Non-hypertensive intracerebral haemorrhage: some interesting observations

Hypertension is the commonest cause of intracerebral hemorrhage (ICH) but non-hypertensive intracerebral hemorrhages (NHICH) are not rare. We report three interesting cases of NHICH subsequent to amyloid angiopathy, alcoholic hepatitis and amphetamine abuse. They suggest the importance of recognizing these conditions and need for urgent specific therapy which may play a vital role in therapeutic planning and prevention of ICH.

Population growth, human development, and deforestation in biodiversity hotspots

Human population and development activities affect the rate of deforestation in biodiversity hotspots. We quantified the effect of human population growth and development on rates of deforestation and analyzed the relationship between these causal factors in the 1980s and 1990s. We compared the averages of population growth, human development index (HDI, which measures income, health, and education), and deforestation rate and computed correlations among these variables for countries that contain biodiversity hotspots. When population growth was high and HDI was low there was a high rate of deforestation, but when HDI was high, rate of deforestation was low, despite high population growth. The correlation among variables was significant for the 1990s but not for the 1980s. The relationship between population growth and HDI had a regional pattern that reflected the historical process of development. Based on the changes in HDI and deforestation rate over time, we identified two drivers of deforestation: policy choice and human-development constraints. Policy choices that disregard conservation may cause the loss of forests even in countries that are relatively developed. Lack of development in other countries, on the other hand, may increase the pressure on forests to meet the basic needs of the human population. Deforestation resulting from policy choices may be easier to fix than deforestation arising from human development constraints. To prevent deforestation in the countries that have such constraints, transfer of material and intellectual resources from developed countries may be needed. Popular interest in sustainable development in developed countries can facilitate the transfer of these resources.

Thallium poisoning presenting as paresthesias, paresis, psychosis and pain in abdomen

Due to involvement of multiple systems, thallium poisoning is notorious for complexity and seriousness as symptoms of toxicity are non-specific and diverse. Alopecia and painful neuropathy are its cardinal features, others being gastrointestinal disturbances, encephalopathy, tachycardia, ataxia, hepatorenal and cardiac damage etc. We report a case of thallium poisoning who presented initially with gastrointestinal symptoms and later developed neurological features (peripheral neuropathy and delirium). Various diagnoses were entertained in this case and thallium poisoning was suspected only after he developed alopecia and neuropsychosis. He made a significant recovery by conservative management in spite of delay in diagnosis. We conclude that a high level of suspicion should be kept for thallium poisoning, especially in patients with painful, peripheral neuropathy and gastrointestinal symptoms which appear earlier than alopecia, since prognosis is more rewarding with early diagnosis, leading to complete recovery.

Dietary (n-3) fatty acids alter plasma fatty acids and leukotriene B synthesis by stimulated neutrophils from healthy geriatric Beagles

The study objective was to determine the effect of feeding food enriched in (n-3) fatty acids (FA) on plasma FA profiles and leukotriene B (LTB) synthesis by stimulated peripheral blood neutrophils from dogs. For 36 weeks, two groups of dogs (n = 5) were fed food that contained either a low ratio of (n-6)-(n-3) FA (1.31:1; fish oil-enriched food) or a high ratio of (n - 6)-(n-3) FA (40.6:1; corn oil-enriched food). Consumption of food enriched in fish oil resulted in higher plasma concentrations of eicosapentaenoic acid and docosahexaenoic acid and lower concentrations of arachidonic acid. Neutrophils from dogs fed fish oil-enriched food produced 7.6-fold more LTB(5)(P = 0.002), and the ratio of LTB(5)-LTB(4) concentrations was 8.3-fold higher (P < 0.001) compared with dogs fed corn oil-enriched food. Dietary FA can modulate leukotriene production by neutrophils in dogs, and suggests that foods enriched in (n-3) FA from fish oil may have value in the treatment of canine inflammatory diseases.

Morphine for post-caesarean section analgesia: intrathecal, epidural or intravenous?

