Gender specificity of sucrose induced analgesia in human adults

Sweet, palatable substances such as sucrose are reported to calm infants undergoing routine investigative procedures. The analgesic effect persists in pre pubertal children and adults with a hint of gender dependent variation in the analgesic response. The present study was therefore designed to explore gender specificity of sucrose induced analgesia in adult volunteers utilizing the nociceptive flexion reflex, an objective tool for pain assessment. Nociceptive flexion reflex was recorded, both before and after (up to 15 min) ingestion of 100 ml of 25% sucrose solution in 6 male and 6 female volunteers. In the male volunteers the maximum amplitude of the response was 20.8 +/- 7.7 microV before sucrose ingestion and 22.6 +/- 9.1 microV, 6.6 +/- 0.7 microV, 6.2 +/- 1.1 microV, 7.5 +/- 0.9 microV at 0, 5, 10 and 15 minutes post sucrose ingestion respectively. In female volunteers, the maximum amplitude of the response was 33.7 +/- 17.7 microV before sucrose ingestion and 43.6 +/- 17.2 microV, 7.1 +/- 1.2 microV, 25.9 +/- 16.1 microV, 50.6 +/- 16.3 microV at the same time intervals post sucrose ingestion. The maximum amplitude values were significantly lower in the males at 10 and 15 minutes after sucrose ingestion (P < 0.05). This is the first objective report of gender specificity in sucrose induced analgesia in adult humans. The gender dependent variation in sucrose induced analgesia is prolonged in male (15 min) and short lived in female (5 min) volunteers. This knowledge may have important implications in pain management.

Role of temporalis muscle over activity in chronic tension type headache: effect of yoga based management

The role of central versus peripheral mechanisms has always been questioned while explaining the etiopathogenesis of chronic tension type headache (CTTH). The following study was done to study the role of muscle spasm in CTTH. 15 patients of CTTH and 7 age matched controls were included in the study and their m. temporalis EMG was recorded for one minute each during rest, mental activity and maximal voluntary contraction and subjective pain scoring was done by visual analogue scale. The results revealed significant overactivity of m.temporalis in CTTH patients at rest when compared with control subjects (P = 0.01 and 0.03 left and right side respectively). After respective interventions namely non steroidal anti inflammatory drugs, botulinum toxin injections and yogic life style course, the EMG records revealed decrease in the mean EMG amplitude of m. temporalis during rest and mental activity more significantly after yoga based interventions (P = 0.03) and subjective pain scores decreased from 7.00 +/- 2.10 to 2.00 +/- 1.26 (P = 0.02) supporting the beneficial effect of such non invasive techniques.

Testicular toxicity of chlorpyrifos (an organophosphate pesticide) in albino rat

Organophosphates are among the most widely used synthetic insect pesticides. The widespread use of organophosphates has stimulated research into the possible existence of effects related with their reproductive toxic activity. Present study was therefore, undertaken to assess the effects of chlorpyrifos on testes, the main organ of male reproduction. Chlorpyrifos at the dose levels of 7.5, 12.5 and 17.5 mg/kg b. wt./day was administered orally to male rats of Wistar strain for 30 days to evaluate the toxic alterations in testicular histology, biochemistry, sperm dynamics and testosterone levels. The body weight of animals did not show any significant change, however, a significant reduction was observed in testes. Chlorpyrifos also brought about marked reduction in epididymal and testicular sperm counts in exposed males and a decrease in serum testosterone concentration. Histopathological examination of testes showed mild to severe degenerative changes in seminiferous tubules at various dose levels. Fertility test showed 85% negative results. A significant reduction in the sialic acid content of testes and testicular glycogen was noticed, whereas the protein and cholesterol content was raised at significant levels. All these toxic effects are moderate at low doses and become severe at higher dose levels. From the results of the present study it is concluded that chlorpyrifos induces severe testicular damage and results in reduction in sperm count and thus affect fertility. Small changes in sperm counts are known to have adverse affects on human fertility. Therefore, application of such insecticide should be limited to a designed programme.

