Tuberculosis infection control measures at health care facilities offering HIV and tuberculosis services in India: A baseline assessment.

BACKGROUND: Tuberculosis (TB) is one of world's oldest infectious disease and ranks alongside HIV as leading infectious killer. Tuberculosis infection control especially in HIV and TB care facilities has warranted attention after the recent health care-associated outbreaks in South Africa. The aim of this study was to describe the tuberculosis infection control measures implemented by HIV and TB care facilities in five high HIV burden provinces in India. METHODS: Baseline assessment of 30 high burden Antiretroviral centers and TB facilities was conducted during Oct 2015-Dec 2015 by AIC trained staff using a structured format. RESULTS: Thirty HIV and TB care facilities in five high HIV burden provinces were enrolled. Facility infrastructure and airborne infection control practices were highly varied between facilities. TB screening and fast tracking at ART centers is happening at majority of centers however inadequate TB infection control training, poor compliance to administrative and personal protective measures and lack of mechanism for health care workers surveillance need attention. CONCLUSIONS: Local specific TB infection control interventions to be designed and implemented at HIV and TB care facilities including implementation of administrative, environmental and use of personal protective equipment's with the training of staff members. Health care workers surveillance needs to be prioritized considering the rising instances of tuberculosis among Health care workers.

In vitro and in vivo antidiabetic activity of isolated fraction of Prosopis cineraria against streptozotocin-induced experimental diabetes: A mechanistic study.

A rapidly increasing incidence of Diabetes mellitus throughout the world is a major concern in both developed and developing countries and the drawbacks associated with currently available treatments led to switching researcher's attention towards naturopathy. Since ancient time, herbal plants have been traditionally used for the treatment of diabetes as they consider to be less toxic and free from side effects than synthetic ones. In our previous studies, we had isolated two new compounds (Methyl 5-tridecyloctadec-4-enoate and Nonacosan-8-one), together with three known compounds (Lupeol, ß-sitosterol and Stigmasterol) from chloroform fraction of stem bark of P. cineraria (CfPc). The present study aimed to determine the in vivo and in vivo antidiabetic activity of CfPc in streptozotocin induced experimental diabetes and also evaluated their possible mode of action. CfPc was orally administrated to STZ (55 mg/kg b.wt) induced diabetic rats at the doses of 50 and 100 mg/kg b.wt for 21 days. Treatment of CfPc significantly (p < 0.05) lowered the level of blood glucose, glycosylated hemoglobin and also restored body weight, liver glycogen content and serum insulin level in diabetic rats in a dose-dependent manner. A significant (p < 0.05) reduction in serum lipid profile markers and elevation in HDL-C after treatment with CfPc, also signifying the protective effects of CfPc in diabetes-associated complications. In addition, CfPc also promoted a significant inhibition of α-amylase enzyme activity with an IC50 value of 40.29 µg/ml. Results indicate that CfPc possess a potential in vitro and in vivo antidiabetic activity and this effect could be due to multitarget mode of action that includes antihyperglycemic, postprandial hypoglycemic, hypolipidemic and insulin secretory actions. Therefore, it could be used as a safer complementary drug in the management of diabetes and associated complications.

Implementation of the Treat All Policy Among Persons with HIV Infection Enrolled in Care But Not on Antiretroviral Therapy - India, May 2017-June 2018.