INTRODUCTION

Good analgesia is important after a caesarean section but there are no studies to date that compared intrathecal (IT), epidural (EP) and intravenous patient-controlled analgesia (IV PCA) morphine for post-caesarean section analgesia. In this study, we compared the differences in the quality of analgesia and side effects rendered by IT, EP and IV PCA morphine for post-caesarean section analgesia.

METHODS

We systematically collected and reviewed the data of 949 women who received IT, EP or IV PCA morphine for post-caesarean analgesia during a six-month period. We reviewed the patients 24 hours after surgery and recorded the type of analgesia, the use of adjuncts, pain scores, side effects and degree of satisfaction with the mode of analgesia. The data was captured in an electronic database and analysed.

RESULTS

IT morphine was the predominant method of post-caesarean analgesia, accounting for 89.5 percent of the cases. Non-steroidal anti-inflammatory drugs (NSAIDs) were more commonly used in the IT and EP group (IT 76 percent, EP 80 percent and IV PCA 49 percent, p-value is less than 0.05). IT morphine group had a significantly lower pain score at rest (p-value is less than 0.001) and on movement (p-value is less than 0.05) when compared with IV PCA group. EP morphine also resulted in a lower pain score than IV PCA on movement (p-value is less than 0.05). There was no difference in pain scores between EP and IT morphine. In the subgroup analysis of patients who did not receive NSAIDs, IT and EP morphine group also registered lower pain scores at rest and on movement than IV PCA group (p-value is less than 0.05). There was no difference in the satisfaction scores among the three groups.

CONCLUSION

The use of IT and EP morphine was associated with lower pain scores than IV PCA morphine at rest and on movement in the first 24 hours after caesarean section. No severe side effects were found.

Optimization of assay conditions for leukotriene B4 synthesis by neutrophils or platelets isolated from peripheral blood of monogastric animals

Neutrophils are involved in inflammation through leukotriene (LT) production. The predominant proinflammatory leukotriene released from neutrophils is LTB4, which serves as a biological marker of inflammation. The purpose of this study was to optimize the conditions ex vivo for LTB4 production by neutrophils from horses and dogs, and platelets from chickens. Optimal production of LTB4 was characterized by incubation time (2.5, 5, 10, 15 or 20 min), temperature (25 or 37 degrees C), and calcium ionophore A23187 concentration (0.1, 1, 10 or 20 microM). Incubation longer than 2.5 min did not increase production of LTB4 in chickens or horses; in dogs, incubation for 2.5 and 10 min resulted in the highest concentrations of LTB4 (P<or=0.05). In all species, incubation at 37 degrees C resulted in optimal LTB4 production (P<or=0.05). Production of LTB4 was highest when neutrophils or platelets were stimulated with 20 microM calcium ionophore in all species (P<or=0.05). These results indicate that neutrophils isolated from horses and dogs, and platelets isolated from chickens, are capable of producing LTB4. Optimum conditions for LTB4 production are similar in all three species.

The root: a potential new source of competent cells for high-frequency regeneration in Tylophora indica

The purpose of this study was to develop a new micropropagation system for Tylophora indica, an important medicinal plant in India, using root explants as starting material. Root explants cultured on MS medium supplemented with 6-benzyladenine (BA) or 2-isopentyladenine (2iP) produced organogenic nodular meristemoids (NMs) within 4 weeks. NMs induced from the cut ends of root segments showed two types of organogenic response--direct shoot bud formation and somatic embryogenesis--when maintained on induction medium. In 42% of the explants, NMs developed shoot buds directly in the presence of 10.72-26.80 microM BA. On average, 18.5 +/- 0.7 shoots per gram of NM tissue were obtained after each 4-week subculture. Elongation of microshoots and root initiation were correlated with the auxin used, with the optimal response occurring in the presence of 28.54 microM indole-3-acetic acid. In 39% of the explants, NMs dedifferentiated into friable embryogenic callus (FEC) in the presence of BA or 2iP after 12 weeks of culture. Of the different treatments, MS medium supplemented with 10.72 microM BA was the most effective in inducing FEC and somatic embryogenesis: at this concentration 64% of the cultured NMs developed FEC and, on the same medium, 89% of the FEC produced globular somatic embryos (SEs). FEC biomass increased nearly five-fold with every 4-week subculture, and about 30 SEs were recovered per gram of FEC during this period. The best conversion of mature SEs to complete plantlets was obtained on basal MS medium-42%. Plantlets derived via somatic embryogenesis and shoot organogenesis were successfully hardened (88-96%) and transferred to the field.

