Investigation on the phenolics of some spices having pharmacotherapeuthic properties

Spices are an important group of agricultural commodities being used by many civilizations all over the world to aid flavor, taste and nutritional values in the food. In traditional medical systems, their ability to heal various physical, mental and emotional problems has widely been reported. With this view, HPLC analysis was performed to estimate phenolic acids in 21 spices (asafetida, Bishop's weed, black mustard, coriander, cinnamon, clove, curry leaf, cumin black, cumin, fennel, fenugreek, garlic, ginger, Indian cassia, Indian dill or dill large cardamom, onion, saffron, tamarind, true cardamom, yellow mustard) commonly used in India in different forms. In all, 7 phenolic acids; viz., tannic, gallic, caffeic, cinnamic, chlorogenic, ferulic and vanillic acids could be identified on the basis of their retention time with standard compounds and co-chromatography. Several parts of the spices, for instance, seeds, leaves, barks, rhizomes, latex, stigmas, floral buds and modified stems were used in the study. Maximum amount of tannic and gallic acids was observed in black mustard and clove. Caffeic, chlorogenic and ferulic acids were found maximum in cumin while vanillic and cinnamic acids in onion seeds. The spices are known to significantly contribute to the flavor, taste, and medicinal properties of food because of phenolics.

Drainage of deep-seated amoebic liver abscess by Supra cath

Supra cath is an effective alternative to trocar for drainage of deep-seated liver abscess especially in obese or muscular patients with a thick parietal wall.

Partially de-epithelialized preputial flap (triangular soft tissue flap): an aid to prevent coronal urethrocutaneous fistulae

A technique is described to fashion a partially de-epithelialized preputial flap, also called triangular soft tissue flap (TSTF), to cover the neourethra in the region of glans, corona and subcorona. This highly vascular TSTF acted as a mechanical barrier against coronal fistula formation in 16 subcoronal hypospadiacs aged 3-12 years who underwent Snodgrass tubularized incised plate urethroplasty. None had complications at 1-year of follow-up.

Circadian variation of basal total vascular tone and chronotherapy in patients with vasospastic angina pectoris

Vasospastic angina pectoris (VSA) is an anginal attack which occurs characteristically between night and early morning. The aim of this study was to clarify the cause of VSA. The subjects consisted of 16 patients with VSA, 18 patients with effort angina (EAP) and 15 healthy individuals, who were used as the control group. Subjects were attached to an ambulatory blood pressure monitor and a non-invasive continuous cardiac output monitor concurrently, over a 24-hour period. Mean blood pressure (MBP), and cardiac index (CI) were measured. Then basal total vascular tone (TVT) was calculated as follows: basal TVT = (MBP/CI) x 1,332 dyne/sec/cm5. The decrement of CO was greater during sleeping hours as compared with the decrement of the MBP in the VSA group. Nocturnal basal TVT was significantly greater in the VSA group than in the EAP group or the control group. The increased nocturnal basal TVT was significantly suppressed by long acting calcium antagonists to the level of the EAP and the control groups. The treatment also decreased the frequency of ischemic attacks.