Since September 2015, the World Health Organization has recommended antiretroviral therapy (ART) for all persons with human immunodeficiency virus (HIV) infection, regardless of clinical stage or CD4 count (1). This Treat All policy was based on evidence that ART initiation early in HIV infection as opposed to waiting for the CD4 count to decline to certain levels (e.g., <500 cells/mm3, per previous guidelines), was associated with reduced morbidity, mortality, and HIV transmission (2-4). Further, approximately half of persons enrolled in non-ART care that included monitoring for HIV disease progression (i.e., in pre-ART care) were lost to follow-up before becoming ART-eligible (5). India, the country with the third largest number of persons with HIV infection in the world (2.1 million), adopted the Treat All policy on April 28, 2017. This report describes implementation of Treat All during May 2017-June 2018, by India's National AIDS Control Organization (NACO) and partners, by facilitating ART initiation among persons previously in pre-ART care at 46 ART centers supported by the U.S. President's Emergency Plan for AIDS Relief (PEPFAR)* in six districts in the states of Maharashtra and Andhra Pradesh. Partners supported these 46 ART centers in identifying and attempting to contact persons who were enrolled in pre-ART care during January 2014-April 2017, and educating those reached about Treat All. ART center-based records were used to monitor implementation indicators, including ART initiation. A total of 9,898 (39.6%) of 25,007 persons previously enrolled in pre-ART care initiated ART; among these 9,898 persons, 6,315 (63.8%) initiated ART after being reached during May 2017-June 2018, including 1,635 (16.5%) who had been lost to follow-up before ART initiation. NACO scaled up efforts nationwide to build ART centers' capacity to implement Treat All. Active tracking and tracing of persons with HIV infection enrolled in care but not on ART, combined with education about the benefits of early HIV treatment, can facilitate ART initiation.

Trends in use of anti-thrombotic agents and outcomes in patients with non-ST-segment elevation myocardial infarction (NSTEMI) managed with an invasive strategy.

OBJECTIVE: To analyze trends in utilization of anti-thrombotic agents (ATA) and in-hospital clinical outcomes in non-ST-elevation myocardial infarction (NSTEMI) patients managed with an invasive strategy from 2007 to 2010. METHODS & RESULTS: Using ACTION Registry(®)-GWTG™ data, we analyzed trends in use of ATA and in-hospital clinical outcomes among 64,199 NSTEMI patients managed invasively between 2007 and 2010. ATA included unfractionated heparin (UFH), low molecular weight heparin (LMWH), glycoprotein IIb/IIIa inhibitors (GPI) and bivalirudin. Although the proportion of NSTEMI patients treated with PCI within 48h of hospital arrival was similar in 2007 and 2010, percentage use of bivalirudin (13.4-27.3%; p<0.01) and UFH increased (60.0-67.5%, p<0.01), and that of GPI (62.3-41.0%; p<0.01) and LMWH (41.5-36.8%; p<0.01) declined. Excess dosing of UFH (75.9-59.3%, p<0.01), LMWH (9.6-5.2%; p<0.01) and GPI (8.9-5.9%, p<0.01) was also significantly lower in 2010 compared with 2007. Though in-hospital mortality rates were similar in 2007 and 2010 (2.3-1.9%, p=0.08), the rates of in-hospital major bleeding (8.7-6.6%, p<0.01) and non-CABG related RBC transfusion (6.3-4.6%, p<0.01) were significantly lower in 2010 compared with 2007. CONCLUSION: Compared with 2007, patients with NSTEMI, who were managed invasively in 2010 received GPI and LMWH less often and bivalirudin and UFH more frequently. There were sizeable reductions in the rates of excess dosing of UFH (though still occurred in 67% of patients), GPI and LMWH. In-hospital major bleeding complications and post-procedural RBC transfusion were lower in 2010 compared with 2007.

HIV Testing among Patients with Presumptive Tuberculosis: How Do We Implement in a Routine Programmatic Setting? Results of a Large Operational Research from India.