Standardisation of Gymnema sylvestre r. Br. with reference to gymnemagenin by high-performance thin-layer chromatography

A simple and reproducible HPTLC method for the determination of gymnemagenin (1) in Gymnema sylvestre has been developed. Components were separated on pre-coated silica gel 60 F254 plates with chloroform:methanol (9:1) and scanned using a densitometric scanner in the UV reflectance mode at 290 nm. Linearity of determination of 1 was observed in the range 4-10 microg. The average percentage recovery of 1 from an extract was 99.09 +/- 0.29, and the content of 1 in leaves of the title plant was 1.61% (dry weight).

Infectious meningitis: prospective evaluation with magnetization transfer MRI

The study was performed with the aim of prospectively characterizing infectious meningitis of different aetiology using magnetization transfer (MT) MRI. Spin-echo (SE) T(1), T(2) and pre- and post-contrast T(1) weighted MT images in 100 patients with aetiologically proven meningitis were evaluated for the visibility and enhancement of the meninges on pre- and post-contrast T(1) weighted MT images, respectively. The MT ratio (MTR) was calculated from the thickened meninges in tuberculous meningitis. In addition, the percentage difference in the mean signal intensity (SI) of the meninges and adjacent brain parenchyma was calculated and compared between different groups using 2-tailed student's t-test. T(1) weighted MT images were highly sensitive (96%) in the detection of abnormal meningeal enhancement. Meninges were visible on pre-contrast T(1) weighted MT images only in patients with tuberculous meningitis. The MTR from meninges in tuberculous infection was 19.10+/-1.02, and the percentage difference in the mean SI of the meninges and the adjacent T(2) normal brain parenchyma was significantly higher (p<0.05) in the tuberculous group compared with that in the non-tuberculous group. MT MRI is an important technique for the detection and characterization of infectious meningitis of different aetiology. Visibility of the meninges on pre-contrast T(1) weighted MT images may be considered highly suggestive of tuberculous meningitis.

Clinical spectrum, pitfalls in diagnosis and therapeutic implications in herpes simplex encephalitis

OBJECTIVES

High index of suspicion is mandatory for early diagnosis of Herpes Simplex Encephalitis (HSE), since acyclovir therapy can prevent its mortality and limit morbidity. We report our observations on clinical spectrum, pitfalls in diagnosis and therapeutic aspects in patients of HSE.

METHODS

There were 34 patients of HSE (26 males and eight females) in age range 6 -72 (mean 23.8 +/- 8.9) years. Diagnosis was confirmed by cranial MRI, EEG and PCR in CSF. Acyclovir was given to 24 patients. Carbamazepine and sodium valproate were the antiepileptic drugs used.

RESULTS

Most of the patients were referred either as Japanese encephalitis, cerebral malaria or tubercular meningitis. High fever, seizures, behavioral abnormality and encephalopathy were present in all, either at onset or later. EEG, CSF abnormality and cranial MRI were abnormal in all 34 patients. PCR for Herpes Simplex virus was positive in 65 % cases CT was performed in 10 cases but abnormality was detected only in four. We observed features of Kluver Bucy syndrome in three patients, suffering from HSE. Following complete acyclovir therapy in 24 patients, 12 recovered completely and four partially. There was no improvement in four patients including two patients who had features of Kluver Bucy Syndrome, while four expired. Among the seven patients who refused therapy of acyclovir, five expired, while two remained in unaltered status. Treatment could not be completed in three patients as they expired during therapy.

