A comparative in vitro study on antifungal and antioxidant activities of Nervilia aragoana and Atlantia monophylla.

Ethyl acetate extract of the whole plant of Nervilia aragoana Gaud. (Orchidaceae) and ethanol extract of the leaves of Atlantia monophylla Linn. (Rutaceae) were evaluated for antifungal and antioxidant activities. At 5 mg/mL concentration of the extracts, the former exhibited more inhibitory activity than the latter against fungi. The order of MIC values for Nervilia aragoana were Saccharomyces cerevisiae (1.4 mg/mL) > Aspergillus niger (1.2 mg/mL) > Aspergillus fumigatus (0.95 mg/mL) > Cryptococcus neoformans (0.75 mg/mL). In the case of Atlantia monophylla values were Cryptococcus neoformans (1 mg/mL) > Candida albicans (0.95 mg/mL) > Aspergillus niger (0.65 mg/mL). TLC-DPPH method assay was carried out to evaluate the antioxidant potential. Further DPPH radical, superoxide, nitric oxide, H(2)O(2) scavenging, and reducing power activities were carried out. N. aragoana (85%) extract exhibited more scavenging activity than that of A. monophylla (66%) by DPPH free radical scavenging method. A. monophylla extract exhibited more superoxide, nitric oxide, H(2)O(2) scavenging activities than that of N. aragoana. The acute toxicity studies of both extracts have shown no mortality rate even up to 3 g/kg body weight in albino rats. Screening for secondary metabolites showed the presence of carbohydrates in both extracts. Flavonoids were found only in the ethyl acetate extract of N. aragoana. Tannins, alkaloids, triterpenoids and steroids were present in A. monophylla. Total phenols present in N. aragoana and A. monophylla were 340 and 560 mg/g extract of gallic acid equivalents, respectively.

Angiotensin converting enzyme gene polymorphism in type II diabetics with nephropathy.

Nephropathy is an important and a frequent complication of long-term type II diabetic nephropathy. Strong evidence exists that genetic predisposition plays a major role in the development of diabetic nephropathy. Recent studies have implicated association between angiotensin converting enzyme (ACE) insertion/deletion (I/D) gene polymorphism and nephropathy. The deletion gene polymorphism of ACE gene has been shown to be associated with increased activity of this enzyme. This study examines the association of ACE I/D polymorphism with type II diabetes without nephropathy in 30 patients and type II diabetes with nephropathy in 30 patients. The results of the study suggest the association between the DD polymorphism and type II diabetes with nephropathy.

Genital lesions following bestiality.

A 48-year-old man presented with painful genital lesions with history of bestiality and abnor-mal sexual behaviour. Examination revealed multiple irregular tender ulcers and erosions, with phimosis and left sided tender inguinal adenopathy. VDRL, TPHA, HIV-ELISA were negative. He was treated with ciprofloxacin 500mg b.d. along with saline compresses with complete resolution.

Changing patterns of atheroembolism.

Among 1011 patients undergoing infrarenal aortic and infrainguinal vascular surgery in a 90-month period (1986-1993), 29 patients (2.9%) with clinical, angiographic and pathologic evidence of atheroembolism were identified. Over one-third (44.8%) of atheroemboli were iatrogenic and the rest spontaneous. All iatrogenic atheroemboli were precipitated by angiographic (n = 11; 84.6%) or operative manipulation (n = 2; 15.4%). The sources of emboli were in the abdominal arota (16), iliac (seven) and femoropopliteal (six) arteries. 'Trash foot' occurred in 19 patients (seven bilateral) and occlusions of tibioperoneal/digital arteries were seen in seven, renal and dermal microcirculation in two each, and calf muscles in one. Larger conduits were affected in three instances (common femoral, popliteal and in situ saphenous vein graft). The management consisted of 54 (43 surgical and 11 endovascular) procedures concurrently with thrombolytic, anticoagulant and antiplatelet therapy. Three early (10.3%) and two late (6.9%) deaths (overall mortality rate 17.2%), eight major (27.6%) and five minor (17.2%) amputations, and four (13.8%) instances of renal failure occurred in 17 patients resulting in a 58.6% complication rate. Besides initial angiography, 53 invasive procedures were required in 25 patients. Among these, 12 patients could be managed with a single definitive procedure in contrast to a group of 13 patients that required 41 (average 3.2 per patient) procedures. The incidence of foot ischemia, reoperation and amputation was higher in the spontaneous group, whereas, the iatrogenic group incurred a higher incidence of endovascular interventions, greater mortality and new onset renal failure. The high morbidity and mortality of atheroemboli demand prompt recognition and treatment, as well as attempts at prevention to achieve good results.