Brain-heart connection and the risk of heart attack

Autonomic functions, such as increased sympathetic and parasympathetic activity and the brain's suprachiasmatic nucleus, higher nervous centres, depression, hostility and aggression appear to be important determinants of heart rate variability (HRV), which is, itself, an important risk factor of myocardial infarction, arrhythmias, sudden death, heart failure and atherosclerosis. The circadian rhythm of these complications with an increased occurrence in the second quarter of the day may be due to autonomic dysfunction as well as to the presence of excitatory brain and heart tissues. While increased sympathetic activity is associated with increased levels of cortisol, catecholamines, serotonin, renin, aldosterone, angiotensin and free radicals; increased parasympathetic activity may be associated with greater levels of acetylecholine, dopamine, nitric oxide, endorphins, coenzyme Q10, antioxidants and other protective factors. Recent studies indicate that hyperglycemia, diabetes, hyperlipidemia, ambient pollution, insulin resistance and mental stress can increase the risk of low HRV. These risk factors, which are known to favour cardiovascular disease, seem to act by decreasing HRV. There is evidence that regular fasting may modulate HRV and other risk factors of heart attack. While exercise is known to decrease HRV, exercise training may not have any adverse effect on HRV. In a recent study among 202 patients with acute myocardial infarction (AMI), the incidence of onset of chest pain was highest in the second quarter of the day (41.0%), mainly between 4.0-8.0 AM, followed by the fourth quarter, usually after large meals (28.2%). Emotion was the second most common trigger (43.5%). Cold weather was a predisposing factor in 29.2% and hot temperature (> 40 degrees celsius) was common in 24.7% of the patients. Dietary n-3 fatty acids and coenzyme Q10 have been found to prevent the increased circadian occurrence of cardiac events in our randomized controlled trials, possibly by increasing HRV. We have also found that n-3 fatty acids plus CoQ can decrease TNF-alpha and IL-6 in AMI which are pro-inflammatory agents. There is evidence that dietary n-3 fatty acids canenhance hippocampal acetylecholine levels, which may be protective. Similarly, the stimulation of the vagus nerve may inhibit TNF synthesis in the liver and acetylecholine, the principal vagal neurotransmitter, significantly attenuates the release of pro-inflammatory cytokines TNF-alpha, interleukin 1,6 and 18, but not the anti-inflammatory cytokine IL-10 in experiments. Therefore, any agent which can enhance brain acetylecholine levels, may be used as a therapeutic agent in protecting the suprachiasmatic nucleus, higher nervous centres, vagal activity and sympathetic nerve activity which are known to regulate the body clock and HRV and the risk of SCD and heart attack.

Plastic reconstruction of a mega vesicovaginal fistula using broad ligament flaps--a new technique

Anew technique is described where medially based flaps raised from anterior folds of broad ligament were used to close a mega vesicovaginal fistula in a 35-year-old woman, with a successful outcome.

New insights into circadian aspects of health and disease

Early awakening and early to bed as well as good conduct, thought, diet, interpersonal dealings and physical activity have been suggested for healthy life in Ayurveda. Circadian rhythms, coordinated in part by the parietal hypothalamic-pituitary and adrenal mechanisms, have been reported in almost all variables examined thus far, including the circulation. It is possible that all metabolic functions undergo circadian rhythms. It remains to be explored whether these rhythms may be optimized by Ayurvedic practices. The onsets of myocardial ischemia, unstable angina, acute myocardial infarction, sudden cardiac death, and strokes have been reported to exhibit a circadian variation, with increased frequency in the second quarter of the day. An increased physical and mental load caused by an attempt to prepare for the day may be important in triggering acute cardiovascular events. Depending on their timing, meditation (Ayurvedic practice), n-3 fatty acids, coenzyme Q10, beta-blockers and estrogens may have beneficial effects, whereas progestins and mental load may have adverse effects on heart rate and blood pressure variability, which may be expressed by different circadian patterns. Around the clock serial recordings of blood pressure and heart rate during usual activities and lifestyles may be recorded and may be analyzed by computer-implemented curve fitting to assess the about 24-hour (circadian) variation, among other rhythmic, chaotic, and trend components of the time structure (chronome) of these variables. The new disease risk syndrome circadian hyper-amplitude-tension (CHAT), a condition characterized by an excessive circadian amplitude of blood pressure, cannot be ascertained on the basis of single casual blood pressure measurements. The International Chronome Ecological Study of Heart Rate (and blood pressure) Variability in various ethnic groups aims at collecting further evidence regarding the role of blood pressure and heart rate variability in the pathogenesis of cardiovascular events, while also examining any role played by ethnicity and lifestyle-associated factors.

Purse-string closure of a mucous fistula in loop colostomy

The technique of purse-string closure of a mucous fistula to prevent faecal contamination during loop colostomy is described in six patients who underwent the procedure. Complete faecal diversion was achieved in all six patients without complications.