CONCLUSION

HSE is commonly misdiagnosed. Important factors influencing mortality and morbidity of HSE were; early acyclovir therapy, age, immune status of patient, duration of illness, and consciousness level before initiation of therapy. We conclude that acyclovir should be given to all patients as soon as suspected, while confirmatory investigations are in progress.

Intravenous sodium valproate in status epilepticus

A study was conducted to observe the effect of intravenous sodium valproate in status epilepticus. Eleven patients with status epilepticus, who were resistant to conventional drugs, underwent treatment with intravenous sodium valproate. The seizures were controlled in 10 patients within 24-48 hrs of starting treatment. No complications were observed during therapy. We conclude that intravenous sodium valproate can be recommended for Myoclonic status epilepticus and non-convulsive status epileticus.

Herpes simplex encephalitis: some interesting presentations

Herpes Simplex Encephalitis (HSE) is the most common cause of fatal viral encephalitis. A high index of suspicion is mandatory for early diagnosis and successful therapy to restrict morbidity and mortality. We report 4 patients of HSE, with interesting presentations, viz. brainstem involvement in an immunosuppressed patient, Kluver-Bucy Syndrome-a consequence of untreated HSE, HSE in the postpartum period mistaken as cortical venous thrombosis, and response to inadequate treatment. They demonstrate the wide spectrum of clinical features, pitfalls in diagnosis, and a variable response to therapy in HSE.

Comparative efficacy of three epigeic earthworms under different deciduous forest litters decomposition

An experiment was conducted during 1998-1999, in a deciduous forest located in the semi-arid tropics of central India, to evaluate the suitability of different forest litters as food material for the tropical epigeic earthworms i.e. Eisenia fetida (Savigny), Perionyx excavatus (Perrier) and Dicogaster bolaui (michaelsen). The aim was to examine the influence of these earthworms on the decomposition processes of three types of forest litters i.e. Tectona grandis (teak), Madhuca indica (mahua) and Butea monosperma (palas), on the maintenance of quality in a vermicomposting system, and to assess the effect of applications of in situ prepared vermicomposts on the growth of forest trees. The results indicated that T. grandis litter was the most suitable food material for the earthworms possibly because it contained high reserves of mineral nutrients. Comparisons of the survival and reproduction rates of the three epigeic earthworm species indicated that a higher reproduction rate was maintained for E. fetida compared to P. excavatus and D. bolaui in the decomposition of these forest litters. The rates of growth and population increases of E. fetida approximately doubled after 12 weeks of litter decomposition. The litter decomposition process was associated strongly with the quality of the materials and their chemical composition. Irrespective of earthworm inoculations, the levels of available nutrient such as NH(4)-N, NO(3)-N, available P and K increased significantly (p</=0.05) in the order T. grandis litter compost>M. indica litter compost>B. monosperma litter compost. The mature decomposed litter had lower C/N ratios (11.3-24.8:1), water-soluble carbon (0.30-0.58%), water-soluble carbohydrates (0.35-0.71%) and larger cation exchange capacity/total organic carbon ratios than the values in the parent forest litter. The lignin content increased with maturation with a concomitant decrease in cellulose resulting in higher lignin/cellulose ratios. Application of all three vermicomposts to forest trees significantly improved their heights and diameters over those of control trees, although the increases were lower than those resulting from the chemical fertilizer applications. However, soil biological activities i.e. soil respiration, soil microbial biomass carbon and dehydrogenase activity were greater by application of vermicomposts over that after application of inorganic fertilizer in a new plantation of T. grandis.

Pitfalls in diagnosis of epilepsy of Janz and its implications

84 patients of juvenile myoclonic epilepsy (JME) of Janz were studied. Diagnosis was confirmed using clinical and electro-encephalographic (EEG) criterias. 58 (78%) patients of JME were referred as 'refractory or uncontrolled seizures'. Ignoring myoclonic episodes and non-use of activation procedures in EEG were important reasons for diagnostic delay. Sodium valproate (VPA) or clonazepam are the drugs of choice while phenobarbitone (PB), carbamazepine (CZ), and phenytoin (PHT) are ineffective. Clinical spectrum of JME is slightly different in India. Family history of epilepsy or JME is not forthcoming and there is gross delay in the diagnosis. Other differences include age of presentation and mild cognitive impairment. All juvenile patients of generalized epilepsy, not responding to more commonly used CZ, PB and PHT should be strongly suspected for JME by carefully searching for myoclonus.