Historical biography of medicinal plants.

Medicinal plants, have been the chief source of drugs used in treatment of various ailments. It is observed that the position of medicinal plants is not the same as in Samhitas. There is a lot of addition of new synonyms and also recording of new observations in terms of actions and uses. Thus, it would be interesting to study such developments in case of each drug historically and scientifically under the heading of 'The Historical Biography', covering the entire life of a medicinal plant along with various changes taking place from time to time.

On improving the disintegration of ayurvedic pills containing guggulu.

An attempt is made in this communication to report a better way of preparing guggulu - containing pills. This technique improves the disintegration time of the preparation, thus enhancing its therapeutic value.

Central and regional hemodynamics determine optimal management of major venous injuries.

Controversy continues in the selection of optimal management of major venous injuries. We analyzed our experience with 191 major venous injuries in 163 patients (1986 to 1991). The mechanism of injury was gunshot (112), stab (44), blunt (six), and iatrogenic (one). Eighteen cervicothoracic, 51 caval, 30 iliac, 36 visceral, and 56 extremity veins were involved. Of the 191 injuries, 105 (54.9%) were repaired (lateral repair 76, end-to-end anastomosis 15, vein patch four, vein graft five, Gore-Tex graft four, and compilation one). Of the remaining venous injuries, 64 were ligated as a result of hemodynamic instability. Twenty-two injuries in 18 patients did not receive treatment because 16 of 18 patients died before vascular control or repair. The overall amputation rate was 1.2%, and the mortality rate was 28.2% (46/163). The highest mortality rate occurred in those patients who required resuscitative thoracotomy (100%, p < 0.00001), retrohepatic caval injuries (90%, p < 0.0004), and multiple venous injuries (81.8%, p < 0.00001). Seventeen patients underwent fasciotomies (15 prophylactic and two therapeutic). Clinical or measured venous hypertension by stump pressure assisted in deciding for venous repair in 20 patients. A significant decrease in venous stump pressure (p < 0.000001) was noted after venous reconstruction. Thus the decision to ligate or repair venous injuries correlated primarily with (1) hemodynamic stability, and in stable patients, with (2) extent and location of injury and (3) clinical and measured venous hypertension. Venous ligation in clinically stable patients did not increase the need for fasciotomy or amputation.(ABSTRACT TRUNCATED AT 250 WORDS)

Meticulously restored lumina of injured veins remain patent.

We report our experience with 38 major venous injury repairs in 37 patients between January 1981 and December 1989. The injuries were caused by gunshot (n = 27), shotgun (n = 3), knife (n = 5), blunt trauma (n = 1), and dog bite (n = 1). These involved 27 femoral, 10 popliteal, and one brachial veins. Thirty patients had associated major arterial injuries and seven had major long bone fractures. Retrospective analysis yielded two groups. Group I consisted of 17 patients who underwent meticulous restoration of venous lumina ensured by intraoperative postreconstruction venography (IPV) in all patients. Two of these required revision on the basis of IPV findings. Late patency of venous repair was confirmed by postoperative venography (n = 10) or duplex scans (n = 7). All 17 venous repairs were patent (100%). In group II none of the 20 patients (21 veins) underwent IPV. Fifteen of the 20 patients underwent venography and five patients (six veins) underwent duplex scanning after surgery. Eight veins were occluded and 13 (62%) were patent. The difference in patency rates of venous repair between groups I and II was significant (p = 0.02). Three (37.5%) of eight patients with occluded venous repair required delayed fasciotomy, but only 1 (3.4%) of 29 limbs (30 veins) with patent lumina required fasciotomy (p = 0.03). We conclude that meticulous restoration to normal-caliber venous lumina, confirmed by IPV, can achieve high patency and low morbidity rates.

The caraka-tattvapradipika of sivadasa sena.

In this article the author describes the salient features of Carakatattvapradipika, a commentary on the Caraka Samhita by Sivadasa sena and highlights his theory and practice of medicine.

Bullet embolism.

