A Study of Catecholamine Levels in Acute ICH Patients and its Clinical Significance

ICH is one of the most serious neurological emergency which can result in high mortality which may be related to catecholamine release. We aim to evaluate serum catecholamine levels in acute ICH and correlate their levels with clinical parameters of stress and outcome.

MATERIAL

Consecutive patients with CT proven ICH within 7 days of ictus were included and their clinical finding, SIRS Parameters, GCS, NIH score, laboratory parameters (ESR, CRP) were evaluated. Serum Catecholamine (DA, NE, E) levels were measured by LCMS. The patients were followed up at discharge and one month, the outcome was defined by mortality and 1 month modified Rankin scale (good 0-2, poor >2).

OBSERVATION

There were 31 patients of acute ICH. Patients were admitted 1 to 2 days after ictus. Among the patients 19 were male and 12 were female.Their age ranged from 31 to 86 with mean 53.3+- 16.7. History of hypertension was present in 27.3% of patients. Their average GCS was median 12 (6.0, 15.0) and NIHSS was 12.5 (8.5, 22) Their average ESR was 30 (13,56) and average CRP was 1.8 (1.1, 5.9). Almost all pateints had raised SIRS parameters. There was an increase in levels of Dopamine (63.2 pg/ml), Epinephrine (73.5 pg/ml) and Norepinephrine (390pg/ml) on admission as compared to their levels 1 week after ictus or on discharge (Dopamine 35.6, Epinephrine 52.1, and Norepinephrine 241 pg/ml).

CONCLUSION

CA surge is common in ICH pateints and it correlates with severity and outcome of patient. 6 pateints died in the hospital 72 % of patients had poor outcome. Catecholamine levels were higher in poor outcome patients.

EPA's pleiotropic mechanisms of action: a narrative review

Treatment with icosapent ethyl 4 g/day, a highly purified and stable ethyl ester of eicosapentaenoic acid (EPA), demonstrated a significant reduction in atherosclerotic cardiovascular disease (ASCVD) events and death in REDUCE-IT. However, analyses of REDUCE-IT and meta-analyses have suggested that this clinical benefit is greater than can be achieved by triglyceride reduction alone. EPA therefore may have additional pleiotropic effects, including anti-inflammatory and anti-aggregatory mechanisms. EPA competes with arachidonic acid for cyclooxygenase and lipoxygenase, producing anti-inflammatory and anti-aggregatory metabolites rather than the more deleterious metabolites associated with arachidonic acid. Changing the EPA:arachidonic acid ratio may shift metabolic status from pro-inflammatory/pro-aggregatory to anti-inflammatory/anti-aggregatory. EPA also has antioxidant effects and increases synthesis of nitric oxide. Incorporation of EPA into phospholipid bilayers influences membrane structure and may help to prevent cardiac arrhythmias. Clinically, this may translate into improved vascular health, including regression of atherosclerotic plaque. Overall, EPA has a range of pleiotropic effects that contribute to a reduction in ASCVD.

The Pleiotropic Effects of Sodium-Glucose Cotransporter-2 Inhibitors: Beyond the Glycemic Benefit

Type 2 diabetes (T2D) is associated with an increased risk of macro- and microvascular complications, including cardiovascular disease (CVD), heart failure (HF), and chronic kidney disease (CKD). Of the currently available glucose-lowering therapies, sodium-glucose cotransporter-2 inhibitors (SGLT-2is) are the only class to target the pathophysiologic increase in renal glucose reabsorption in patients with T2D. In CV outcomes trials of SGLT-2is in patients with T2D and established CVD or varying levels of CV risk, empagliflozin, canagliflozin, and dapagliflozin were associated with significant improvements in the risk of composite CV and renal outcomes compared with placebo that extended beyond their glycemic effects. Real-world observational studies have also reported improvements in CV outcomes with SGLT-2is compared with other glucose-lowering therapy in routine clinical practice. This review describes the pleiotropic effects of SGLT-2is and discusses the potential mechanisms for these effects as well as how they potentially provide benefits beyond glycemic control in patients with T2D. These favorable nonglycemic effects indicate that SGLT-2is may be of particular benefit in patients with diabetic complications, such as CVD, HF, or CKD. Ongoing large randomized trials in specific patient populations, including those with CVD, HF, or CKD (with or without T2D), may help to confirm the benefits of SGLT-2is in these patients and further elucidate the potential mechanisms of their pleiotropic effects. FUNDING: AstraZeneca.

