New Innovation: Use of Flash Glucose Monitoring for Evaluating Glycaemic Variability, Patient Satisfaction and Clinical Utility in Pregnant Women with Diabetes.

AIM: Application of Flash glucose monitoring (FGM) system to evaluate glycaemic variability (GV), patient satisfaction and clinical utility in pregnant women with diabetes. METHODS: This prospective study was conducted in a tertiary care teaching hospital on 70 pregnant women with diabetes where blood sugar levels were monitored by FGM and self-monitoring of blood glucose (SMBG). RESULTS: FGM generated 19,950 readings versus 1470 readings by SMBG over 3 days. Glucose values measured by FGM and SMBG had significant positive correlation (r > 0.89; p < 0.001). Significant difference (p < 0.001) was present between minimum glucose values by FGM (52.49 ± 15.42 mg/dl) and SMBG (72.74 ± 18.30 mg/dl). FGM (20.9%) was able to pick exact duration of hypoglycaemia, while one-third of this duration was missed by conventional SMBG (14.7%; p < 0.05). Hypoglycaemic episodes were observed in 92.9% women by FGM as compared to 45.7% by SMBG (p < 0.001). No significant difference was observed in maximum glucose level or duration of hyperglycaemia by both methods. FGM identified hyperglycaemia in 74% women vs. 52% by SMBG (p < 0.001). GV calculated by using MODD by FGM was 118.4 ± 52.4 mg/dl and by SMBG was 83.2 ± 53.2 mg/dl (p < 0.001). 100% women preferred AGP vs. SMBG. CONCLUSION: This is the first study to evaluate FGM for GV and patient satisfaction in women with GDM. Significant correlation was observed in glucose values by FGM and SMBG. FGM was more sensitive in detecting GV and hypoglycaemic excursions as compared to SMBG. All women preferred FGM over SMBG. Use of FGM gave new insights in clinical management of challenging cases.

In vivo anti-inflammatory activity of Tabernaemontana divaricata leaf extract on male albino mice / 中国天然药物

AIM@#To study the in vivo anti-inflammatory activity of Tabernaemontana divaricata leaf extract on male albino mice.@*METHODS@#Aqueous decoction and methanol leaf extracts were tested for their ability to reduce croton oil-induced edema in the mouse ear after topical application. The methanol leaf extract dose-dependently inhibited the croton oil-induced ear edema in mice (ID50 <500 μg·cm(-2)). A bioassay-guided liquid-liquid fractionation of this methanol extract gave four active fractions: water insoluble (F1), hexane (F2), ethyl acetate (F3) and water (F4).@*RESULTS@#The hexane fraction showed a very high activity (42.1% inhibition at 0.7 μg·cm(-2)) as compared to the control. The other fractions were less active (F1: 56.1% at 506.2 μg·cm(-2); F3: 57.3% at 289.3 μg·cm(-2); and F4: 31.9% for 203.8 μg·cm(-2)) while indomethacin gave 48.8% of inhibition at 90 μg·cm(-2). The activity of F1 and F3 may be at least in part explained by the presence of anti-inflammatory flavonoids, while the activity was not correlated to the tannin contents. No compounds were detected in the most active F2 fraction.@*CONCLUSIONS@#The results give a rational support to the traditional use of T. divaricata in tropical India as anti-inflammatory agent.

Antifertility effect of chronically administered Tabernaemontana divaricata leaf extract on male rats

OBJECTIVE@#To investigate the antifertility effect of chronically administered Tabernaemontana divaricata (T. divaricata) leaf extract on male rats.@*METHODS@#The effect of 50% ethanol extract of T. divaricata leaves on reproduction was studied on male rats. The study was divided into four groups of five animals each. The first groups (I) received vehicle alone to serve as control. The second, third and fourth groups (II, II and IV) of animals were administered the leaf extract daily at 50 mg/kg body weight, p.o.,100 mg/kg body weight, p.o., and 200 mg/kg body weight, p.o., respectively, for a period of 60 days.@*RESULTS@#Significant decreases in the weight of testes, epididymis, seminal vesicle and ventral prostate were observed. A dose related reduction in the testicular sperm count, epididymal sperm count and motility, number of fertile male, ratio between delivered and inseminated females and numbers of pups were observed. The testis showed a clear correlation between the dose and severity of lesions of seminiferous epithelium. In general, the seminiferous tubules appear reduced in size with a frequently filled eosinophilic material. Spermatogenesis arrested at the secondary spermatocyte stage. Pachytene spermatocytes were undergoing degeneration. Disorganigation and sloughing of immature germ cell were visible. Leydinf cells were atrophied. No morphological changes were observed in Sertoli cells. Significant reduction in serum concentration of luteinizing hormone and testosterone were observed. No distinct change in serum FSH concentration was recorded. The final body weights of all groups were elevated markedly. No alterations were recorded in any hematologiocal parameters.@*CONCLUSION@#It is concluded that the 50% ethanol extract of T. divaricata leaf produced dose related effect on male reproduction without altering general body metabolism.

Pharmacognostic Screening, Phytochemical Evaluation and In- Vitro free radical Scavenging Activity of Acacia leucophloea Root

Objective: Pharmacognostic Screening and evaluate the in-vitro free radical scavenging activity of roots Acacia leucophloea. Methods: Pharmacognostic Standardization, Physico-chemical evaluation of the roots of Acacia leucophloea was carried out to determine its macro-and microscopical characters and also some of its quantitative standards. Microscopical studies were done by using trinocular microscope. Microscopically, root showed cork, cortex, stellar region and calcium oxalate crystals. Petroleum ether, ethanol, aqueous extracts of Acacia leucophloea were prepared, with successive extraction in soxhlet apparatus. Each extract was selected to study the free radical scavenging activity by superoxide scavenging assay method. Results: It was found that aqueous extract contained carbohydrates, glycosides amino acids flavonoids, tannins, alkaloids, steroids; ethanolic extract contained glycosides amino acids flavonoids, tannins, alkaloids, steroids. Ethanolic extract of Acacia leucophloea shows maximam inhibition in superoxide scavenging model. Aqueous extract also showed almost similar activity compared to ethanolic extract), while Petroleum ether extract showed poor inhibition of superoxide scavenging activity. Conclusion: The present study on pharmacognostic standardization, physico and phytochemical evaluation of Acacia leucophloea root might be useful to supplement information about its identification parameters assumed significantly in the way of acceptability of herbal drugs in present scenario lacking regulatory laws to control quality of herbal drugs.

Solitary nasal schwannoma clinically presenting as an angiofibroma of the nasopharynx.

Benign schwannomas of the nasal cavity are rare. When they do occur, their clinical presentation is variable, and some are fairly vascular. We report the case of a 17-year-old boy who presented with epistaxis associated with a unilateral nasal mass that extended into the nasopharynx. The tumor was removed via a transpalatal approach. In most such cases, a clinical diagnosis of angiofibroma is made. In this case, however, histopathologic examination identified the lesion as a schwannoma.