Antimicrobial activity and identification of potential antimicrobial compounds from aquatic pteridophyte, Azolla microphylla Kaulf.

Azolla microphylla Kaulf. is an aquatic nitrogen fixing pteridophyte commonly found in aquatic habitats including paddy fields. Methanolic extract of the fronds of A. microphylla was subjected to partial purification by solvent partitioning with diethyl ether and ethyl acetate followed by hydrolysis, and further partitioning with ethyl acetate. The two fractions, thus obtained were tested for antibacterial activity. It was observed that the ethyl acetate fraction inhibited the growth of the pathogenic bacterium Xanthomonas oryzae. The GC-MS analysis of the ethyl acetate fraction showed several prominent peaks with retention time ranging from 8.83 to 45.54 min. A comparison of these peaks with the GC-MS libraries revealed that it could be eicosenes and heptadecanes with potential of antimicrobial activity.

Pattern of macrovascular disease phenotypes amongst newly diagnosed type 2 diabetic patients in a rural institute in Uttar Pradesh, India.

Background: The objective of current study was to determine the proportion of Macrovascular Disease (MVD) phenotypes amongst newly diagnosed type 2 diabetic patients in our institute by dividing the cases into sub-groups according to the MVD sites involved (NMVD - no macrovascular disease; NSCS - non-significant carotid stenosis; CBVD - cerebrovascular disease; CAD - coronary artery disease; PAD - peripheral artery disease; PVD - polyvascular disease) and studying the anthropometric, clinical and laboratory parameters in each group. Methods: The study included a cohort of 136 newly diagnosed patients with T2 DM. Demographic, clinical and laboratory parameters were included in analyses. Standardized procedures were used to assess the risk factors of associated metabolic syndrome (MetS). Results: The proportion of patients with MVD was 27.94% amongst the participants in the study. The majority of patients with MVD were in the CAD group (15.44%). Age, male sex and smoking history were independent risk factors in the CAD and PAD groups (P <0.01). A low HDL-C value was an independent risk factor in the CAD and PVD group P = 0.03). Very high frequencies of MetS were observed in the PAD and PVD groups (90% and 91.7% respectively). Prevalence of PVD was three times more common in males as compared to that in females. All patients with PAD had associated CAD also. Conclusion: This study projects a high proportion of MVD amongst newly diagnosed Type 2 diabetics in rural sub-population in Uttar Pradesh. High rates of mortality and morbidity in these patients due to macroangiopathy warrant early screening of MVD to ensure timely preventive and therapeutic measures.

A study of habit of fast food eating among school going adolescents and parental advice and its relation with their nutritional status.

Background: A study of habit of fast food eating among school going adolescents and parental advice and its relation with their nutritional status. Methods: Design: an epidemiological analytic observational study. Subjects: 600 adolescents’ 15-19 years of age, studying in 11 and 12 classes and included both boys and girls. A single observer interviewed each student and gathered the information regarding their eating habits. It was recorded on a pre-tested open and closed ended Performa. Nutritional status was assessed by BMI. The adolescents for the purpose of analysis were broadly grouped in two groups. Group I (those having normal BMI ranging 18.5 to 25) and group II (Malnourished i.e. those having BMI <18.5 to >25). Group II adolescents were further divided into group IIa (Underweight, BMI<18.5) and group IIb is (Over weight and obese BMI >25). Results: Adolescents who took both fast food and soft drinks 73.1% were malnourished (group II) as compared to those who did not take both the things 13.7% in group II. Difference was found to be statistically significant (p value <0.01). Out of 73.1% who took both fast food and soft drinks 62.1% and 11.0% were in group IIa (Underweight, BMI <18.5) and group IIb (Over weight and obese BMI >25) subsequently. Incidence of malnutrition was significantly less in 12.4% adolescents’ interfered by their parents as compared to 69.6% of those where parents was not interfering. Difference was found to be statistically significant (P value <0.01). Conclusion: A habit of fast food eating and taking soft drink provokes malnutrition. Interference in eating by parents is beneficial among adolescents.

Imaging appearance of subependymoma: A rare tumor of the cord.

Subependymoma of the cord are rare tumors with very few cases described in the literature. They represent a diagnostic dilemma as far as imaging and histopathology is concerned. They are biologically benign with low proliferative index, hence postoperative prognosis is very good. We present a case of a 42-year-old male patient with an intramedullary Subependymoma located within the central canal of thoracic region cord. On imaging with T1-weighted and T2-weighted sequences it mimicked syringohydromyelia, however, on heavily T2-weighted images the tumor located within the central canal could be delineated. The tumor was excised with complete recovery.

Telemedicine in neurology: underutilized potential.

