism. Knowledge of the spectrum of cutaneous manifestations of alcohol abuse can allow its early detection and treatment in an attempt to minimize the medical consequences.

Cerebral perfusion pressure management of severe diffuse head injury: effect on brain compliance and intracranial pressure.

BACKGROUND: Cerebral perfusion pressure management (CPPM) is an accepted modality of treatment of severe diffuse head injury (SDHI). However, CPPM has the potential to cause transcapillary exudation in the presence of a disrupted blood brain barrier and can lead to further increase of intracranial pressure (ICP) and worsening of compliance. AIMS: This study attempts to evaluate the effect of both transient and prolonged changes in cerebral perfusion pressure (CPP) on ICP and cerebral compliance as measured by the Pressure Volume Index (PVI), and to correlate changes in PVI with outcome at 12 months using the Glasgow Outcome Score. SETTINGS AND DESIGN: Prospective study in a neurosurgical ICU. MATERIAL AND METHODS: Twenty-seven SDHI patients managed using standard protocol to maintain CPP above 70 mmHg. Mean arterial pressure (MAP), ICP and CPP were monitored every half-hour. Daily monitoring of the PVI and ICP was done before, and after the induced elevation of MAP using IV Dopamine infusion. The relationship between CPP, MAP, ICP, PVI and outcome was evaluated. STATISTICAL ANALYSIS USED: The paired and independent samples T-test, and the Pearson correlation coefficient. RESULTS: CPPM rarely leads to progressive rise in ICP. Maintaining CPP above 70mmHg does not influence ICP or PVI. Transient elevations in CPP above 70mmHg may produce a small rise in ICP. Trend of change in PVI influenced outcome despite similar ICP and CPP. CONCLUSION: Elevating the CPP above 70mmHg does not either reduce the ICP or worsen the compliance. Monitoring changes in compliance should form an integral part of CPPM.

Pattern of skin diseases in an Indian village.

Disease pattern in a given population is generally determined by different ecological factors. Thus the objective of our study was to find out the pattern of skin diseases in a given population. Analysis of 3673 patients attending a medical camp at Kumble in Kerala state showed 410(11.16%) patients with dermatological problems. 260(63.41%) of them were males and 150(36.59%) females with a male to female ratio of 1.7:1. Of these patients, 178(43.41%) had cutaneous infections and 234(57.07%) had non-infectious dermatoses. Few patients had more than one dermatoses. Fungal infection was the commonest infection seen (22.92%) and eczemas took an upper hand in non-infectious group (32.19%). Improvement in the standard of living, education of the general public, improvement in the environmental sanitation and good nutritious food may help us to bring down the skin disease in this area.

Intraoperative blood glucose levels in neurosurgical patients : an evaluation of two fluid regimens.

Based on the evidence that hyperglycaemia aggravates ischaemic cerebral injury, it has been suggested that blood glucose levels be kept within 200 mg/dL during intracranial neurosurgery. Hypoglycaemia, however, can be a serious problem if glucose-containing solutions are avoided during the first four hours, as suggested in some studies. In order to explore the possibility of administering glucose in moderation so that the blood glucose levels are within acceptable limits, but at the same time the risk of hyoglycaemia is eliminated, we compared two intraoperative fluid regimens. Of the 52 neurosurgical patients studied, 32 patients received alternately 500 ml of 5% dextrose in normal saline and Ringer's lactate (DNS/RL Group) and 18 patients received alternately 500 ml of Ringer's lactate and normal saline (RL/NS Group). Blood glucose concentrations were determined at the end of each unit of fluid, until the patient received 4 units of fluid. In the DNS/RL group, blood glucose values peaked with the administration of each unit of DNS and tended to return towards the baseline with the subsequent RL, but remained higher than the previous control value. In the RL/NS group, there was a progressive increase in blood glucose values throughout the study period, but the increase was not statistically significant. The blood glucose levels were significantly different between the two groups after each unit of fluid except at the end of the fourth unit. Two patients in the RL/NS group had hypoglycaemia. In conclusion, the DNS/RL regimen maintains blood glucose levels within acceptable limits while avoiding the risk of hyperglycaemia. Withholding glucose completely, lowers blood glucose levels, but carries a risk of hypoglycaemia in some patients.