BACKGROUND: In March 2012, World Health Organization recommended that HIV testing should be offered to all patients with presumptive TB (previously called TB suspects). How this is best implemented and monitored in routine health care settings in India was not known. An operational research was conducted in Karnataka State (South India, population 64 million, accounts for 10% of India's HIV burden), to test processes and learn results and challenges of screening presumptive TB patients for HIV within routine health care settings. METHODS: In this cross-sectional study conducted between January-March 2012, all presumptive TB patients attending public sector sputum microscopy centres state-wide were offered HIV testing by the laboratory technician, and referred to the nearest public sector HIV counselling and testing services, usually within the same facility. The HIV status of the patients was recorded in the routine TB laboratory form and TB laboratory register. The laboratory register was compiled to obtain the number of presumptive TB patients whose HIV status was ascertained, and the number found HIV positive. Aggregate data on reasons for non-testing were compiled at district level. RESULTS: Overall, 115,308 patients with presumptive TB were examined for sputum smear microscopy at 645 microscopy centres state-wide. Of these, HIV status was ascertained for 62,847(55%) among whom 7,559(12%) were HIV-positive, and of these, 3,034(40%) were newly diagnosed. Reasons for non-testing were reported for 37,700(72%) of the 52,461 patients without HIV testing; non-availability of testing services at site of sputum collection was cited by health staff in 54% of respondents. Only 4% of patients opted out of HIV testing. CONCLUSION: Offering HIV testing routinely to presumptive TB patients detected large numbers of previously-undetected instances of HIV infection. Several operational challenges were noted which provide useful lessons for improving uptake of HIV testing in this important group.

Scaling up of HIV-TB collaborative activities: Achievements and challenges in India.

India has been implementing HIV/TB collaborative activities since 2001 with rapid scale-up of infrastructure across the country during past decade in National AIDS Control Programme and Revised National TB Control Programme. India has shown over 50% reduction in new infections and around 35% reduction in AIDS-related deaths, thereby being one of the success stories globally. Substantial progress in the implementation of collaborative TB/HIV activities has occurred in India and it is marching towards target set out in the Global Plan to Stop TB and endorsed by the UN General Assembly to halve HIV associated TB deaths by 2015. While the successful approaches have led to impressive gains in HIV/TB control in India, there are emerging challenges including newer pockets with rising HIV trends in North India, increasing drug resistance, high mortality among co-infected patients, low HIV testing rates among TB patients in northern and eastern states in India, treatment delays and drop-outs, stigma and discrimination, etc. In spite of these difficulties, established HIV/TB coordination mechanisms at different levels, rapid scale-up of facilities with decentralisation of treatment services, regular joint supervision and monitoring, newer initiatives like use of rapid diagnostics for early diagnosis of TB among people living with HIV, TB notification, etc. have led to success in combating the threat of HIV/TB in India. This article highlights the steps taken by India, one of the largest HIV/TB programmes in world, in scaling up of the joint HIV-TB collaborative activities, the achievements so far and discusses the emerging challenges which could provide important lessons for other countries in scaling up their programmes.

Descriptive study of the utility of individual tracking tool in program monitoring for prevention of mother-to-child transmission of HIV, Maharashtra, India.

OBJECTIVE: The objective is to describe the utility of prevention of parent-to-child transmission tracking tool in terms of the in-depth information that it provides for better decision making to improve the services. METHODS: The excel-based tracking tool is initiated by 578 Integrated Counselling and Testing Centre (ICTC) Counsellor and shared with 70 antiretroviral treatment (ART) centres. Between April and September 2014, total of 1118 HIV-infected pregnant women were registered in the tool. The secondary data for this period that is captured in the prevention of parent-to-child transmission tracking tool has been analyzed and presented in this descriptive study. RESULTS: Of the total 1118 HIV-positive pregnant women, registered in the tool, 760 (68%) were newly detected with HIV infection and 358 (32%) had already been detected before their current pregnancy. In total, 1095 (98%) pregnant women were registered at ART centre out of which 1007 (91%) were initiated on lifelong ART. The average time delay between HIV detection and registration at ART centre was 12 days (n = 844). In this cohort of 1118 pregnant women, 45% delivered live babies, 7% underwent medical termination of pregnancy, 2% were stillbirths and abortions, and 46% were yet to deliver. Only 29 infants were tested for HIV at 6 weeks of age and six were found reactive. CONCLUSION: The tracking tool provides in-depth information regarding the pregnant women registered in the program and in the tracking tool. The information throws more light on the characteristics of the registered women and the various services provided to them and highlight key areas where the program has to be improved. The tool is effective for assessing the treatment status of HIV-positive pregnant woman, retention in care and early infant diagnosis of the baby. The tool has identified programmatic bottlenecks component wise such as the need to focus on earlier detection of HIV-positive women during pregnancy, decreasing the time delay between detection and ART registration, and improving the early infant diagnosis.

