Ethnomedicinal plants traditionally used in health care practices by inhabitants of Western Himalaya.

ETHNOPHARMACOLOGICAL RELEVANCE: Inspite of tremendous advances made in allopathic medicine, herbal practice still plays an important role in management and curing various ailments in remote and rural areas of India. However, traditional knowledge on the use of medicinal plants is eroding day by day and there is a need to document such knowledge, before it is lost forever. The aim of the present study was to document the indigenous and traditional knowledge of medicinal plants used by local inhabitants in and around Kedarnath Wildlife Sanctuary of Indian Himalaya for the advancement of biomedical research and development. MATERIALS AND METHODS: The intensive field survey was carried out at three different altitudes of Kedarnath Wildlife Sanctuary (KWLS) and its adjoining areas. The inhabitants were interviewed about the local name of plants having ethno-medicinal values, plant parts used, mode of processing/application and preparation and dosage through discussions and semi structured questionnaires. RESULTS: A total of 97 medicinal plant species belonging to 52 families and 83 genera were reported for curing various ailments like fever, cough, cold, digestive disorders, constipation, menstrual disorders etc. Out of 97 plant species reported, 21 are rare or threatened. Literature review revealed that 11 out of the 97 plant species are reported with new therapeutic uses. The most frequently utilized plant part was the root/rhizome (33%) followed by leaf (27%). In some cases whole plant was utilized. A few medicinal plants had some veterinary uses also. CONCLUSION: The study provides comprehensive information about the eroding indigenous and traditional knowledge of medicinal plants used by local inhabitants in a part of Western Himalaya, India. The identification of the active ingredients of the plants used by the local people may provide some useful leads for the development of new drugs and such new approaches of traditional knowledge regarding medicinal plants and laboratory analysis might help pharmaceutical industry in new chapters for the wellbeing of mankind.

Drug resistant cases of tuberculosis in directly observed treatment short course.

BACKGROUND: Resistance of Mycobacterium tuberculosis to antituberculous drugs has emerged as a major public health threat. The objective of this study was to determine Multi Drug Resistance cases of tuberculosis in Directly Observed Treatment Short Course program of Nepal. METHODS: The sputum samples collected and culture on Lowenstein Jensen media followed by biochemical test. All the isolates antibiotic sensitivity test performed on medium by proportion method. RESULTS: Tuberculosis was most commonly found in economically active age group (21-50 years). All the isolates of pulmonary tuberculosis were found to be M. tuberculosis. A Multi-drug resistant case of tuberculosis primary and acquired in Directly Observed Treatment Short Course Program of Nepal was found (3.6%). Out of 460 untreated cases, 9 (1.9%) cases were found to be MDR and among 90 previously treated cases 11 (12.2%) were found to be MDR. Multi drug resistant cases of tuberculosis were found most commonly in productive age group (21-30). The incidence of tuberculosis was found higher in male than in female. But multi drug resistant M. tuberculosis cases equally affected both the gender. Majority of the MDR cases found higher number of M. tuberculosis in their sputum. CONCLUSIONS: The above study showed that drug resistant cases of tuberculosis in DOTS program of Nepal was found higher. To reduce the drug resistance, before starting chemotherapy antibiotic sensitivity test should be performed.

Abnormal Doppler flow velocimetry in the growth restricted foetus as a predictor for necrotising enterocolitis.

BACKGROUND: Obstetric decision- making for the growth restricted foetus has to take into consideration the benefits and risks of waiting for pulmonary maturity and continued exposure to hostile intra-uterine environment. Necrotising Enterocolitis (NEC) results from continued exposure to hostile environment and is an important cause of poor neonatal outcome. AIMS: To evaluate the predictive value of abnormal Doppler flow velocimetry of the foetal umbilical artery for NEC and neonatal mortality. SETTINGS AND DESIGN: A retrospective study carried out at a tertiary care centre for obstetric and neonatal care. MATERIALS AND METHOD: Seventy-seven neonates with birth weight less than 2000 gm, born over a period of 18 months were studied. These pregnancies were identified as having growth abnormalities of the foetus. Besides other tests of foetal well-being, they were also subjected to Doppler flow velocimetry of the foeto-placental vasculature. Obstetric outcome was evaluated with reference to period of gestation and route of delivery. The neonatal outcome was reviewed with reference to birth weight, Apgar scores and evidence of NEC. STATISTICAL ANALYSIS USED: Chi square test. RESULTS: In the group of patients with Absent or Reverse End Diastolic Frequencies (A/R EDF) in the umbilical arteries, positive predictive value for NEC was 52.6%, (RR 30.2; OR 264). The mortality from NEC was 50%. When umbilical artery velocimetry did not show A/REDF, there were no cases of NEC or mortality. Abnormal umbilical or uterine artery flow increased the rate of caesarean section to 62.5% as compared to 17.6% in cases where umbilical artery flow was normal. CONCLUSION: In antenatally identified pregnancies at risk for foetal growth restriction, abnormal Doppler velocimetry in the form of A/REDF in the umbilical arteries is a useful guide to predict NEC and mortality in the early neonatal period.