A peptide inhibitor of HIV-1 protease using alpha, beta- dehydro residues: a structure based computer model.

HIV-1 encodes an aspartic protease, an enzyme crucial to viral maturation and infectivity. It is responsible for the cleavage of various protein precursors into viral proteins. Inhibition of this enzyme prevents the formation of mature, infective viral particles and therefore, it is a potential target for therapeutic intervention following infection. Several drugs that inhibit the action of this enzyme have been discovered. These include peptidomimetic inhibitors such as ABT-538 and saquinavir, and structure based inhibitors such as indinavir and nelfinavir. Several of these have been tested in human clinical trials and have demonstrated significant reduction in viral load. However, most of them have been found to be of limited clinical utility because of their poor pharmacological properties and also because the viral protease becomes rapidly resistant to these drugs on account of mutations in the enzyme. One way to overcome these limitations is to design an inhibitor that interacts mainly with the conserved residues of HIV-1 protease. By a rational drug design approach based on the high resolution X-ray crystal structure of the HIV-1 protease with--MVT 101 (a substrate based inhibitor) and the specific design principles of peptides containing dehydro-Alanine (delta Ala) derived from our earlier studies, we have designed a tetrapeptide with the sequence: NH2-Thr-delta Ala-delta Ala-Gln-COOH. Energy minimization and molecular modelling of the interaction of the designed tetrapeptide with the inhibitor binding site indicate that the inhibitor is in an extended conformation and makes excessive contacts with the viral enzyme at the interface between the protein subunits. The designed inhibitor has 33% of its interaction with the conserved region of HIV-1 protease which is of the same order as that of MVT 101 with the enzyme.

Safety of acute normovolemic haemodilution with hydroxyethyl starch during intracranial surgery.

The effect of acute normovolemic haemodilution on haemodynamics, serum osmolality and coagulation parameters was studied in 20 patients undergoing intracranial surgical procedures. After induction of anaesthesia, 740+/-153 ml of blood was collected and the same was replaced with an equal volume of 6% hexaethyl starch. Heart rate (HR), blood pressure (BP), central venous pressure (CVP) and end tidal carbon dioxide tension (Et CO2) were monitored for 45 min. Haemoglobin concentration (Hb), haematocrit (Hct), serum osmolality (Osm), bleeding time (BT), prothrombin time (PT) and platelet count were determined before and 45 min after haemodilution. Hb and Hct were significantly lower following haemodilution (13.1+/-1.8 and 10.3+/-1.7 g/dL for Hb and 38.0+/-4.6%. and 30.1+/-4.5% for Hct). There was no significant change in the HR, BP and Et CO2 throughout the study period. CVP increased marginally from 35 to 45 min but was within normal limits. There was no significant change in serum osmolality, bleeding time and prothrombin time following haemodilution. Platelet count decreased following haemodilution but the values were within normal limits. The brain relaxation, as assessed by a semiquantitative scale, was satisfactory in all cases. None of the patients developed intraoperative brain swelling. In conclusion, acute normovolemic haemodilution with hexaethyl starch is tolerated well haemodynamically. It does not cause changes in serum osmolality which can increase brain oedema. It has no adverse effect on intraoperative haemostasis. It is a safe technique to decrease homologous blood transfusion during intracranial surgery.

Role of iron and copper during benzene toxicity.

Role of transition metal ions in expression of benzene toxicity has been suggested. Intraperitoneal administration of benzene to female albino rats daily for 10 days resulted in accumulation of iron in liver nuclei, without any change in copper content. Incubation of hydroquinone (HQ), one of the principal metabolites of benzene with rat liver nuclei resulted in formation of thiobarbituric acid reactive products (TBAR). However, presence of bathocuproine, a copper chelator and EDTA, an iron chelator caused significant inhibition of TBAR release. Thus, the present study revealed that iron accumulation and involvement of copper in nuclear damage induced by HQ.

