High versus low intensity exercise training in pulmonary rehabilitation: is more better?

Background:Exercise training is considered a necessary component of comprehensive pulmonary rehabilitation. However, to date, there is no consensus on an exercise training strategy for pulmonary rehabilitation, and this has resulted in varied approaches to this intervention in its literature. As in healthy individuals, the effect of exercise training on patients with chronic lung disease is dose dependent, with higher intensities resulting in greater physiological adaptations than lower intensities. Results:It is not clear from our review of the literature that these enhanced physiological effects from higher levels of exercise training translate into a reduced burden of symptoms, hence a better quality of life. Indeed, there is some evidence that pulmonary rehabilitation approaches incorporating lower intensities of exercise training are at least as good in improving questionnaire rated symptoms of health status. This provides food for thought, since the prominent goal of pulmonary rehabilitation should be to reduce bothersome symptoms or enhance health status, not simply increase endurance time on a cycle ergometer.

Prosthetic rehabilitation of upper limb amputees: a five year review

A review of 55 upper limb amputees, acquired and congenital, referred to a subregional centre for amputee rehabilitation in a five year period is presented. Ninety-six per cent of the amputees were provided with prostheses. Seventy-three per cent of these patients have successfully accepted their prostheses with a minimum follow-up period of two years. The importance of a multidisciplinary approach in providing a comprehensive rehabilitation programme cannot be overemphasized. Patient's views and needs must be at the forefront in formulating the rehabilitation programme. Success of the prostheses should not be determined only on the grounds of active use, as cosmetic replacement may also play a major role in the total rehabilitation of upper limb amputees.

α-Solanine induces ROS-mediated autophagy through activation of endoplasmic reticulum stress and inhibition of Akt/mTOR pathway

α-Solanine is a glycoalkaloid found in species of the nightshade family including potato. It was primarily reported to have toxic effects in humans. However, there is a growing body of literature demonstrating in vitro and in vivo anticancer activity of α-solanine. Most of these studies have shown activation of apoptosis as the underlying mechanism in antitumor activity of α-solanine. In this study, we report α-solanine as a potential inducer of autophagy, which may act synergistically or in parallel with apoptosis to exert its cytotoxic effect. Induction of autophagy was demonstrated by several assays including electron microscopy, immunoblotting of autophagy markers and immunofluorescence for LC3 (microtubule-associated protein 1 (MAP1) light chain-3) puncta. α-Solanine-induced autophagic flux was demonstrated by additionally enhanced – turnover of LC3-II and – accumulation of LC3-specific puncta after co-incubation of cells with either of the autophagolysosome inhibitors – chloroquine and – bafilomycin A1. We also demonstrated α-solanine-induced oxidative damage in regulating autophagy where pre-incubation of cells with reactive oxygen species (ROS) scavenger resulted in suppression of CM-H₂DCFDA (5 (and 6)-chloromethyl-2′,7′-dichlorodihydrofluorescein diacetate acetyl ester) fluorescence as well as decrease in LC3-II turnover. α-Solanine treatment caused an increase in the expression of endoplasmic reticulum (ER) stress proteins (BiP, activating transcription factor 6 (ATF6), X-box-binding protein 1, PERK, inositol-requiring transmembrane kinase/endonuclease 1, ATF4 and CCAAT-enhancer-binding protein (C/EBP)-homologous protein) suggesting activation of unfolded protein response pathway. Moreover, we found downregulation of phosphorylated Akt (Thr³⁰⁸ and Ser⁴⁷³), mammalian target of rapamycin (mTOR; Ser²⁴⁴⁸ and Ser²⁴⁸¹) and 4E-BP1 (Thr^37/46) by α-solanine implying suppression of the Akt/mTOR pathway. Collectively, our results signify that α-solanine induces autophagy to exert anti-proliferative activity by triggering ER stress and inhibiting Akt/mTOR signaling pathway.

Descriptive epidemiology and high risk behavior of male prescription opioid abusers: Cross-sectional study from Sikkim, North East India

BACKGROUND

Sikkim is emerging as an important area for prescription opioid abuse with frequent news of seizures and arrests due to possession of prescription opioids. However, till date there is a little information on descriptive epidemiology and high risk behavior of prescription opioid abusers from Sikkim.

AIMS

The aim was to describe demographic (age, sex, religion, marital status, community, occupation, etc.); socioeconomic (income, education, family information etc.); and high risk behavior (e.g., injection sharing, visit to commercial sex workers [CSWs], homosexuality etc.) among treatment-seeking prescription opioid abusers in Sikkim.

MATERIALS AND METHODS

Epidemiological data were collected by administering predevised questionnaires from n = 223 prescription opioid abusers (main problem prescription opioids) reporting for treatment at five different drug abuse treatment centers across Sikkim.

RESULTS

The mean age of prescription opioid abusers in Sikkim was 27 years; all were male, of Nepalese ethnicity and single/never married, school dropout and/or illiterate, earning < Rs. 10,000/month with most spending almost Rs. 5000 a month on prescription opioids. Most (57.4%) prescription opioid abusers belonged to the urban community. Commonly abused prescription opioids were dextropropoxyphene and codeine. Injection sharing was more in urban areas whereas syringe exchange was observed equally among rural and urban prescription opioid abusers. Among urban injectors visits to CSWs, and multiple sex partners were also common in spite of knowledge about AIDS. Limited condom use was observed among rural respondents. Incidences of arrests, public intoxication, and violence under the influence of prescription opioids were also reported.

CONCLUSION

Both the rural and urban areas of Sikkim show increasing rates of prescription opioid abuse among males. It is more prevalent among school dropouts and unemployed youth. Trends of injection drug use, unsafe injection, high risk behavior have also been observed.

Bioactive Compounds from Marine Invertebrates for Potential Medicines - An Overview

The present review deals with the bioactive compounds of the marine non-chordates. The potent medicinal usage of the bioactive compounds viz. steroids, terpenoids, isoprenoid and non-isoprenoid compounds, quinones, brominated compounds, nitrogen heterocyclics and nitrogen-sulphur heterocyclics from marine non-chordates have been compiled. Various literatures survey revealed that the bioactive compounds isolated in recent past from the marine poriferans, cnidarians, annelids, arthropods, molluscs and echinoderms could be rich sources of therapeutic agents having antibacterial, antiinflamatory, anticarcinogenic properties. In overall, the present study will be benefitted to know global drug discovery researches on bioactive compounds from marine organisms for students, scholars, scientists, pharmaceutical sector, and government regulating authorities as new challenging technology in clinical applications through medicines.

Bioactive Compounds from Marine Invertebrates for Potential Medicines - An Overview

The present review deals with the bioactive compounds of the marine non-chordates. The potent medicinal usage of the bioactive compounds viz. steroids, terpenoids, isoprenoid and non-isoprenoid compounds, quinones, brominated compounds, nitrogen heterocyclics and nitrogen-sulphur heterocyclics from marine non-chordates have been compiled. Various literatures survey revealed that the bioactive compounds isolated in recent past from the marine poriferans, cnidarians, annelids, arthropods, molluscs and echinoderms could be rich sources of therapeutic agents having antibacterial, antiinflamatory, anticarcinogenic properties. In overall, the present study will be benefitted to know global drug discovery researches on bioactive compounds from marine organisms for students, scholars, scientists, pharmaceutical sector, and government regulating authorities as new challenging technology in clinical applications through medicines.