Diabetic ketosis as a presenting feature of acromegaly

Secondary diabetes mellitus is known to occur in acromegaly due to insulin resistance caused by growth hormone excess. However diabetes in acromegaly usually does not lead to ketosis. We describe here a case of acromegaly who presented in diabetes ketosis, which is unusual.

Complete ureteral avulsion

Complete avulsion of the ureter is one of the most serious complications of ureteroscopy. It requires open or laparoscopic intervention for repair. This case report emphasizes its management and presents recommendations for prevention in current urological practice.

Amygdalar neuronal responses to peripheral nociceptive stimuli in rats

Amygdala plays a very important role in the mediation of pain. In the present study the behaviour of the amygdalar neurons in response to various peripheral noxious stimuli was observed. Noxious mechanical, thermal, electrical, chemical and the non-noxious stimuli (touch) were applied individually to the animal and then the neuronal responses to these stimuli were recorded. Our results showed that the majority of amygdalar units recorded from medial, lateral and basolateral nuclei, responded to different peripheral noxious (thermal, electrical, chemical mechanical) and non-noxious stimuli by excitation. However few neurons decreased their activity on stimulation. Some of these neurons also exhibited after discharge following application of higher intensity of noxious stimuli.

Antinociceptive effect of sucrose ingestion in the human

Sucrose ingestion has been shown to alleviate pain and distress in rats, human infants as well as adults. Sucrose induced analgesia is related to the reward value associated with its sweet taste. The sweet taste of sucrose is a stimulus for the activation of endogenous opioid pool. The opioids in turn modulate pain perception. It has been demonstrated in a number of animal and human studies that sucrose ingestion increases the hypothalamic/CSF opioid levels. This gains support from the results obtained from naloxone challenge test, a neuro-endocrine method for assessment of endogenous opioid tone. Moreover, the analgesic effects of sucrose can be reversed by administration of opioid antagonists such as naloxone. On the other hand, long-term sucrose ingestion leads to hyperalgesia in rats and it has been hypothesized to result from a complex interaction of sucrose with the endogenous opioid system leading to a deficiency of opioids. In the present article mechanisms underlying sucrose induced analgesia including the interaction of the palatability and reward value of food with the neural substrates and its neuro-chemical basis have been reviewed in the light of both animal and human studies. In addition, clinical application of the knowledge about sucrose and its modulatory effect on the endogenous opioid system has been suggested.

Protrusion of bladder mucosa in exstrophy mimicking cloacal exstrophy

An interesting case of bladder exstrophy with protrusion of bladder mucosa mimicking cloacal exstrophy is reported. The child presented with continuous leakage of urine and swelling in the lower abdomen since birth. Before the operation, this was considered to be a variant of cloacal exstrophy.

Asthma management in police study

Asthma is a common condition and, therefore, may be seen by the clinical forensic physician and police in widely different circumstances ranging from the autopsy room to roadside breath alcohol testing. This paper concentrates on the assessment and treatment of asthmatics detained in custody and does not refer to the Road Traffic Act provisions. A careful history and objective recording of simple severity markers and peak expiratory flow rate should identify patients who may require hospitalization or urgent treatment. Asthma mortality may be reduced by better understanding of the disease and its treatment and by greater use of prophylactic rather than reliance on relief therapy for bronchospasm.

Effectiveness of ethylene glycol bis (2-aminoethyl ether) tetraacetic acid (EGTA) against cerium toxicity

Therapeutic efficacy of EGTA (ethylene glycol bis (2-aminoethyl ether) tetraacetic acid) against cerium intoxicated mice was studied. Administration of cerium showed significant decrease in haemoglobin percentage, RBC counts and blood glucose level with an increase in the activity of serum transaminases and WBC counts. Decrease in the activity of alkaline phosphatase and glycogen content was noted in liver and kidney after cerium exposure. Light and electron microscopical investigations showed that these changes were recouped considerably with the administration of EGTA suggesting its therapeutic efficacy against cerium toxicity.