Bullet embolism is a rare complication of vascular trauma. During the last ten years we have treated six patients with bullet embolism. Three patients had inferior vena caval injuries with embolizations of the bullets to the heart or pulmonary arteries. Two had infrarenal aortic injuries with embolization to vessels of the lower extremities. One patient with a shotgun injury to the superficial femoral artery and vein had both arterial and venous embolizations. The site of vascular penetration was repaired in all six patients. All peripheral arterial bullet emboli were removed except for an asymptomatic shotgun pellet in the peroneal artery. One bullet was removed from a right atrium and another from a proximal pulmonary artery. Emboli in the distal pulmonary artery branches were left undisturbed in two patients. All six patients survived without any complications. A 14-year review of the literature is presented in order to emphasize some important features of this rare pathology.

On lehas (linctus formulations).

The author renders here an English translation to Lehdhyaya of the Kasyapa-samhita, Suthrasthana, 1-6.

Flavouring agents in pharmaceutical formulations.

This paper deals with the various aspects of commonly used flavouring agents for the preparation of medicaments.

Standardization of an ayurvedic drug: trivanga bhasma.

The quantitative estimation of various metallic constituents of Trivanga Bhasma, an important Ayurvedic drug, has been carried out which provided interesting results.

Present status of research on genus: mimosa.

The research work done on different species of the genus Mimosa have been reviewed with special reference to Chemistry, Biochemistry and Biological activities.

Haramekhala - tantra (the first chapter on medicine).

This translation of Haramekhala - tantra of the author is based on Banaras Hindu University manuscript which seems to be a novel one. The manuscript runs into 133 stanzas in all in the form of dialogue between lord Siva and goddess Parvati. This is only the first chapter (of the great work) dealing with medicine. From stanza 109 onwards some magic spells are described and as such those have not been included in this translation.

Some new facts about candranandana.

In this paper the author probes the identity of Candranandana a well known author and commentator of various works in Ayurvedic literature by interpreting the classical texts.

Arterial thrombosis and embolism in malignancy.

In most reviews of arterial embolism or thrombosis the source of emboli or the cause of thrombosis can reasonably be established in over 90% of patients. Still about 10% remain without demonstrable cardiac or intraarterial sources. Although hypercoagulability induced by malignancy has been alluded to as a cause of unexplained intravascular thrombosis reports of arterial thromboembolism with such association are rare. Seven patients with unequivocal thromboembolism are presented. Two distinct clinical patterns are observed, one with in situ thrombosis of small arteries and the other with occlusion of large arteries causing limb ischemia or fatal organ infarction. The various pathogenetic mechanisms of arterial thrombosis or embolism in malignancy include sustained spasm of arteries, precipitation of cryoglobulins or other abnormal proteins in small arteries, direct tumor invasion of arteries, fragmentation and embolization of intracardiac or intraarterial metastases and spontaneous arterial thrombosis due to hypercoagulability. The hypercoagulable state can be recognized by the observation of shortened bleeding and clotting times, partial thromboplastin and prothrombin times, elevation of coagulation factors, platelets and yield stress index and resistance to anticoagulation. Patients presenting with arterial thromboembolic events with out demonstrable source should be investigated for malignancy. Conversely patients with malignancy should be searched for evidence of hypercoagulability in an attempt to prevent arterial thromboembolic complications.

Changing patterns in civilian arterial injuries.

A critical review of 185 patients with 211 arterial injuries over an eleven year period was performed to recognize the changing patterns in clinical findings, management and results. A ten fold increase in multiple arterial injuries as well as higher incidence of associated venous and visceral injuries occurred during the last five years. Despite this, the incidence of hypotension on arrival at hospital was reduced by half due to rapid transportation and resuscitation during transit. Shock in patients with only extremity injuries heralded dual injuries (arterial and venous). Lateral repair of both arterial and venous injuries has given way to end to end anastomoses, vein grafts and patch grafts. A greater tendency to repair all major arteries, most minor arteries, more liberal use of heparin, fasciotomy, intraluminal shunts, repair of venous injuries and extra-anatomic bypass has been noted. Rapid patient retrieval, early resuscitation, improved recognition and management of arterial injuries has not lead to better limb salvage or survival. The apparent lack of benefit in limb salvage is probably due to the higher incidence of multiple arterial injuries and associated venous injuries as well as the willingness to attempt repair all major arterial injuries and reluctance to advise primary amputation. Early patient retrieval, rapid transportation and resuscitation during transit has increased the number of potentially unsalvageable patients (who would otherwise be declared dead on arrival) resulting in an unchanging mortality.