MRI features of toxoplasma encephalitis in the immunocompetent host: a report of two cases

Central nervous system involvement due to toxoplasmosis in an immunocompetent host is rare. We describe MRI features in two immunocompetent patients with cerebral toxoplasmosis and compare these with those for the immunocompromised host.

Arsenic poisoning in a family

A family of six members is reported, who accidently consumed arsenic, during preparation of indigenous medicine in their home, and developed arsenic poisoning.

Outcome of colposcopy in women presenting with postcoital bleeding and negative or no cytology--results of a 1-year audit

We set out to identify histological abnormalities in women presenting with postcoital bleeding at the colposcopy clinic and the detection rate of abnormalities. This was a retrospective study based on the colposcopy clinic at Scunthorpe General Hospital. We investigated 45 patients with postcoital bleeding, 12 with negative referral smears and 33 with no referral smears. We found that 8.33% of patients with a negative referral smear had a histological abnormality. In patients with no referral smear the rate was 24.24%. The overall incidence of histological abnormality in the study group was 20% and of cytological abnormality 11.11%. Colposcopically directed biopsy is almost twice as effective as cytology in the detection of abnormality. Patients referred with negative cytology have a lower incidence of histological abnormality than those with no cytology. Women with postcoital bleeding should be seen in the colposcopy clinic.

Syringomyelia with syringobulbia presenting only with paralysis of 9th and 10th cranial nerves

We report a case of syringomyelia with syringobulbia, in a patient who presented only with involvement of the 9th and 10th cranial nerves.

Effect of common anti-epileptic drugs on cognition in schoolchildren with epilepsy

This study was conducted to observe the effect of some commonly used anti-epileptic drugs (AEDs), on cognition, in 118 school going children with epilepsy, in an age range of 9-12 yrs., (Mean 10.4 +/- 1.7 yrs.). For comparison, 28 healthy, age and sex matched schoolchildren served as controls. After a clinical, electrophysiological and radiological evaluation, the cognitive functions were assessed in both groups, using a modified Wechsler's Intelligence Scale. It was observed that cognition was impaired in only 2.5% of children with epilepsy, there being no relationship between cognitive performance and the type of AED used. It is concluded that cognitive functions are impaired in only a limited number of children with epilepsy and effect of phenobarbitone and phenytoin on cognitive functions is comparable to carbamazepine and sodium valproate, particularly when demand of task is not very high.

Acute transverse myelitis following electrical injury: a short report

We report a 30 years lady who developed transverse myelitis following an accidental electric shock and later recovered completely.

Production of withaferin A in shoot cultures of Withania somnifera

Multiple shoot cultures of Withania somnifera were established from single shoot tip explants and their potential for the production of two principle withanolides, withaferin A and withanolide D was investigated. Shoot tips grown on MS medium supplemented with BA (1 mg l(-1)) induced 10.0 +/- 1.15 microshoots per explants and shoot cultures accumulated both withanolides (withaferin A = 0.04%, withanolide D = 0.06%). Supplementation of MSSM (solid) agar medium with 4% sucrose enhanced accumulation of both withaferin A (0.16%) and withanolide D (0.08%). Reduction of the agar concentration to 0.16% increased the number of microshoots induced per explant to 25.5. MSSM liquid medium containing 10% coconut milk favoured a maximum increase in biomass (27 fold); number of microshoots induced (37.6 +/- 1.45) as well as accumulation of withaferin A (0.14%).

Recurrent pyogenic meningitis: an unusual presentation in a case of neurofibromatosis-1

We report a case of recurrent pyogenic meningitis with cerebrospinal fluid rhinorrhoea in a patient with neurofibromatosis-1, which has not been reported previously.