Use of Xpert MTB/RIF in Decentralized Public Health Settings and Its Effect on Pulmonary TB and DR-TB Case Finding in India.

BACKGROUND: Xpert MTB/RIF, the first automated molecular test for tuberculosis, is transforming the diagnostic landscape in high-burden settings. This study assessed the impact of up-front Xpert MTB/RIF testing on detection of pulmonary tuberculosis (PTB) and rifampicin-resistant PTB (DR-TB) cases in India. METHODS: This demonstration study was implemented in 18 sub-district level TB programme units (TUs) in India in diverse geographic and demographic settings covering a population of 8.8 million. A baseline phase in 14 TUs captured programmatic baseline data, and an intervention phase in 18 TUs had Xpert MTB/RIF offered to all presumptive TB patients. We estimated changes in detection of TB and DR-TB, the former using binomial regression models to adjust for clustering and covariates. RESULTS: In the 14 study TUs, which participated in both phases, 10,675 and 70,556 presumptive TB patients were enrolled in the baseline and intervention phase, respectively, and 1,532 (14.4%) and 14,299 (20.3%) bacteriologically confirmed PTB cases were detected. The implementation of Xpert MTB/RIF was associated with increases in both notification rates of bacteriologically confirmed TB cases (adjusted incidence rate ratio [aIRR] 1.39; CI 1.18-1.64), and proportion of bacteriological confirmed TB cases among presumptive TB cases (adjusted risk ratio (aRR) 1.33; CI 1.6-1.52). Compared with the baseline strategy of selective drug-susceptibility testing only for PTB cases at high risk of drug-resistant TB, Xpert MTB/RIF implementation increased rifampicin resistant TB case detection by over fivefold. Among, 2765 rifampicin resistance cases detected, 1055 were retested with conventional drug susceptibility testing (DST). Positive predictive value (PPV) of rifampicin resistance detected by Xpert MTB/RIF was 94.7% (CI 91.3-98.1), in comparison to conventional DST. CONCLUSION: Introduction of Xpert MTB/RIF as initial diagnostic test for TB in public health facilities significantly increased case-notification rates of all bacteriologically confirmed TB by 39% and rifampicin-resistant TB case notification by fivefold.

Contraceptive studies of isolated fractions of Cuminum cyminum in male albino rats.

The contraceptive efficacy of Cuminum cyminum isolated fractions (CcFr) in male albino rats was investigated. Oral dose of CcFr at 50 mg/rat/day for 60 days revealed no significant changes in body weight, while marked abnormalities in spermatogenesis were observed with decreased counts (P ≤ 0.001) in round spermatids, preleptotene spermatocytes and secondary spermatocytes. Cross sectional surface area of Sertoli cells as well as number of mature Leydig cell were decreased significantly (P ≤ 0.001). Testicular as well as accessory sex organ biochemical parameters were significantly changed (P ≤ 0.001). Sperm motility, density and morphology were resulted in 100% negative fertility. Testosterone levels were declined significantly. In conclusion, Cuminum cyminum inhibited spermatogenesis in rats, indicating the possibility of developing an herbal male contraceptive.

Modulatory potential of α-amyrin against hepatic oxidative stress through antioxidant status in Wistar albino rats.

