Cytotoxic diterpenoid quinonemethides from the roots of Pygmacopremna herbacea.

Two new diterpenoid quinonemethides (1 and 2) along with two known compounds (3 and 4) were isolated from the hexane and ethyl acetate extracts of root nodules of Pygmacopremna herbacea. The structures of the new compounds were established by spectroscopic data interpretation. Single crystal X-ray diffraction analysis confirmed the structure of 1. The cytotoxic activities of these compounds were evaluated against A 549, HEPG2, MCF-7, PC-3 and HELA cancer cell lines. Compounds 4, 2 and 1 were shown very good cytotoxic activity.

Subclinical autonomic nervous system dysfunction in compressive cervical myelopathy.

STUDY DESIGN: Laboratory evaluation of autonomic nervous system (ANS) in patients with cervical compressive myelopathy (CCM). OBJECTIVE: To study the autonomic functions and heart rate variability (HRV) in patients with CCM and compare the findings after surgery. SUMMARY OF BACKGROUND DATA: ANS dysfunction is well known after traumatic spinal cord injury. There are very few studies of ANS dysfunction in noncompressive myelopathy and there are no studies on compressive myelopathies. METHODS: After excluding patients on cervical traction or with medical comorbidities, 29 adult patients with CCM were evaluated. Conventional autonomic function tests and HRV were studied in these patients. The same tests were done on 29 age- and sex-matched healthy controls. Student t test was used to find the significance of study parameters on continuous scale. Chi-square/Fisher exact test was used to find the significance of study parameters on categorical scale between two groups. Significance was assessed at 5% level. RESULTS: Patients with CCM as compared with controls, showed significant difference in following parameters; deep breathing, Valsalva ratio, 30:15 (longest RR interval (duration between two consecutive R waves of ECG) around 30th second and the minimum RR interval around 15 seconds after standing up), and orthostatic fall of blood pressure. Except 30:15, there was no significant change of other autonomic function tests after surgery. Among the HRV parameters, there was a trend in increase in total power and decrease in root-mean-square differences of successive RR intervals; however, it did not reach statistical significance. CONCLUSION: Patients with CCM have definite ANS dysfunction as compared to healthy age- and sex-matched controls. There is significant improvement in 30:15 ratio after surgery. HRV indices are also impaired and there is a trend for change in total power and root-mean-square differences of successive RR intervals suggesting loss of HRV.

Perioperative stroke following anterior cervical discectomy.

We describe a case of postoperative stroke in a patient undergoing anterior cervical discectomy caused by a combination of intraoperative retraction of an atherosclerotic carotid vessel and arterial hypotension.

Nutritional status of affluent Indian school children: what and how much do we know?

OBJECTIVE: This paper reviews available literature on nutritional status of Indian school children 6-18 years from middle and high socio economic status (MHSES). METHODS: Literature search was conducted using Medline literature database search, followed by review of full length journal papers and unpublished materials such as research reports. RESULTS: Studies showed that anemia prevalence (hemoglobin concentration <120 g/L) ranged from 19 to 88% across five different cities in India. Other micronutrient deficiencies including, folate, riboflavin, niacin, vitamin C, vitamin A, and vitamin B12 were also present based on biochemical parameters in one study and clinical signs of deficiency in three other studies. Overweight and obesity were prevalent among 8.5-29.0% and 1.5-7.4% respectively among school children, as indicated by 11 studies. Predominant components in children's diet were cereals and pulses, followed by milk and milk products; the fruits and vegetables component was comparatively lower. CONCLUSION: Nutritional status of MHSES children in India needs attention especially with respect to the high prevalence of anemia, overweight and obesity. There are indications that micronutrient deficiencies exist, but sufficient data are lacking, in particular biochemical data. A current estimate, using well designed methodologies, of prevalence of micronutrient deficiencies and information on the etiology of anemia among children of MHSES groups would be valuable to help understand the nutritional status and extent of micronutrient malnutrition.