Can nutrition influence circadian rhythm and heart rate variability?

Recent studies indicate that there is an interaction between biorhythms, the biological clock and triggers, which may be important in the pathogenesis of altered heart rate variability (HRV) and blood pressure variability (BPV). Circadian rhythms are under the influence of, and physiological variables are mediated by the activation of the adrenals, sympathetic/parasympathetic, hypothalamic and pituitary activity. Emotional stress, physical exertion, sleep deprivation and large fatty meals are major triggers of myocardial ischemia, angina, infarction, sudden cardiac death (SCD) and stroke. These events have been reported to exhibit a circadian variation with increased frequency in the second quarter of the day, which has also been observed in our studies on Indians. Recent studies indicate that altered HRV and BPV are also important in the pathogenesis and progression of heart failure, atheroma and thrombosis. Mediation via beta-blockers, oestrogens, n-3 fatty acids, vitamin E and coenzyme Q10 and fasting appears to have a beneficial influence whereas progestins, nifedipine, stress and exercise may have an adverse effect on HRV and BPV. We have reported that plasma levels of vitamin E and C are lower in the second quarter of the day than at other times, indicating their role in the pathogenesis of variability and cardiac events. Prospective studies also indicate that HRV and BPV are important and independent risk factors for cardiovascular events. However, no study has yet been conducted in patients with abnormal HRV and BPV in a randomized, placebo-controlled intervention trial to find out whether improvement in variability can cause a significant reduction in cardiovascular events. There is a need to study the role of n-3 fatty acids, coenzyme Q10, the effect of regular physical training, medication and ACE inhibitors in patients with abnormal HRV and BPV to demonstrate that improving variability can modulate cardiovascular events.

Glove-finger dressing in paediatric hypospadias

Dressing post-operative hypospadias using a glove finger is technically easy to apply, inspect, and remove; gives uniform compression; is cheap and easily available; prevents contamination; and does not slip like ordinary dressings.

Sensitivity analysis and evaluation of microFacCO: a microscale motor vehicle emission factor model for CO emissions

This paper presents a sensitivity analysis of a microscale emission factor model (MicroFacCO) for predicting real-time site-specific motor vehicle CO emissions to input variables, as well as a limited field study evaluation of the model. The sensitivity analysis has shown that MicroFacCO emission estimates are very sensitive to vehicle fleet composition, speed, and ambient temperature. For the present U.S. traffic fleet, the CO emission rate (g/mi) is increased by more than 500% at 5 mph in comparison with a speed greater than 40 mph and by approximately 67% at ambient temperatures of 45 degrees F and > or = 95 degrees F in comparison with an ambient temperature of 75 degrees F. The input variable "emission failure standard rate" is more sensitive to estimating emission rates in the 1990s than in the 2000s. The estimation of emission rates is not very sensitive to relative humidity. MicroFacCO can also be applied to examine the contribution of emission rates per vehicle class and model year. The model evaluation is presented for tunnel studies at five locations. In general, this evaluation study found good agreement between the measured and the modeled emissions. These analyses and evaluations have identified the need for additional studies to update the high-speed (>35 mph) air conditioning (A/C) correction factor and to add effects due to road grades. MicroFacCO emission estimates are very sensitive to the emission standard failure rate. Therefore, the model performance can be greatly improved by using a local emission standard failure rate.

The influence of climate variation and change on diarrheal disease in the Pacific Islands

Freshwater resources are a high-priority issue in the Pacific region. Water shortage is a serious problem in many small island states, and many depend heavily on rainwater as the source of their water. Lack of safe water supplies is an important factor in diarrheal illness. There have been no previous studies looking specifically at the relationship between climate variability and diarrhea in the Pacific region. We carried out two related studies to explore the potential relationship between climate variability and the incidence of diarrhea in the Pacific Islands. In the first study, we examined the average annual rates of diarrhea in adults, as well as temperature and water availability from 1986 to 1994 for 18 Pacific Island countries. There was a positive association between annual average temperature and the rate of diarrhea reports, and a negative association between water availability and diarrhea rates. In the second study, we examined diarrhea notifications in Fiji in relation to estimates of temperature and rainfall, using Poisson regression analysis of monthly data for 1978-1998. There were positive associations between diarrhea reports and temperature and between diarrhea reports and extremes of rainfall. These results are consistent with previous research and suggest that global climate change is likely to exacerbate diarrheal illness in many Pacific Island countries.

