Algae extracts and methyl jasmonate anti-cancer activities in prostate cancer: choreographers of 'the dance macabre'.

There is an overwhelmingly increasing trend of analysis of naturally occurring ingredients in treatment of prostate cancer. Substantial fraction of information has been added that highlights activity at various levels and steps of deregulated cellular proliferation, metastasis and apoptosis. Among such ingredients, algae extracts and jasmonates are documented to have anti-cancer activity in vitro and in vivo and induce growth inhibition in cancer cells, while leaving the non-transformed cells intact. In this short review we outline systematically, how these ingredients predispose prostate cancer cells to undergo apoptosis.

PBL wrap up sessions: an approach to enhance generic skills in medical students.

BACKGROUND: Problem based learning (PBL) tutorials are being used in various medical schools world wide. Students' active participation is a must for the success of a teaching program. The objective of this study was to evaluate the effectiveness of PBL Wrap-up sessions in an integrated modular medical curriculum in enhancing the generic skills of medical students. METHODOLOGY: This study was conducted on 100 students of 2nd year MBBS who had been taking PBL sessions since 1 1/2 years. Each session concluded with a wrap-up session where students demonstrated their acquired knowledge in the form of PowerPoint presentations, concept maps, skits, models etc. A questionnaire based survey was conducted to find out overall effectiveness of PBL sessions including wrap-up sessions. The questionnaire comprised of 15 questions. Students were asked to rate all those sessions on a likert scale of 1 to 5. RESULTS: Student's responses showed 'Moderate improvement' in 8 out of 15 skills like communication with peers and teachers, presentation skills, self confidence, application of acquired knowledge, using internet and other resources and understanding group dynamics. Improvement in abilities like problem solving, time management, creativity, motivation in studies and self-directed learning was 'Minimal'. In addition students recommended continuation of PBL in the same way for future classes. CONCLUSION: PBL with wrap-up sessions contributed in bringing moderate enhancement of generic learning skills in students which were not properly addressed in the traditional curriculum and are therefore recommended for future implementation.

Correlation of plasma endothelin-1 levels with pulmonary hypertension after inhaled nitric oxide therapy.

BACKGROUND: Variable response to inhaled nitric oxide (iNO) therapy in patients with mitral stenosis (MS) having pulmonary hypertension (PH) has been documented in early studies. The objectives of this study were to measure plasma Endothelin-1 (ET-1) levels in those patients and to correlate them with pulmonary vascular indices after iNO therapy. It was Quesi-experimental study. METHODS: Thirty patients with mitral or mixed mitral and aortic valve disease with severe pulmonary hypertension and enrolled for valve replacement surgery were included. Before the replacement, baseline pulmonary vascular indices and cardiac output were recorded. After the surgery, 10-20 ppm iNO was administered for 1 hour and all the parameters were again recorded. Patients were grouped into responders and non responders on the basis of % reduction in Pulmonary Vascular Resistance (PVR) after iNO therapy. Plasma ET-1 levels were measured in both groups by ELISA before and after the iNO therapy. Paired sample t-test was used to compare mean values for significance. The correlations between variables were then calculated by using Pearson's coefficient. RESULTS: The plasma ET-1 levels were very high in all patients. They reduced in responders after iNO therapy; non-responders paradoxically showed significant increase in the levels of ET-1 after iNO therapy. Moreover, a positive correlation was observed in plasma ET-1 levels and post operative levels of PVR. CONCLUSION: The correlation of changes in PVR and plasma ET-1 levels in responders suggests that high plasma ET-1 is a key mediator of poor response in PH secondary to MS, after iNO therapy.

Variable response to inhaled nitric oxide in postoperative patients of mitral stenosis with pulmonary hypertension.

BACKGROUND: This study was carried out to determine the vasodilator response of inhaled nitric oxide in patients with pulmonary hypertension (PH) after valve replacement surgery for mitral valve disease. METHOD: This Quesi experimental study was carried out at the intensive care unit of Armed Forces Institute of Cardiology (AFIC) in collaboration with Department of Physiology, Army Medical College, Rawalpindi from March 2004 to February 2006. Thirty patients with systolic Pulmonary Artery Pressure (PAP) > 50 mmHg on pre-operative echocardiography were inducted. Swan Ganz catheter was inserted to record baseline pulmonary artery pressure and pulmonary capillary wedge pressure (PCWP), while cardiac output (CO) was recorded through lithium dilution method. Pulmonary Vascular Resistance (PVR) was calculated with the help of a formula. Inhaled nitric oxide (iNO) was administered after the surgery and the same parameters were recorded again after one hour. RESULTS: The majority of patients were females (73%), while males were only 27%. Out of 30, 21 had isolated mitral stenosis and 9 had mixed mitral and aortic valve disease. 22 patients responded significantly to iNO therapy with > or = 40.0% reduction in their baseline PVR while 8 patients showed insignificant improvement in their PVR (663 +/- 233 dynes.sec.cm(-5) to 605 +/- 222 dynes.sec.cm(-5)). CONCLUSION: Significant improvement in pulmonary vascular resistance in the responders and maintenance of high pressures despite iNO therapy in non-responders indicate that apart from some abnormality in nitric oxide pathway, some other factors may be a contributing in the causation of PH secondary to mitral stenosis in adults, which warrant further studies.