Chemical Composition and Antioxidant Activity of Essential Oil and Organic Extracts of Premna integrifolia Linn

ABSTRACT This study was designed to examine the chemical composition and in vitro antioxidant activity of the hydrodistillated essential oil and various extracts obtained from Premna integrifolia Linn. GC-MS analysis of the essential oil was resulted in determination 29 different compounds, representing 95.73% of total oil. Antioxidant activities of the essential oil and organic extracts of chloroform, ethyl acetate and methanol were determined by three different test systems namely DPPH (2,2-diphenyl-1-picrylhydrazyl), superoxide and nitric oxide radical scavenging assays. The essential oil and methanol extract showed potent antioxidant activity among all the tested samples. Furthermore, the amount of total phenolic compounds was determined and its content in methanol extract was the highest as compared to other samples. The results indicate that the essential oil and extracts of Premna integrifolia could serve as an important bio-resource of antioxidants for using in the pharmaceutical industries.

Comparative Study of Surgical Treatment of Chalazion.

A chalazion is chronic lipogranulomatous inflammatory lesion caused by blockage of meibomian gland orifices & stagnation of sebaceous secretion. Common practices in treatment of chalazion are intralesional steroid injection, incision & curettage and excision of chalazion. Recurrence rate is high for incision & curettage in case of large chalazion. The aim of the study is to established that excision large chalazion give better result than incision & curettage. The study was carried out at Diabetic Association Medical College & Hospital, Faridpur and General Hospital, Fadidpur. A total 100 cases were selected for study. Technique of operation were incision & curettage through conjunctival surface and excision of chalazion through skin surface. In 50 % cases we performed incision & curettage both in small (size <5mm) and large (size >5mm) chalazion. In 50 % cases of large chalazion we performed excision of chalazion. The follow up period was 3 months to 6 months. In group -A with incision & curettage through conjunctival surface, in case of small chalazion 27 out of 30 patients were cured (90%). In case of large chalazion 14 out of 20 patients were cured (70%). In group B with excision of chalazion through skin surface, in case of large chalazion 49 out of 50 patients were cured (98%). So higher success rate after excision of large chalazion through skin surface.

Amblyopia of Refractive Origin: a Clinical Evaluation.

Amblyopia is defined as unilateral or bilateral decrease in visual acuity without any organic ocular lesion. It generally develops during the first decade of life when the visual system is vulnerable to deprivation. Unilateral amblyopia is more common than bilateral and the amblyopic eye is called lazy eye. This study was carried out in Faridpur Medical College & Hospital (FMCH) and Diabetic Association Medical College & Hospital (DAMCH) Faridpur, in the department of Ophthalmology from January - 2010 to December 2012 with a view to establish that anisometropic (Refractive) amblyopia is more in patients with astigmatism with the rule of both hypermetropic & myopic types also astigmatism against the rule in hypermetropic patients but simple myopia is not associated with amblyopia. Clinically diagnosed 110 patients of amblyopia of refractive origin were selected. Age of the patients was 6 to 15 years with male & female ratio 1.2:1. There was no pathology in the eyes except refractive error. Refraction done all the cases and found the following results: 26 cases (23.63%) of simple myopic astigmatism with the rule, 19 cases (17.27%) of compound myopic astigmatism with the rule, 10 cases (9.09%) of simple hypermetropia, 38 cases (34.54%) of simple hypermertopic astigmatism with the rule and 17 cases (15.45%) of compound hypermetropic astigmatism againt the rule. No case of simple myopia was associated with amblyopia. Amblyopia was more in patients with astigmatism with the rule of both hypermetropic and myopic types and also astigmatism against the rule in hypermetropic patients but simple myopia was not associated with amblyopia.

Prevalence of Rheumatic Fever and Rheumatic Heart Disease in School Children of Bharateswari Homes of Bangladesh.

Background: Rheumatic fever (RF) and rheumatic heart disease (RHD) continue to affect millions of people around the world, including Bangladesh. Children and adolescents are especially susceptible to this disease. Classical risk factors, i.e. poverty, overcrowding, ignorance and insufficient health care services are responsible for the high incidence and prevalence of these diseases. To assess the prevalence of RF and RHD among children, a school survey was conducted in Bharateswari Homes, in the district of Tangail, Bangladesh. Methods: A total of 947 students were examined. Revised Jones’ criteria (1992), and clinical examination were used for the diagnosis of RF and RHD. Results: Four cases of RF/RHD were found giving the prevalence of 4.22/1000. This is lower than the prevalence reported in eighties, but is consistent with those found in nineties. Conclusion: Among the school children, there is a declining trend in the prevalence of RF/RHD.

Advantage of Crescent Knife in Making Excision of Pterygium.