The influence of climate variation and change on diarrheal disease in the Pacific Islands

Freshwater resources are a high-priority issue in the Pacific region. Water shortage is a serious problem in many small island states, and many depend heavily on rainwater as the source of their water. Lack of safe water supplies is an important factor in diarrheal illness. There have been no previous studies looking specifically at the relationship between climate variability and diarrhea in the Pacific region. We carried out two related studies to explore the potential relationship between climate variability and the incidence of diarrhea in the Pacific Islands. In the first study, we examined the average annual rates of diarrhea in adults, as well as temperature and water availability from 1986 to 1994 for 18 Pacific Island countries. There was a positive association between annual average temperature and the rate of diarrhea reports, and a negative association between water availability and diarrhea rates. In the second study, we examined diarrhea notifications in Fiji in relation to estimates of temperature and rainfall, using Poisson regression analysis of monthly data for 1978-1998. There were positive associations between diarrhea reports and temperature and between diarrhea reports and extremes of rainfall. These results are consistent with previous research and suggest that global climate change is likely to exacerbate diarrheal illness in many Pacific Island countries.

Development of a microscale emission factor model for CO for predicting real-time motor vehicle emissions

The U.S. Environmental Protection Agency's (EPA) National Exposure Research Laboratory has initiated a project to improve the methodology for modeling human exposure to motor vehicle emissions. The overall project goal is to develop improved methods for modeling the source through the air pathway to human exposure in significant microenvironments of exposure. This paper presents the technical description of a newly developed model for CO emissions. The sensitivity analysis and evaluation of this emission model is presented in a companion paper titled "Sensitivity Analysis and Evaluation of MicroFacCO: A Microscale Motor Vehicle Emission Factor Model for CO Emissions." The MOBILE models (used in the United States, except California) and EMFAC models (used in California only) used to estimate emissions are suitable for supporting mostly regional (county)-scale modeling and emission inventory because of their dependence on vehicle-miles-traveled aggregate data. These emission models are not designed to estimate real-time emissions needed for human exposure studies near roadways. A number of independent studies have found that current mobile source emission factor models are not very reliable at estimating microscale emissions and are, therefore, inappropriate for use with microscale modeling necessary to estimate human exposures near roadways. A microscale emission factor model for predicting real-world real-time motor vehicle CO emissions (MicroFacCO) has been developed. It uses available information on the vehicle fleet composition. The algorithm used to calculate emission factors in MicroFacCO is disaggregated based on the on-road vehicle fleet. The emission factors are calculated from a real-time fleet rather than from a fleet-wide average estimated by a vehicle-miles-traveled weighting of the emission factors for different vehicle classes. MicroFacCO uses the same database used to develop the MOBILE6 model. As compared with MOBILE emission models, MicroFacCO requires only a few input variables, which are necessary to characterize the real-time fleet being modeled. The main input variables required are on-road vehicle fleet, time and day of year, ambient temperature, and relative humidity.

Hypertension and stroke in Asia: prevalence, control and strategies in developing countries for prevention