Advances in telecommunication which started with telephone lines, FAX, integrated service digital network (ISDN) lines and now internet have provided an unprecedented opportunity for transfer of knowledge and sharing of information. The information can be used for overlapping applications in patient care, teaching and research. In medicine there is increasing utilization of telemedicine; radiology and pathology being regarded as mature specialties and emergency medicine as maturing specialties compared to other evolving specialties which include psychiatry, dermatology, cardiology and ophthalmology. Of the emergencies, status epilepticus and stroke have high potential for improving patient management. Administration of tPA was more frequent when carried out under telemedicine guidance. Telemedicine has great potential for medical education. The principles of education are in congruence with those of telemedicine and can be closely integrated in the existing medical education system. Our experience of telemedicine as a medical education tool is based on video conferencing with SCB Medical College, Cuttack. We had 30 sessions during 2001 to 2004 in which 2-3 cases were discussed in each session. The patients' details, radiological and neurophysiological findings could be successfully transmitted. These conferences improved the knowledge of participants, provided an opportunity for a second opinion as well as modified the treatment decisions in some cases. The advances in telemedicine should be utilized more extensively in neurology, especially in emergency management, epilepsy and stroke patients as well, as it may have a role in neurophysiology and movement disorders.

Serum lipid response to introducing ghee as a partial replacement for mustard oil in the diet of healthy young Indians.

Ghee (clarified butter) has generally been assumed to be hypercholesterolaemic on the basis of its composition but there is hardly any study to support or refute the assumption. The present study was conducted on sixty-three healthy, young, physically active adult volunteers (52 male, 11 female). The study design was that of a randomized controlled trial with a parallel design. After a lead-in period of 2 wk, the subjects were randomly divided into two groups, Group A (n = 30; 25 male, 5 female) and Group B (n = 33; 27 male, 6 female). Group A (experimental) consumed for 8 wk a diet in which ghee provided 10% of the energy intake. The only other visible fat in the diet was mustard oil, and total energy from fats was 25% of the energy intake. Group B (control) consumed for 8 wk a similar diet except that all visible fat came from mustard oil. The serum total cholesterol level showed a significant rise in the experimental group at 4 wk; the rise persisted at 8 wk. A similar rise was also seen in HDL cholesterol. Hence the total cholesterol/HDL cholesterol ratio did not show any significant change. In the control group, there was a trend towards a fall in LDL cholesterol but the change was not significant. The study does not indicate any adverse effect of ghee on lipoprotein profile. However, more studies are needed on older subjects, hyperlipidaemic subjects, and on subjects following less healthy lifestyles before the results of this study can be extrapolated to the general population.

Clinical spectrum, pitfalls in diagnosis and therapeutic implications in herpes simplex encephalitis.

OBJECTIVES: High index of suspicion is mandatory for early diagnosis of Herpes Simplex Encephalitis (HSE), since acyclovir therapy can prevent its mortality and limit morbidity. We report our observations on clinical spectrum, pitfalls in diagnosis and therapeutic aspects in patients of HSE. METHODS: There were 34 patients of HSE (26 males and eight females) in age range 6 -72 (mean 23.8 +/- 8.9) years. Diagnosis was confirmed by cranial MRI, EEG and PCR in CSF. Acyclovir was given to 24 patients. Carbamazepine and sodium valproate were the antiepileptic drugs used. RESULTS: Most of the patients were referred either as Japanese encephalitis, cerebral malaria or tubercular meningitis. High fever, seizures, behavioral abnormality and encephalopathy were present in all, either at onset or later. EEG, CSF abnormality and cranial MRI were abnormal in all 34 patients. PCR for Herpes Simplex virus was positive in 65 % cases CT was performed in 10 cases but abnormality was detected only in four. We observed features of Kluver Bucy syndrome in three patients, suffering from HSE. Following complete acyclovir therapy in 24 patients, 12 recovered completely and four partially. There was no improvement in four patients including two patients who had features of Kluver Bucy Syndrome, while four expired. Among the seven patients who refused therapy of acyclovir, five expired, while two remained in unaltered status. Treatment could not be completed in three patients as they expired during therapy. CONCLUSION: HSE is commonly misdiagnosed. Important factors influencing mortality and morbidity of HSE were; early acyclovir therapy, age, immune status of patient, duration of illness, and consciousness level before initiation of therapy. We conclude that acyclovir should be given to all patients as soon as suspected, while confirmatory investigations are in progress.

Left vocal cord paralysis and aortic arch aneurysm: an unusual presentation.

Recurrent laryngeal nerve in its course, follows a path that brings it in proximity to numerous structures. These structures can interfere with its function by pressure or by disruption of the nerve caused by disease invading the nerve. We report aortic aneurysm and atherosclerotic plaque as a rare cause of left vocal cord paralysis.

Effect of yogic practice on pulmonary functions in young females.