A pterygium is a triangular sheet of fibrovascular tissue which invades the cornea. In the management of pterygium surgical excision is needed. Common practices in pterygium surgery are simple excision, excision with post operative b- radiation or tropical thio-TEPA solution(1:2000) or mitomycin-C solution(0.4%), excision with peroperative use of mitomycin-C or conjunctival autograft or amneotic membrane graft or lamellar keratoplasty of the affected part of the cornea. Recurrence is high in pterygium surgery probably due to facing difficulty for easy and complete separation of fibrovascular growth. So this is a search for new technique where easy smooth and complete separation pterygial tissue can be done with minimum surgical trauma and a good cosmetic look. This study was carried out at Faridpur Medical College Hospital (FMCH) from January 2010 to December 2011. A total 50 cases were selected for study. Technique of operation in all the cases were excision of pterygium with conjunctival autograft. In 50% cases, the head of the pterygium removed from the cornea with crescent knife and in 50% cases the head of the pterygium removed with tooks knife. The follow up period was 12 to 24 months. In the group- A, recurrence occurred in two eyes i.e 8% and succeed in 23 eyes i.e 92%. In the group-B, recurrence occurred in 6 eyes i.e 24% and succeed in 19 eyes i.e. 76%. So, higher success rate and low recurrence rate with good cosmetic look and minimum surgical trauma for those where crescent knife were used.

Prevalence of Pre-Existing Corneal Astigmatism in Age Related Cataract Patient.

Cataract surgery is no more a blind rehabilitation surgery, it absolutely gives normal vision. In the era of modern cataract surgery patients expectations are also high about visual outcome. This prospective study was carried out to investigate the magnitude and pattern of pre-existing corneal astigmatism in age related cataract patient at Faridpur Medical College Hospital, Faridpur and Agha Yusuf Adhunik Hospital, Kustia, from July 2009 to June 2012. We examined 850 eyes of 730 patients who underwent cataract surgery. The mean age at the time of surgery was 61.9±8.1 (40 to 70) years. Corneal astigmatism was measured by Auto Refracto Keratometer at least two times for each patient. Astigmatism was calculated from diopteric difference of vertical reading from horizontal reading. With the rule (WTR) astigmatism was considered when steep meridian at 900± 200. Against the rule (ATR) astigmatism was considered when steep meridian at 1800±200. Astigmatism is in other direction is defined as oblique. On keratometry, when vertical reading (k1) was found greater than horizontal (k2) was considered WTR astigmatism and the reverse reading for ATR astigmatism. The percentage of corneal astigmatism was 1D or less was 69.6%, more than 1D and less than 1.5D, 27.6% and more than 1.5D and less then 2D 2.8%. Prevalence of ATR astigmatism was more than WTR astigmatism and prevalence of ATR astigmatism increases significantly with age. Approximately two third of pre-operative patient had 1D or less astigmatism and one third had more than 1D corneal astigmatism.

Study of Serum Insulin Level in Hypertensive Patients.

Background and aims: Hypertension is a frequent and almost ubiquitous health disorder, prevalent both in developed and developing countries. Hyperinsulinemia and insulin resistance have been suggested to be closely associated with the pathogenesis of essential hypertension. However there is considerable controversy in this regards. The present study was designed to explore the relationship between serum insulin and serum ionized calcium in non diabetic and diabetic hypertensive subjects. Subjects and Methods: A total of 57 hypertensive and diabetic hypertensive patients attending out patients department of the BIRDEM and NICVD were included in the study. Fasting serum glucose was measured by glucose oxidase method, lipid profile was measured by enzymatic method. Serum insulin was measured by Enzyme Linked Immunosorbent assay (ELISA) method and serum ionized calcium by the Ion Sensitive Electrode (ISE) technique. Results: Glucose-insulin ratios were calculated as the index for insulin. Serum insulin (pmol/ml), Mean ± SD, 147 ± 48 in DC and 170 ± 80 in DH groups vs 118 ± 21 in NC and 120 ± 41 in EH groups, p= 0.023 and p= 0.031 respectively. Although, from the serum insulin results, the diabetic groups seemed to have insulin resistance, the glucose-insulin ratios in the two groups were significantly lower compared to nondiabetic groups (Glucose-insulin ratio, mmol/pmol, 0.066 ± 0.025 in DC, 0.074 ± 0.025 in DH vs 0.044 ± 0.11 in NC, 0.043 ± 0.012 in EH, p= 0.005 - 0.0001). The serum ionized calcium in the healthy subject, first time reported in the country by an up to date method (1.17 ± 0.05 M ± SD), were within the range found in healthy subjects of the other populations. No significant difference in the serum Ca2+ could be found between any of the study groups. Also, serum Ca2+ did not correlate with blood pressure, glucose or insulin in any of the study groups or with all the patients as a whole. Serum total cholesterol, triglyceride, HDLc and LDLc levels in the DC, EH and DH group did not show any significant difference compared to NC group and among the groups. The lipid abnormality as reflected by the mean LDL-HDL cholesterol ratios was the highest in the DH group but the differences were not statistically significant compared to the NC, DC and EH group. Conclusions: The data suggest the following conclusions: a) Serum ionized calcium level in our population is similar to that reported for other population. b) Serum glucose and insulin by themselves do not have any direct influence on serum ionized calcium. c) Non obese diabetes mellitus subjects in our population do not show insulin resistance as the primary defect. Rather, there is significant decompensation of the insulin secretory capacity in the subjects. d) Insulin resistance should be measured directly in relation to blood pressure and Ca2+ in appropriate groups of subjects to explore the relationship between insulin resistance, hyperinsulinemia and serum ionized calcium.