ETHNOPHARMACOLOGICAL RELEVANCE: α-Amyrin (a pentacyclic triterpene widely distributed in nature and isolated from a variety of plant sources and pharmacologically shown a wide spectrum of activity including anti-inflammatory, anti-ulcer, anti-hyperlipidemic, anti-tumor, and hepatoprotective actions) explored as hepatomodulator from the ethanol extract of the stem bark of Alstonia scholaris Linn. against CCl4-induced hepatic oxidative stress through antioxidant status in wistar albino rats. MATERIALS AND METHODS: Experimental rats, hepato-oxidatively stressed by CCl4 (0.2 ml/kg b wt/twice a week, intra-peritoneally), were concurrently received α-amyrin (20mg/kg body weight/day, orally) for 30 consecutive days. Hepatomodulatory potential was assessed by using the serum- markers like γ-glutamyl transpeptidase (GGT), aspartate and alanine transaminases (AST, ALT), lactate dehydrogenase (LDH), alkaline phosphatase (ALP), acid phosphatase (ACP), sorbitol dehydrogenase (SDH), glutamate dehydrogenase (GDH), and total bilirubin, total protein, glutathione reduced (GSH), ceruloplasmin, ß-carotene, vitamin C and vitamin E in serum concomitantly with the hepatic-antioxidants like superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GPx), glutathione reductase (GR), glutathione-s-transferase (GST), and 5´-nucleotidase, acid ribonuclease, glucose-6-phosphatase, succinic dehydrogenase and cytochrome-P-450 in liver tissue whereas lipid peroxidation (LPO) was estimated in both serum and liver contents. RESULTS: The assessment of all biochemical parameters registered a significant (P<0.001) hepatic oxidative stress in CCl4 treated rats, which was considerably recovered near to almost normal level in rats co-administered with α-amyrin at the dose level of 20mg/kg body weight/day for 30 consecutive days. The histoarchitectural examination of liver sections from treated groups further corroborated the hepatomodulatory potential of α-amyrin and compared with standard drug-silymarin. CONCLUSIONS: These findings indicate that the modulatory potential of α-amyrin against hepatic oxidative stress possibly involve mechanism related to its ability to block the P-450 mediated CCl4 bioactivation through selective inhibitors of ROS (reactive oxygen species) as antioxidants brought about significant inhibition of the formation of LPO suggesting possible involvement of O2(●-), HO2, HO2(●-), H2O2 and •OH. Therefore this study suggests that the use of α-amyrin as a hepatomodulatory potent to feasibility for a promising liver curative drug.

Feasibility of decentralised deployment of Xpert MTB/RIF test at lower level of health system in India.

BACKGROUND: Xpert MTB/RIF is an automated cartridge-based nucleic acid amplification test that has demonstrated its potential to detect tuberculosis and rifampicin resistance with high accuracy. To assist scale-up decisions in India, a feasibility assessment of Xpert MTB/RIF implementation was conducted within microscopy centres of 18 RNTCP TB units. METHODS: As part of programme-based demonstration of Xpert MTB/RIF implementation, we recorded and analysed association between key implementation factors and the ability of test to produce valid results. Factors contributing to test failures were analysed from GeneXpert software data which provides 'failure codes' and causes for test failures. RESULTS: From March'12 to January'13, total 40,035 suspects were tested by Xpert MTB/RIF, and 39,680 (99.1%) received valid results (Cumulative: 37157 (92.8%) on first attempt, 39410 (98.4%) on second attempt, 39637 (99.0%) on third attempt and 39680 (99.1%) on more attempts). Overall initial test failure was 2,878 (7.2% (4%-17%)); of these, 2,594 (90.1%) were re-tested and produced valid results. Most frequent reason of test failure was inadequate sample processing or equipment malfunction (3.9%). Other reasons included power failure (1.1%), cartridge integrity/component failure (0.8%), device-computer communication error (0.5%), and temperature-related errors (0.08%). Significant variation was observed in failure rates both across instruments and over time; furthermore, substantial variation was observed in failure rate in two cartridges lots. CONCLUSION: Installation required minimal infrastructure modifications and concerns about adequacy of human resources under public sector facilities and temperature extremes proved unfounded. Under routine conditions, Xpert MTB/RIF provided 99.1% valid results in TB suspects with low overall failure rates (7.2% initial failure, 0.9% final failure); devices provided valuable real-time feedback on reasons for test failure, which were used for rapid corrective action. High modular replacement (32%) and inter-lot cartridge performance variation remain sources of concern, and warrant close monitoring of failure rates as a key quality indicator.