During recent years, a lot of research work has been done to show the beneficial effects of yoga training. The present study was undertaken to assess the effects of yogic practice on some pulmonary functions. Sixty healthy young female subjects (age group 17-28 yrs.) were selected. They had to do the yogic practices daily for about one hour. The observations were recorded by MEDSPIROR, in the form of FVC, FEV-1 and PEFR on day-1, after 6 weeks and 12 weeks of their yogic practice. There was significant increase in FVC, FEV-1 and PEFR at the end of 12 weeks.

Effect of fasting on the intestinal absorption of D-glucose and D-xylose in rats in vivo.

The present study was planned to elucidate the role of fasting on the intestinal absorption of monosaccharides particularly--glucose and xylose in inbred female albino rats. Rats (weighing 250-300 grams) were divided into three groups. One group of rats served as control while the other two were experimental. One of the experimental groups was starved for 48 hours while the other for a period of 72 hours. It was found that fasting for 72 hours causes an overall increase in absorption of glucose from small intestine. Forty-eight hours of fasting caused a significant increase in glucose absorption from distal ileum only. Increase in the glucose absorption in fasting from small intestine can well be explained on the basis of a reduction in glucose metabolism in general as an adaptation to starvation so as to leave more glucose for cerebral metabolism. No significant changes, whatsoever, were encountered with xylose absorption in fasting animals.

An evaluation of myelography with non-ionic water soluble contrast medium-iohexol.

Iohexol myelography was performed in 25 cases of suspected spinal cord compression. Out of these, 24 cases gave optimally informative myelogram, while one case showed quasi-informative myelogram. Myelographic efficacy regarding the level of lesion was correct in all cases. On final evaluation 15 cases were diagnosed as extradural lesions, 9 cases as intradural extramedullary type and one case as diastematomyelia. Only single case which was diagnosed as intramedullary lesion on myelography was, in fact, an extradural lesion. There were only minor side-effects in the form of headache and paraesthesia in the lower limb. It was concluded that iohexol is a safe contrast medium with high efficacy and minimal side-effects for the total examination of spinal canal.

Evaluation of various diagnostic signs on percutaneous transhepatic cholangiography in obstructive jaundice.

Twenty patients of obstructive jaundice were subjected to percutaneous transhepatic cholangiography (PTC) of which 17 were operated on. Patients were divided in 4 groups according to the site of obstruction. The diagnostic signs observed were: Complete block with interface having convexity downwards (4), convexity upwards (3), biconcave caudal cut off (6), smooth edged cut off (one), irregular edged cut off (one) and non-specific appearance (one); incomplete block with interface having convexity upwards (one); biconcave caudal cut off (2) and multiple smooth central filling defects (2). In one case there was incomplete obstruction at two sites giving rise to two different signs. PTC was 100% correct in accurately telling the site of lesion. As regards the nature of the lesion the diagnosis on PTC was found correct in 15 out of 17 cases (88.5%).

Comparative evaluation of computed tomography and cerebral angiography in the management of subarachnoid haemorrhage.

Plain and contrast enhanced computed tomography (CT) scan of brain and cerebral angiography were done in 20 subjects of subarachnoid haemorrhage (SAH), diagnosed on the basis of clinical parameters and proved by cerebrospinal fluid (CSF) examination. Plain CT scan of brain confirmed the diagnosis of SAH in all the 20 (100%) cases, but was able to demonstrate the cause of SAH in 11(55%) cases only. Contrast CT scan provided additional information in 7 more cases. CT was also able to demonstrate the site and extent of bleeding, evidence of intraventricular bleeding and hydrocephalus. Cerebral angiography done in all the cases, confirmed the diagnosis in 14 (70%) cases diagnosed on CT and was able to give additional information in 4 more cases. It also showed excellent vascular details which were not possible with CT scan. It is concluded that enhanced CT scan should be done first in all the cases of SAH for preliminary scouting and angiography should be done where CT scan gives incomplete information or where surgical management is contemplated. Both the investigations were found to be complementary to each other.

Mummified insect as foreign body in the respiratory tract.

A case report of a child with a cockroach in bronchus is described.

Huge omental cyst mimicking ascites.

An unusual case of omental cyst is described. A 4-year-old child presenting as abdominal distension of short duration, clinically diagnosed as ascites, was subsequently proved to be giant omental cyst. The case is reported because of its unique presentation.

Fine needle aspiration cytology in the diagnosis of prostatic enlargements.

One hundred patients with enlarged prostate were subjected to fine needle aspiration cytology and histopathologic examination of prostate. The results have been found encouraging. The cytodiagnostic accuracy rate was 99 p.c. in identification of benign or malignant nature of the lesions and 94 p.c. in cytologic specific diagnosis (exactly similar to histopathologic diagnosis). The technique was simple, rapid, economical, reliable, easy to repeat and highly suitable for outpatients. The procedure can routinely be adopted in places where facilities for preparation of paraffin section do not exist or when quick diagnosis is required.