A study of the technologically modified sources of 222Rn and its environmental impact in an Indian U mineralised belt

These investigations present qualitative and quantitative assessments of the 222Rn contributing potential of the technologically modified sources, e.g. mine exhausts and tailings piles, arising due to the mining and processing of uraniferous minerals at Jaduguda, India. The overall geometric mean of the 222Rn flux from low-grade uranium (U) mill tailings being 1.19 Bq m-2 s-1, requisite attenuation of 37.8% to the recommended limit of 0.74 Bq m-2 s-1 can be attained by a typical clay coverage of 20 cm. Theoretically, feasible options for selection of overburden materials for stabilisation of the tailings piles are examined. Extrapolation studies with a turbulent diffusion model yield an atmospheric dispersion pattern of 222Rn in reasonable correspondence with the prevailing concentrations, especially for locations beyond a 4 km radius. The overall 222Rn contribution of the U complex to the ambient air is the same as that contributed by the adjoining land mass of 2.75 km radius in this mineralised terrain.

Neurocysticercosis presenting as stroke

Stroke is a common but under recognized complication of neurocysticercosis (NCC). We report six patients having NCC who presented with stroke. All patients were young with no vascular risk factors. The arteritis which resulted in ischaemic infarct in these patients was related to the presence and severity of arachnoiditis. All patients responded well to steroids and albendazole therapy with minimal residual deficit.

Antibody to transforming growth factor-beta ameliorates tubular apoptosis in unilateral ureteral obstruction

BACKGROUND

Unilateral ureteral obstruction (UUO) is characterized by progressive renal atrophy, renal interstitial fibrosis, an increase in renal transforming growth factor-beta (TGF-beta), and renal tubular apoptosis. The present study was undertaken to determine the effect of a monoclonal antibody to TGF-beta (1D11) in UUO.

METHODS

Mechanical stretch was applied to tubular epithelial cells (NRK-52E) by a computer-assisted system. Three doses of 1D11 (either 0.5, 2, or 4 mg/rat) were administered to rats one day prior to UUO and every two days thereafter, and kidneys were harvested at day 13. Fibrosis was assessed by measuring tissue hydroxyproline and mRNA for collagen and fibronectin. Apoptosis was assessed with the terminal deoxy transferase uridine triphosphate nick end-labeling assay. TGF-beta levels were determined by bioassay. Western blot and immunostaining were used to identify proliferating cell nuclear antigen (PCNA), p53, bcl-2, and inducible nitric oxide synthase (iNOS).

RESULTS

Stretch significantly induced apoptosis in NRK-52E cells, which was accompanied by an increased release of TGF-beta; 1D11 (10 microg/mL) totally inhibited stretch-induced apoptosis. Control obstructed kidney contained 20-fold higher TGF-beta as compared with its unobstructed kidney; 1D11 neutralized tissue TGF-beta of the obstructed kidney. Control obstructed kidney exhibited significantly more fibrosis and tubular apoptosis than its unobstructed counterpart, which was blunted by 1D11. In contrast, 1D11 significantly increased tubular proliferation. p53 immunostaining was localized to renal tubular nuclei of control obstructed kidney and was diminished by 1D11. In contrast, bcl-2 was up-regulated in the 1D11-treated obstructed kidney. Total NOS activity and iNOS activity of the obstructed kidney were increased by 1D11 treatment.

CONCLUSION

The present study strongly suggests that an antibody to TGF-beta is a promising agent to prevent renal tubular fibrosis and apoptosis in UUO.