Risk factor Analysis and Angiographic Profiles in First 228 Cases Undergone Coronary Angiography in Cardiac Cath Lab of Dhaka Medical College Hospital.

Background: Coronary artery diseases are one of the major challenges faced by cardiologists. Control of certain risk factors for CAD is associated with decrease in mortality and morbidity from myocardial infarction and unstable angina. So, identification and taking appropriate measures for primary and secondary prevention of such risk factors is, therefore, of great importance. This retrospective study was carried at the newly set up cath lab in Dhaka Medical college. Materials and Methods: Total 228 consecutive case undergone diagnostic coronary angiogram from 10th January 2007 to31st January 2009 out of which 194(80%) were male and 34 (20%) were female. In both sexes most of the patients were between 41 to 60 years of age. Risk factors of the patients were evaluated. Results: In females commonest risk factor was Diabetes (58.8%) followed by dyslipidaemia (35.3%). In males commonest risk factor was hypertension (30.9%) followed by smoking (29.9%) and diabetes (28.3%). In males 44.3% patients presented with acute myocardial infarction followed by stable angina (43.3%); but in females stable angina was the commonest presentation (50.0%) followed by myocardial infarction (38.2%).CAG findings revealed that in males 33.5% had double vessel disease 26.8% followed by single vessel 26.8% and multivessel disease 25.3%. In females normal CAG was found in 35.5% followed by double vessel 23.5%, multivessel 20.6% and single vessel 20.6%. On the basis of CAG findings; in males 41.8% patients were recommended for CABG, followed by PTCA & stenting 26.3% and medical therapy 30.0%; where as in females 55.9% were recommended for medical therapy , followed by CABG 32.4% and PTCA & stenting11.8%. Conclusion: The commonest presentation of CAD was 4th and 5th decades in both sexes. Diabetes and dyslipidaemia were more common in females whereas hypertension and smoking were more common in males. Myocardial infarction and stable angina were most common presentation in both sexes though in males myocardial infarction was more common. In males the angiographic severity of CAD was more and they were more subjected for CABG in comparison to females.

Acquired pure red cell aplasia--a case report.

A married female patient of 36 years with chronic anaemia, because of pure erythroid aplasia with a haemolytic component and hypothyroidism due to antithyroid auto-antibodies, was subsequently discovered as a case of systemic lupus erythematosus (SLE). She was treated with corticosteroid and immunosuppressive therapy and her anaemia was corrected. The response of erythroid aplasia to corticosteroid and other immunosuppressive agents suggests that immunological factors play a role in erythroid aplasia in SLE. The occurrence of red cell aplasia in association with a variety of immune phenomenon supports the concept that in SLE, erythroid aplasia may be of immune aetiology.

Chemotherapy of acute myeloblastic leukaemia with DAM regimen.

32 patients of denovo-ANLL were treated with Doxorubicin, Ara-C and 6-Mercaptopurine (DAM) regimen. Remission induction was instituted with 1-3 cycles of DAM regimen and maintenance was given by 6-MP continuously with intermittent DA (1,5) regimen. In the remission induction, Doxorubicin 30 mg/m2 for 3 days, Ara-C 150 mg/m2 for 5 days and 6-Mp 100 mg/m2 daily was given. Complete remission (CR) was observed in 60% cases. The probability of 2 years disease-free survival of patients with complete remission is 56.73%.

Prevalence of diarrhoeal diseases amongst tribals of Car Nicobar Island, India.

In a cross sectional study of total 14514 tribal Nicobarese people of Car Nicobar Island, an union territory of India, situated in Bay of Bengal, morbidity, mortality and treatment practices of diarrhoeal diseases of under-five children were surveyed. The incidence of diarrhoea (0.2 episode/ch.year), Crude death rate (3.6/1000) and IMR (31/1000 live births) were exceedingly low as compared to SouthEast Asian Countries including mainland of India. ORS utilisation rate was high (41%) as compared to the National figure (12.0%). This is the first study of it's kind carried out in this island and amongst the Nicobarese tribe in India. A preliminary study carried out among the mothers of the hospitalised children indicated that protective behaviours like breast feeding, hand washing, use of chlorinated water and proper disposal of stool were regularly being practiced by the community traditionally. An in-depth study on risk factors of diarrhoea in this island can yield useful clue for describing the same.

Pernicious anaemia with subacute combined degeneration of cord in a Bangladeshi male.

Pernicious anaemia (PA) has previously not been reported from Bangladesh. A case is described which had the typical clinical features of PA with subacute combined degeneration of the cord and polyneuropathy. The patient had typical macroovalocytosis, megaloblastic bone marrow and Schilling test result in the range of PA. Vitamin B12 level in the serum was markedly reduced. There was rapid clinical and haematological response to vitamin B12 therapy.