Fertility suppression in male albino rats by administration of methanolic extract of Opuntia dillenii.

To control growing world population, there is a need for male contraceptive methods that are comparable to female contraceptives, but due to lack of knowledge or investigation, no sufficient safe and effective contraceptives were developed till now. In the present investigation, the effect of 100% methanol extract of Opuntia dillenii phylloclade on reproduction in male rats was studied. A first group (I) received vehicle alone to serve as control. The second group (II) was further divided into treated and recovery groups, and the plant extract at 50 mg kg body weight(-1) was administered orally for 30 days. Biochemical, haematological and histopathological analyses were carried out to reveal the effects on reproductive organs in the male rats. The weights of reproductive organs were recorded. It was found that the number of fertile males, number of inseminated females, number of litters delivered and testosterone levels were reduced significantly. Epididymal sperm count and motility were also significantly decreased. Biochemical parameters support the antifertility activity of O. dillenii i.e. decreases in protein, glycogen content and elevation in cholesterol level. Testes and sperm morphology were altered significantly. Haematological parameters have not shown any significant changes. It is concluded that 100% methanol extract of O. dillenii possesses antifertility effects on male reproduction without change in general physiology.

Evaluation of antidiabetic and antioxidant potential of lupeol in experimental hyperglycaemia.

Oxidative stress, produced under diabetic conditions, is a possible cause of various forms of tissue damage. The concentrations of antioxidant enzymes in cases of diabetes are significantly decreased, with a concomitant increase in lipid peroxidation. In this study, lupeol, a phytoconstituent from Solanum xanthocarpum, is shown to suppress the progression of diabetes after 21 days. Lupeol treatment caused decreases in glycated haemoglobin, serum glucose and nitric oxide, with a concomitant increase in serum insulin level. Furthermore, treatment with lupeol also increased antioxidant levels, with a decrease in the level of thiobarbituric acid-reactive oxygen species.

Phytochemical evaluation and antispermatogenic activity of Thevetia peruviana methanol extract in male albino rats.

This study was conducted to evaluate the antifertility potential of Thevetia peruviana (Apocynaceae) in male albino rats with their phytochemical evaluations. Phytochemical examination showed that plant is rich in active constituents, i.e. α-amyrin acetate, lupeol acetate, α-amyrin, ß-amyrin, lupeol and thevetigenin. T. peruviana stem bark methanol extract (TPMtE) administered orally to male rats at the dose level of 100 mg/rat/day did not cause any significant reduction in body weight, while the weight of reproductive organs reduced significantly. A significant fall in the total protein and sialic acid content of the testes, epididymides, seminal vesicle and ventral prostate, as well as in the glycogen content of testes was also observed; however, cholesterol was increased significantly. TPMtE also caused a decline in spermatogenic elements, i.e. preleptotene and pachytene spermatocytes, secondary spermatocytes, round spermatids and mature Leydig cells. At this dose level Leydig cell nuclear diameter, seminiferous tubular diameter and Sertoli area were significantly reduced (p < 0.001). The reduction in sperm density and motility resulted in 18% residual fertility. In conclusion, T. peruviana inhibited spermatogenesis in rats, indicating the possibility of developing a herbal male contraceptive.

Antidiabetic and antioxidant potential of ß-sitosterol in streptozotocin-induced experimental hyperglycemia.