Establishment of forskolin yielding transformed cell suspension cultures of Coleus forskohlii as controlled by different factors

Suspension cultures derived from gall calli which were obtained following infection with Agrobacterium tumefaciens (C58) were established in Coleus forskohlii. Cell line selection following single cell cloning or cell aggregate cloning was carried out to select cell lines capable of fast growth and for producing high level of forskolin. A fast growing cell line (GSO-5/7) thus selected was found to accumulate 0.021% forskolin in 42 days. The effect of cultural conditions on cell growth was studied to identify factors influencing biomass yield. Cell growth in suspension was found to be influenced significantly by carbon source, initial cell density and light or dark condition. Optimal cell growth (20 fold increase in biomass in a 42 day period) was obtained when the cells were grown in dark condition in B5O media containing 3% sucrose as sole carbon source with an initial cell density of 1.5 x 10(5) cells per ml. Forskolin accumulation was maximum (0.021%) in the stationary phase of cell growth. These suspension cultures showed continuous and stable production of forskolin.

Randomised controlled trial of aminosidine (paromomycin) v sodium stibogluconate for treating visceral leishmaniasis in North Bihar, India

OBJECTIVES

To assess the efficacy and tolerability of aminosidine compared with sodium stibogluconate for treating visceral leishmaniasis.

DESIGN

Randomised, unblinded, controlled trial with 180 day follow up.

SETTING

Kala-Azar Research Centre, Brahmpura, Muzaffarpur, Bihar, India.

SUBJECTS

People of either sex aged 6-50 years with symptoms and signs suggestive of visceral leishmaniasis (fever, loss of appetite, enlarged spleen) with leishmania amastigotes detected in Giemsa stained aspirates of spleen or bone marrow.

INTERVENTIONS

Aminosidine at three daily doses (12, 16, and 20 mg/kg) for 21 days and sodium stibogluconate 20 mg/kg/day for 30 days.

MAIN OUTCOME MEASURES

Laboratory measures of efficacy: parasite count, haemoglobin concentration, white cell count, platelet count, serum albumin concentration. Clinical measures of efficacy: spleen size, fever, body weight, and liver size. Measures of safety: liver and renal function tests, reports of adverse events.

RESULTS

Of the 120 patients enrolled (30 per treatment arm), 119 completed treatment and follow up. Cure at end of follow up was achieved in 23 (77%), 28 (93%), and 29 (97%) patients treated with 12, 16, and 20 mg aminosidine/kg/day respectively, and in 19 (63%) patients given sodium stibogluconate. At 16 and 20 mg/kg/day, aminosidine was significantly more active than sodium stibogluconate in both clinical and laboratory measures of efficacy. No significant clinical or laboratory toxicity occurred in any treatment group.

CONCLUSIONS

A 21 day course of aminosidine 16 or 20 mg/kg/day should be considered as first line treatment for visceral leishmaniasis in Bihar.

Improved taxol yield in cell suspension culture of Taxus wallichiana (Himalayan yew)

Cell culture of Taxus wallichiana Zucc (= T. baccata ssp wallichiana Zucc. Pilg.) (Himalayan yew) has been established and taxol-producing cell lines selected by cell line cloning. Cell line NC110 derived from needle leaf of a 40-year-old tree growing in Darjeeling Himalayas produced 0.018% taxol in B5 basal medium supplemented with 2,4-D (2 mg/l), kinetin (0.5 mg/l), and casein hydrolysate (0.5%). This cell line has been maintained for over 2 years. Significant enhancement in the level of taxol (0.05%) was obtained in this cell line by supplementation of the basal medium with 5 mg/l of IAA-phenylalanine instead of 2,4-D without adversely affecting cell growth. IAA-glycine also enhanced taxol level (0.03%) while IAA alone (1-10 mg/l) was ineffective in inducing taxol accumulation. Using three different cell lines with different taxol-producing capacities, it has been demonstrated that 2,4-D and IAA-phenylalanine when present alone favour growth and taxol production but when combined enhance biomass to a maximum (six-fold in NC110) without enhancing taxol accumulation, suggesting that a two-stage culture may be beneficial for optimising taxol accumulation in cell culture of T. wallichiana.