Comparative effectiveness of CaNa3DTPA and tiron along with alpha-tocopherol against beryllium-induced biochemical alterations in rats

The therapeutic efficacy of chelating agents CaNa3DTPA (calcium trisodium diethylene triamine penta acetic acid) and Tiron (sodium-4,5-dihydroxy-1,3-benzene disulphonate) with and without antioxidant, alpha-Tocopherol was evaluated in the treatment of beryllium-induced toxicity in female albino rats. The animals were exposed to beryllium (as beryllium nitrate) at a dose of 1 mg/kg (ip) once a day for 28 consecutive days followed by chelation therapy by CaNa3DTPA (0.1 mM/kg, ip) and Tiron (471 mg/kg, ip) with and without alpha-Tocopherol (25 mg/kg, orally) for 5 consecutive days after toxicant administration. Tissue biochemistry revealed severe alterations in liver and kidney. A significant fall in total protein and glycogen contents, alkaline phosphatase, adenosine tri-phosphatase and succinic dehydrogenase level was noticed. On the contrary, an elevation in acid phosphatase was recorded. The significant rise in hepatic lipid peroxidation and decreased level of hepatic reduced glutathione showed toxicity due to beryllium. CaNa3DTPA with alpha-Tocopherol showed moderate therapeutic efficacy while Tiron in combination with alpha-Tocopherol exerted statistically more beneficial effects to reverse biochemical alterations in different variables altered due to beryllium intoxication.

Amygdalar tissue transplants improve recovery of nociceptive behaviour in rats

PURPOSE: Amygdala plays a very important role in the mediation of emotional and affective components of pain. Bilateral amygdalectomy increases the threshold for vocalization, a measure of emotional reactivity, without any change in the tail flick latency. The present work was designed to study the recovery of emotional nociceptive behaviour following neural tissue transplantation in lesioned rats. METHODS: In a group of adult wistar rats lesions of the central nucleus of amygdala (CeA) were produced electrolytically. In a separate group of rat's amygdalar tissue was transplanted at the lesioned site 2 days thereafter. The vocalization tests, viz. simple vocalization (SV) and vocalization after discharge (VA), which were used to study the emotional nociceptive behaviour were carried out both before and after pro-ducing lesion/transplant. RESULTS: Bilateral CeA lesions increased the thresholds for SV and VA significantly (p < 0.001), indicating analgesia. Following amygdalar tissue transplantation a significant decrease (p < 0.05) in the thresholds were observed when compared with the lesioned group, although when compared with the basal data it showed an increase (p<0.05). CONCLUSIONS: The results indicate a partial recovery of the vocalization response following amygdalar tissue transplantation.

Changes in brain intracellular pH and membrane phospholipids on oxygen therapy in hypoxic patients with chronic obstructive pulmonary disease

Chronic hypoxia due to chronic obstructive pulmonary disease (COPD) constitutes a stress to cerebral metabolic homeostasis. Previous studies using phosphorus-31 magnetic resonance spectroscopy (31P MRS) have suggested that the brains of such patients utilize anaerobic glycolysis, which in neonatal, animal, and in vitro studies is associated with a protective intracellular alkalosis. To identify such a compensatory intracellular alkalosis in hypoxic COPD patients, in vivo cerebral 31P MRS was performed in eight patients and eight controls. The mean intracellular pH (pHi) in patients with COPD was similar to that of age-matched controls, but decreased in the patients with COPD by a mean pHi of 0.02 (p = 0.04), following supplemental oxygen. There was no change in cerebral pHi in normal subjects following oxygen administration. The broadband component of the MR spectrum increased in all the patients with COPD (p = 0.01), suggesting altered phospholipid membrane fluidity in the brain associated with the change in pHi following oxygen administration. The change in the broadband resonance was strongly correlated with the change in pHi (r = -0.68, p = 0.014). This study suggests that patients with COPD exhibit a compensatory change in pHi and abnormalities in cerebral membrane phospholipid conformation in the face of chronic hypoxia.