BACKGROUND: Oxidative stress, produced under diabetic conditions, may cause tissue damage. Although several drugs are currently available for the treatment of diabetes, their continued use may cause unwanted side effects. The aim of the present study was to evaluate the antioxidant potential of ß-sitosterol (BS), a phytosterol from Solanum surattense, using an experimental model for diabetes-induced oxidative damage. METHODS: The effects of 21 days treatment with BS (10, 15 and 20 mg/kg, p.o.) on blood, serum, and tissue biochemical parameters were evaluated in control and streptozotocin-induced diabetic rats. Nine experimental groups, including a control group, a diabetic group, and BS- and glibenclamide-treated diabetic groups, were evaluated. RESULTS: All three dose levels dose dependently resulted in decreases in glycated hemoglobin, serum glucose, and nitric oxide, with concomitant increases in serum insulin levels. Furthermore, treatment with BS doses also increased pancreatic antioxidant levels, with a concomitant decrease in thiobarbituric acid-reactive substances. CONCLUSIONS: ß-Sitosterol has promising antidiabetic as well as antioxidant effects and may be considered in clinical studies for drug development.

The water-deficit stress- and red-rot-related genes in sugarcane.

Sugarcane is an important international commodity as a valuable agricultural crop especially in developing countries. Sequencing was carried out to generate >35,000 expressed sequence tags (ESTs) from healthy as well as red-rot-infected tissue of Indian subtropical variety of sugarcane. Subsequent clustering with existing sugarcane ESTs in public databases identified 4,087 clusters, including 85 clusters that preferentially express upon Colletotrichum falcatum (red-rot) infection, which were previously unreported. Real-time reverse transcription-PCR profiling of selected EST clusters identified several sugarcane clusters that show differential expression in response to biotic and abiotic stress conditions. Twenty-five stress-related clusters showed >2-fold relative expression during water-deficit stress in sugarcane. Similarly, EST clusters could be identified, which exhibit association with red-rot disease when assessed in red-rot-susceptible and red-rot-resistant varieties of sugarcane. Such EST clusters are good candidates for in-depth analysis to elucidate stress-responsive pathways in sugarcane and facilitate genetic manipulation to tailor this crop for tolerance to various stresses.

Adenosine kinase and ribokinase--the RK family of proteins.

Ribokinase (RK) and adenosine kinase (AK) catalyze the phosphorylation of ribose and adenosine to ribose-5-phosphate and AMP, respectively. Belonging to the RK family of proteins, these enzymes share a number of unique structural and functional elements. Extensive work has been carried out on many aspects of these enzymes in recent years, and we summarize the wealth of information currently available on them. The topics covered include descriptions of the primary and three-dimensional structures of AK and RK, their phylogenetic relationships, biochemical aspects of these enzymes including their reaction mechanisms and ionic requirements, and also work on certain inhibitors of these enzymes. The cellular metabolism and transport of ribose and adenosine are also briefly discussed, as well as the beneficial effects of ribose and adenosine in physiology and how these effects can be harnessed for pharmacological purposes.

Evaluation of contraceptive activity of methanol extract of Dendrophthoe falcata stem in male albino rats.

The present study was undertaken to evaluate the contraceptive efficacy of methanol extract of Dendrophthoe falcata Ettingsh (family-Loranthaceae), stem in male albino rats as reported in folk remedies. Adult proven fertile male rats were gavaged methanol extract of D. falcata stem at 50, 100 and 200mg/rat/day for 60 days. The activity was compared with standard drug, i.e. Lonidamine. On day 61 the animals were autopsied and the testes, epididymides, seminal vesicle and ventral prostate were dissected out and weighed. Sperm motility and density and serum testosterone level were assessed. The sperm motility and density were significantly reduced. The histoarchitecture of testes revealed degenerative changes in the seminiferous tubules, arrest of spermatogenesis at the stage of round spermatid. Serum testosterone levels were decreased significantly in all treatment groups. It is concluded that D. falcata methanol stem extract showed a significant effect on fertility in male rats as reported in folk remedies.