Withanolide production by root cultures of Withania somnifera transformed with Agrobacterium rhizogenes

Transformed root cultures of Withania somnifera Dunal (Solanaceae) were obtained by infecting shoots cultured in vitro with Agrobacterium rhizogenes LBA 9402. They grew axenically in the absence of exogenous plant growth regulators in Murashige and Skoog's medium containing 3% (w/v) sucrose. The root cultures synthesized several withanolides of which withanolide D was isolated and identified. Transformed root (clone HR (1)) showed a growth index of 20.07 and a withanolide D yield of 0.30 mg g(-1) DW. The productivity of withanolide D in transformed roots (0.181 mg 1(-1) d(-1)) was higher than in untransformed root cultures (0.026 mg 1(-1) d(-1)).

Withanolide production by root cultures of Withania somnifera transformed with Agrobacterium rhizogenes

Transformed root cultures of Withania somnifera Dunal (Solanaceae) were obtained by infecting shoots cultured in vitro with Agrobacterium rhizogenes LBA 9402. They grew axenically in the absence of exogenous plant growth regulators in Murashige and Skoog's medium containing 3% (w/v) sucrose. The root cultures synthesized several withanolides of which withanolide D was isolated and identified. Transformed root (clone HR (1)) showed a growth index of 20.07 and a withanolide D yield of 0.30 mg g(-1) DW. The productivity of withanolide D in transformed roots (0.181 mg 1(-1) d(-1)) was higher than in untransformed root cultures (0.026 mg 1(-1) d(-1)).

Direct agglutination test for early diagnosis of Indian visceral leishmaniasis

In a prospective study, 80 cases of fever with hepatosplenomegaly, anemia and leucopaenia coming from the hyperendemic zones for visceral leishmaniasis of North-Bihar, India were screened and subjected to bone marrow or splenic puncture for demonstration of Leishman-donovan bodies (LDB) and DIRECT AGGLUTINATION TEST (DAT) with antigen prepared by Harith et al. 59 cases were confirmed for Visceral Leishmaniasis (VL) by demonstration of LDB in which DAT was also positive in different titres ranging from 1:1600 onwards. Out of 21 cases in which the bone marrow was negative for parasite, DAT was positive in 10 cases. 8 Out of 10 cases responded to WHO regimen of treatment with sodium stibogluconate (SSG). Remaining two cases who did not respond to this therapy became positive for parasites on subsequent splenic aspirate. They were treated with pentamidine isethionate and were cured. 11 out of 80 cases showing a titre of 1:400 or lower in DAT, 6 proved to be cases of enteric fever and 5 of malaria. Thus DAT using Harith's antigen was found to be 100% sensitive and specific in detection of early cases of Indian VL.

Forskolin synthesis in in vitro cultures of Coleus forskohlii Briq transformed with Agrobacterium tumefaciens

Agrobacterium tumefaciens mediated tumor tissue and shooty teratomas of Coleus forskohlii were cultured in vitro. Forskolin was detected in tumorous callus (0.002%), rhizogenic callus (0.011%) and root cultures (0.014%), but not in shooty teratomas. Forskolin synthesis and accumulation in tumorous C. forskohlii cultures may permit the elucidation of diterpene metabolism in this species.

In vitro propagation of cashewnut

In vitro plant propagation was developed for seedling shoot tips, leaf axils, and cotyledonary nodes of cashew, Anacardium occidentale. Factors affecting multiplication rate included age of explant source, explant type, medium composition, light requirements, and transfer frequency. Cotyledonary nodes produced more buds than other explant types. Nodes had a 90% viability when transferred daily to fresh medium containing activated charcoal for 7 d while exposed to continuous dark. Cultures were then exposed to low light illumination with weekly transfers. The phytohormone composition producing the most buds was 2.32 μM kinetin, 9.12 μM zeatin and 4.40 μM BA. The highest frequency of rooted shoots was obtained by treating shoots with the bacterium, Agrobacterium rhizogenes. Plants also were recovered by induction of roots using auxin treatment on propagated shoots.

Stroke--a rare presentation of Eales' disease. A case report

Eales' disease is common in India and the Middle East, but its neurologic manifestations are rare. The authors report a young man with recurrent vitreous hemorrhage and acute amnestic confusional state who subsequently developed myelopathy. Eales' disease should be considered in the differential diagnosis of stroke in a young patient.