Reliable statistics related to the prevalence, incidence and mortality of hypertension and stroke are not available from Asia. The data may be in national or institutional reports or journals published in the local language only. The mortality rate for stroke has been on the decline since the mid 1960s in the developed countries of Asia, such as Australia, New Zealand, and Japan, with some improvement in Singapore, Taiwan and Hong Kong, some areas of China and Malaysia about 15 years later. In India, China, Philippines, Thailand, Sri Lanka, Iran, Pakistan, Nepal, there has been a rapid increase in stroke mortality and prevalence of hypertension. The prevalence of hypertension according to new criteria (>140/90 mm Hg) varies between 15-35% in urban adult populations of Asia. In rural populations, the prevalence is two to three times lower than in urban subjects. Hypertension and stroke occur at a relatively younger age in Asians and the risk of hypertension increases at lower levels of body mass index of 23-25 kg/m2. Overweight, sedentary behaviour, alcohol, higher social class, salt intake, diabetes mellitus and smoking are risk factors for hypertension in most of the countries of Asia. In Australia, New Zealand and Japan, lower social class is a risk factor for hypertension and stroke. Population-based long-term follow-up studies are urgently needed to demonstrate the association of risk factors with hypertension in Asia. However prevention programmes should be started based on cross-sectional surveys and case studies without waiting for the cohort studies.

Development and preliminary evaluation of a particulate matter emission factor model for European motor vehicles

Although modeling of gaseous emissions from motor vehicles is now quite advanced, prediction of particulate emissions is still at an unsophisticated stage. Emission factors for gasoline vehicles are not reliably available, since gasoline vehicles are not included in the European Union (EU) emission test procedure. Regarding diesel vehicles, emission factors are available for different driving cycles but give little information about change of emissions with speed or engine load. We have developed size-specific speed-dependent emission factors for gasoline and diesel vehicles. Other vehicle-generated emission factors are also considered and the empirical equation for re-entrained road dust is modified to include humidity effects. A methodology is proposed to calculate modal (accelerating, cruising, or idling) emission factors. The emission factors cover particle size ranges up to 10 microns, either from published data or from user-defined size distributions. A particulate matter emission factor model (PMFAC), which incorporates virtually all the available information on particulate emissions for European motor vehicles, has been developed. PMFAC calculates the emission factors for five particle size ranges [i.e., total suspended particulates (TSP), PM10, PM5, PM2.5, and PM1] from both vehicle exhaust and nonexhaust emissions, such as tire wear, brake wear, and re-entrained road dust. The model can be used for an unlimited number of roads and lanes, and to calculate emission factors near an intersection in user-defined elements of the lane. PMFAC can be used for a variety of fleet structures. Hot emission factors at the user-defined speed can be calculated for individual vehicles, along with relative cold-to-hot emission factors. The model accounts for the proportions of distance driven with cold engines as a function of ambient temperature and road type (i.e., urban, rural, or motorway). A preliminary evaluation of PMFAC with an available dispersion model to predict the airborne concentration in the urban environment is presented. The trial was on the A6 trunk road where it passes through Loughborough, a medium-size town in the English East Midlands. This evaluation for TSP and PM10 was carried out for a range of traffic fleet compositions, speeds, and meteorological conditions. Given the limited basis of the evaluation, encouraging agreement was shown between predicted and measured concentrations.

Fourier transform infrared spectra and normal mode analysis of 1-[(3-methylphenyl)piperazin-1-yl]-3-[thio(4-acetamido-phenyl]pro pane: a potent 5-HT2 and D2 receptor ligand

1-[(3-methylphenyl)piperazin-1-yl]-3-[thio(4-acetamidophenyl]propa ne and its analogs have shown good hypotensive activity and the title compound has shown a profile of centrally acting anti-hypertensive agent. It also binds with the 5-HT2 receptors. The conformation of the title compound was determined by X-ray diffraction but this is not possible for its analogs because of the difficulty in preparing their single crystals. A novel and easy approach is envisaged to determine the conformation in such cases by the application of semi-empirical molecular orbital calculations, Fourier transform infra red (FTIR) spectroscopy and normal mode analysis. As a first step in this direction the FTIR spectrum of the title compound has been recorded and its normal mode analysis carried out. The assignments of the frequencies are based on the concept of group frequencies and band intensities. The spectrally observed frequencies have been tabulated along with the theoretically calculated ones and their assignments. Good agreement has been obtained between them and a set of 101 force field constants is established.