Release of aldehydic products from glutamate or deoxyuridine by delta-aminolevulinic acid in presence of copper ions.

Glutamate or deoxyuridine in the presence of Cu2+ and delta-aminolevulinic acid (ALA) reaction resulted in the formation of thiobarbituric acid reactive compounds (TBAR), which was linear up to 2 hr. TBAR increased linearly with the increase of both ALA and copper ion concentration. Oxygen consumption was directly proportional to the concentration of formaldehyde perhaps formed by secondary oxidation of dimethyl sulfoxide. Addition of oxyradical scavengers in the reaction mixture resulted in the inhibition of TBAR formation.

Antioxidant potential in serum and liver of albino rats exposed to benzene.

Administration of benzene (ip, 0.5 ml/kg body wt or sc, 1 ml/kg body wt) consecutively for 10 days to male and female rats resulted in decrease in antioxidant potentials in serum. Serum uric acid and albumin showed significant decrease in all groups exposed to benzene. alpha-Tocopherol levels did not exhibit significant change in any of the groups when compared to control. Increase in liver lipid peroxidation and decrease in content of free sulphydryl group were observed in rats exposed to benzene. Serum ferroxidase activity, total iron content (TIC) and total iron binding capacity (TIBC) in female rats exposed to benzene showed significant decrease in ferroxidase activity without any change in TIC or TIBC when compared to control. The decrease in antioxidant potentials observed may be due to oxidation reactions exhibited by benzene metabolites, particularly, hydroquinone and 1, 2, 4-benzenetriol, resulting in oxidative stress in treated rats.

Styrene induced pancreatic changes in rodents.

Subchronic oral exposure to styrene in rodents (25 or 50 mg/kg/day in mice; 160 or 320 mg/kg/day in rats and guinea pigs, 5 days/week) for 4 weeks resulted in moderate congestion of pancreatic lobules, focal inflammatory reactions around islets (in mice) and altered serum insulin level while blood glucose levels remained unaffected. Increased beta cell degranulation together with characteristic neoformation of islets were predominantly seen in pancreas of guinea pigs.

Trichloroethylene toxicity in mice: a biochemical, hematological and pathological assessment.

Oral administration of trichloroethylene (TCE; 0, 500, 1000 and 2000 mg/kg/day) to male mice once daily, 5 days a week for a period of 28 days, caused a significant increase in liver weight, degeneration/necrosis of hepatocytes and characteristics proliferation of endothelial cells of hepatic sinusoids. Increase in kidney weight, glomerular nephrosis, degeneration/desquamation of tubular epithelium and characteristic amyloid deposition in glomeruli were observed only in the group of mice treated with 2000 mg/kg TCE. These changes occurred concurrently with a significant increase in total protein and free sulphydryl contents, elevated activities of acid phosphatase and catalase and decreased activity of delta-aminolevulinic acid dehydratase (delta-ALAD) indicating the sensitivity of liver and kidney as target tissues in TCE-toxicity. Hematological studies showed a significant increase in RBC counts and a reduction in WBC counts without any statistically significant change in the hemoglobin, urea nitrogen, creatinine and uric acid levels in the blood of TCE-exposed mice. A dose-related increase in cell density and acid phosphatase activity with a parallel significant decrease in the activity of delta-ALAD were observed in the bone marrow, which appear to be responsible for hematological alterations in TCE-exposed mice. The results suggest that early metabolic, pathological and hematological perturbations following a short-term exposure of TCE in mice, can provide the basis for its documented potential for chronic effects like blood dyscrasia and cancer.

Blood basopenia as an indicator of ovulation.

Direct basophil counts were done on capillary blood samples in thirteen normal young women, during the different phases of their menstrual cycles. Mean basophil counts during the follicular and progestational phases were 36.6/cumm and 39.3/cumm respectively. A significant midcycle fall in counts of 36% and a premenstrual fall of 22% were observed. These changes are probably due to migration of the cells from the peripheral blood into the rupturing follicle of the ovary and into the ischemic premenstrual endometrium.