Treadmill training accelerates restoration of locomotion after complete spinal cord transection in the rat

This short communication is devoted to the problem of the effect of the regular treadmill training on the restoration of motor function after spinal cord interruption. Experiments were carried out on the full spinalized rats. One group of the operated rats (n = 5) received regular treadmill training and another group (n = 5) did not receive any training. Motor behavior and activity were investigated weekly up to week 9 after spinalization. It was observed that trained rats restarted motor behavior earlier and demonstrated locomotor hindlimbs movements, and were more active than untrained rats.

Pain measurement: a formidable task

Pain is defined as unpleasant sensory and emotional experience, associated with actual or impending tissue damage. It consists of multi-dimentional phenomenon having sensory discriminative, cognitive-evaluative and effective motivational components. Though the technology has advanced, still it is very difficult to objectively assess all the attributes of pain, including alteration in cognitive behaviour. However, subjective methods like Visual Analog Scale rating (VAS) and preliminary objective methods like pain evoked responses, behaviral monitoring and event related evoked potentials for cognition are currently in vogue. It will take some more time and effort to evolve yet other newer and sophisticated techniques to measure all aspects of pain in human beings.

Hyperalgesic response in rats fed sucrose from weaning to adulthood: role of VMH

The ventromedial nucleus of hypothalamus (VMH) is implicated in food intake, food preference, nociception and its modulation by palatable food. Palatable drink for 5-48 h in adult rat produced hyperalgesia, which is mediated by VMH. The effect of palatable dietary supplement after weaning on the nociceptive response in adult rats has not been reported. Whether or not VMH influences these nociceptive responses is also not known. The present study was therefore undertaken to investigate the effect of VMH lesion on the nociceptive responses in adult rats ingesting (ad libitum) sucrose from weaning. Weanling rats received sucrose solution in addition to drinking water and laboratory pellets (sucrose-fed group), while the control group of rats received laboratory pellets alone. On attaining adulthood, the behavioral responses, namely tail flick latency (TFL), thresholds of tail flick (TF), vocalization during stimulus (SV), and vocalization after discharge (VA) to phasic and formalin pain rating (FP) to tonic noxious stimuli, were noted in pre- and post-VMH lesion states of both groups of rats. In chronic sucrose-fed rats, the TFL was not affected, the thresholds of TF, SV and VA were significantly decreased (P<.001) and the FP was increased in comparison to the control group, suggesting a hyperalgesic response to chronic sucrose ingestion. After the VMH lesion, in sucrose-fed rats, the thresholds of TF, SV and VA remained unaltered, while the FP was attenuated and TFL decreased. In control rats, VMH lesion produced a hyperalgesic response to both the phasic and tonic noxious stimuli. The data indicate that chronic sucrose feeding and VMH lesion differentially affect the nociceptive responses to the phasic and tonic noxious stimuli. These results suggest that chronic sucrose feeding from weaning to adulthood produces hyperalgesia to both the tonic and phasic noxious stimuli (except TFL), which is probably mediated by VMH.

Gynecomastia: pathomechanisms and treatment strategies

Gynecomastia is common in adolescents and adults, and reflects an underlying imbalance in hormonal physiology in which there is an increase in estrogen action relative to androgen action at the breast tissue level. Most patients have persistent pubertal gynecomastia or breast glandular enlargement from medications, age-related reduction in testicular function, or idiopathic causes. Gynecomastia must be differentiated from pseudogynecomastia due to increased breast adipose tissue, as well as from breast carcinoma. The evaluation of the causes of gynecomastia can be accomplished through history, physical examination and a few laboratory tests. Painful gynecomastia of recent onset may respond to antiestrogen therapy. Surgical removal is the mainstay for long-standing gynecomastia or glandular enlargement that is unresponsive to medical therapy.