Effect of coenzyme Q10 on experimental atherosclerosis and chemical composition and quality of atheroma in rabbits

The effects of the administration of coenzyme Q10 (3 mg/kg per day) (group A, n=10) and placebo (aluminum hydroxide, 3 mg/kg per day) (group B, n=10) were compared over 24 weeks in a randomized, single-blind, controlled trial. There were two groups of rabbits receiving a trans fatty acid (TFA)-rich diet (5-8 g/day) for 36 weeks. Oxidized rabbit chow with vitamin C plus ferric chloride was administered for 4 weeks in all rabbits. Intervention with coenzyme Q10 after feeding of TFA-rich diet was associated with a significant decline in thiobarbituric acid reactive substances (TBARS), diene conjugates and malondialdehyde, and an increase in plasma levels of vitamin E in the coenzyme Q group compared to placebo group. These changes, which were indicators of a decrease in oxidative damage, were independent of lipid lowering. The aortic and coronary artery plaque sizes, coronary atherosclerosis index, aortic and coronary atherosclerosis scores were significantly lower in the coenzyme Q group than placebo group. Aortic and coronary plaque frequencies, as well as frequencies of ulceration, thrombosis or hemorrhage, and cracks and fissures, were also significantly lower in the coenzyme Q group, indicating a better quality of atheroma compared to those in the control group. Aortic cholesterol, triglycerides and sudanophilia were significantly lower and vitamin E significantly higher in the coenzyme Q group in comparison to the placebo group indicating that coenzyme Q10 can have beneficial effect on the chemical composition of atheroma. The findings suggest that antioxidant therapy with coenzyme Q10 may be used as an adjunct to lipid lowering for additional beneficial effects related to chemical composition and quality of atheroma independent of hypolipidemic agents.

Extra-hepatic biliary-ductal necrosis in acute pancreatitis: a rare complication

An 8-year-old male presented with an acute abdomen. Exploration revealed bilious ascites, oedematous pancreatitis with areas of necrosis, and omentum showing patches of fat necrosis. The common bile duct and almost all of the common hepatic duct were gangrenous and had sloughed, with bile leaking from the junctional stump of the right and left hepatic ducts. The patient was managed successfully by Roux-en-Y hepaticojejunostomy. This is a rare case showing necrosis and sloughing of the extrahepatic bile ducts in acute pancreatitis.

Clinical evaluation of the tolerability and efficacy of trovafloxacin compared with sparfloxacin in the treatment of lower respiratory tract infections

OBJECTIVE

To evaluate the clinical tolerability and efficacy of trovafloxacin compared with sparfloxacin in the treatment of lower respiratory tract infections.

DESIGN

This was a randomised, double-blind, controlled, parallel study.

PARTICIPANTS AND INTERVENTIONS

92 patients with lower respiratory tract infection were enrolled in three centres. 45 patients received trovafloxacin 200mg once daily orally for 10 days and 43 patients received sparfloxacin 400mg on the first day and 200mg once daily orally for 9 days. Clinical evaluation was performed for fever, dyspnoea, pulmonary symptoms, cough and sputum on days 1, 3, 6 and 12 of the study along with bacteriological evaluation on days 1 and 12. Any adverse effects were also recorded during the study period.

RESULTS

There was a significant reduction in the severity of symptoms from day 4 until the end of the study. Clinical cure or improvement was seen in 87 and 95% of the trovafloxacin and sparfloxacin groups, respectively. Bacteriological eradication rates were 84 and 89% for the trovafloxacin and sparfloxacin groups, respectively. The number of adverse effects was 10 and 13 reported by 10 and 13 patients in the trovafloxacin and sparfloxacin groups, respectively.

CONCLUSIONS

Trovafloxacin is well tolerated and effective in the treatment of lower respiratory tract infections in a dosage of 200mg daily. It was observed that the efficacy and tolerability of trovafloxacin is comparable to that of sparfloxacin (200mg daily, with a loading dose of 400mg on the first day) in the treatment of lower respiratory tract infections. However, further studies are needed to confirm this.