Comparative study on efficacy of Antimicrobial activity of three Ayurvedic drugs Balaguduchi, Dhanadanayanadi and Dasamoolabala on isolated Nosocomial Pathogens.

The antibacterial activity of various solvent fractions of Balaguduchi, Dhanadanayanadi and Dasamoolabala was studied against the isolated nosocomial pathogens by in vitro method. The methanol, acetone, choloroform, acetone fractions of test drugs and decoctions exhibited different levels of antibacterial activity from low to very high level against the gram positive and gram -negative bacteria. The zone of inhibition of each fraction of drugs was compared with the standard antibiotics Penicillin and Streptomycin. The present study proves and explains the ability and potency of the extracts of Balaguduchi, Dhanadanayanadi and Dasamoolabala as a preventive measure of secondary infections by bacteria in the hospitalixe patients. Even though, these medicines are prescribed in ayurveda for the different clinical indications, the possible secondary activity is also proved through this study.

Structural characterization of impurities in pioglitazone.

In the pioglitazone bulk drug three prominent impurities I-III were detected up to concentrations of 0.1% (ranging from 0.05-0.1%) by reversed phase HPLC. These impurities were isolated from enriched mother liquor samples and characterized as 5-(4-hydroxybenzyl)-1,3-thiazolidine-2,4-dione (I) 5-(4-fluorobenzyl)-1,3-thiazolidine-2,4-dione (II), 2-[2-(4-bromophenoxy) ethyl-5-ethyl pyridine (III) based on their 1H, and 13C NMR, DEPT, Mass and IR spectral data. Structure elucidation and synthesis of these impurities is discussed.

Safety and immunogenicity of indigenous recombinant hepatitis B vaccine (Shanvac-B) in comparison with commercially available vaccine.

AIM: To assess the clinical safety, reactogenicity and immunogenicity of an indigenously developed recombinant hepatitis B vaccine (Shanvac-B; Shantha Biotechnics) and to compare it with another commercially available vaccine (Engerix-B, SmithKline Beecham) in healthy adults. METHODS: 120 healthy adults randomLy received 20 micrograms of either Engerix-B (Group A; n = 61) or Shanvac-B (Group B; n = 59) in 0, 1, 2 months schedule. Anti HBs was assessed using commercially available AUSAB kits (Abbott Laboratories) one month after each dose. RESULTS: Protective seroconversion rates after first, second and third dose were 10%, 62.7% and 91.4%, respectively in Group A and 22.4%, 68.9% and 96.4% in Group B, respectively. The geometric mean titer (GMT) after the third dose was significantly high in Group B (419 mIU/mL) than in Group A (140 mIU/mL; p < 0.001). The GMT was significantly higher in women in both the groups. The indigenous vaccine was found to be clinically safe and well tolerated without significant side effects. CONCLUSION: The recombinant hepatitis B vaccine (Shanvac-B) developed in India is safe, well tolerated, and highly immunogenic, with high seroconversion and GMT response.

Clinical safety and efficacy of first indigenous recombinant hepatitis B vaccine.

A pilot study was conducted to assess the clinical safety and immunogenicity of an indigenously developed recombinant hepatitis B vaccine (Shanvac B) in 18 healthy adults. 20 microg of vaccine was administered at 0, 1 and 2 months. Protective anti HBs titres developed in 22%, 77% and 100% one month after 1st, 2nd and 3rd dose of vaccination, respectively. The geometric mean titre after the 3rd dose was 1015.29 mIu/ml. The vaccine was well tolerated with minor local and systemic side effects in 28% and 22%, respectively. The indigenously developed recombinant hepatitis B vaccine is safe, well tolerated and highly immunogenic.

Intestinal strongyloidiasis--a rare opportunistic infection.

We describe the features of intestinal strongyloidiasis in six patients; five of them were immunosuppressed (four on corticosteroids, one with chronic renal failure). Vomiting and diarrhea were the predominant symptoms. Duodenal mucosa on endoscopy varied from normal to severe ulceration. Albendazole 400 mg/day for two weeks was effective. This condition should be considered in immunosuppressed individuals with gastrointestinal symptoms, especially since these symptoms may be mistakenly attributed to the underlying disease.

Endoscopic treatment of postoperative biliary leak.

External biliary leak is a rare complication of biliary tract surgery. We report six cases in which postoperative biliary-cutaneous fistulae were treated successfully by endoscopic sphincterotomy and endoprosthesis placement. This procedure is safe, associated with minimum morbidity and appears to be a viable alternative to surgery in the management of biliary leaks.

Icterus due to tumor emboli--a rare presentation of hepatoma.

Two cases of hepatocellular carcinoma presenting with features of obstructive jaundice are reported because of their unusual presentation. Both of them had obstruction of the common bile duct by tumor emboli and underwent palliation with surgical evacuation of the tumor thrombus.

Fatal pulmonary arterial hypertension complicating noncirrhotic portal fibrosis.

A 25-yr-old female with noncirrhotic portal fibrosis underwent a lienorenal shunt for variceal bleed. Ten years after shunt surgery, she presented with progressive breathlessness, and severe pulmonary arterial hypertension was detected, to which she subsequently succumbed. Autopsy revealed classical plexogenic pulmonary arteriopathy.