Pharmacokinetic and pharmacodynamic differences of new generation, longer-acting basal insulins: potential implications for clinical practice in type 2 diabetes

The treatment of type 2 diabetes (T2D) is often complicated by factors such as patient co-morbidities, complex drug-drug interactions, and management of adverse events. In addition, some of these factors are highly dependent on the nature of the treatment regimen and the molecular and physical properties of the drugs being used to treat patients with this disease. This calls for a better understanding of how the properties of individual drugs affect the overall outcome for patients with diabetes. Clinical pharmacology studies to assess the pharmacokinetic (PK) and pharmacodynamic (PD) characteristics of new diabetes drugs play an important role in advancing our understanding of the interactions between a drug and the human body. Specific PK and PD techniques such as the glucose clamp test can be applied to assess the properties of drugs used for the treatment of diabetes. Basal insulin analogs are a common treatment option for the maintenance of glycemic control in patients with T2D. These drugs work by mimicking endogenous insulin secretion within the body and provide stable and prolonged insulin action to achieve optimal glucose levels. Insulin glargine 300 U/mL (Gla-300) and insulin degludec (IDeg) 100 U/mL and 200 U/mL represent a new generation of longer-acting basal insulins. These drugs demonstrate improved PK and PD properties compared with previous basal insulins, allowing them to more closely mimic physiological basal insulin secretion. Here we review the methods used to evaluate the PK and PD profiles of Gla-300 and IDeg and describe studies that have investigated the PK/PD properties of these drugs in type 1 diabetes. The aim of this review is to inform primary care physicians of the value and limitations of data from clinical pharmacology studies when prescribing these agents for the management of T2D.

Safety and tolerability of new-generation anti-obesity medications: a narrative review

The prevalence of obesity and associated comorbidities is rising. Despite their weight-loss efficacy, new generation anti-obesity medications are only prescribed to a minority of adults with obesity, possibly, which in part may be due to safety concerns. This review presents detailed safety profiles for orlistat, phentermine/topiramate, lorcaserin, naltrexone/bupropion and liraglutide 3.0 mg, and discusses the associated risk-benefit profiles. Two anti-obesity medications presented safety issues that warranted further discussion; phentermine/topiramate (fetal toxicity) and liraglutide 3.0 mg (risk of gallstone disease and mild, acute pancreatitis), whereas the adverse events associated with orlistat, lorcaserin, and naltrexone/bupropion were mostly transient tolerability issues. The difficulties surrounding the objective determination of risk-benefit for anti-obesity medications is discussed. The need for more long-term data, thorough patient assessment, individualization of pharmacological interventions and adherence to stopping rules to maximize risk-benefit are highlighted. Overall, the majority of new generation anti-obesity medications present encouraging tolerability profiles; however, in some cases a lack of long-term clinical trials confounds the accurate determination of risk-benefit.

Sugar before bed: a simple dietary risk factor for caries experience

Clinical care pathways have placed renewed emphasis on caries risk assessment and the ability to predict and prevent further disease. With diet considered a key factor in the development of caries, the level of caries risk posed by dietary habits, such as the frequency of intake and timing of free sugars is questioned.

OBJECTIVE

To identify reliable and simple dietary risk factors for caries experience.

RESEARCH DESIGN

A cross-sectional observational study of a convenience sample with data gained from clinical examinations, questionnaire and a 24 hour dietary-recall interview.

PARTICIPANTS

128 subjects aged 11-12 from comprehensive schools in Greater Manchester and Newcastle upon-Tyne, UK.

OUTCOME MEASURES

free sugars consumed between meals, before bed and total % of total free sugars consumed were assessed from dietary assessments led by a dietitian. D4-6MFT was generated with a caries threshold of ICDAS stage 4 from clinical examinations.

RESULTS

Analysis revealed no significant differences in caries experience when looking specifically at caries into dentine, referred to as the cavity group (split at D4-6MFT), between high and low deprivation, consumption of free sugars between meals and free sugars (%). The consumption of free sugars within the hour before bed revealed a statistically significant difference between the cavity/no cavity groups (p=0.002). Logistic regression analysis on the cavity/no cavity groups revealed an odds ratio of 2.4 (95%CI 1.3,4.4) for free sugars consumption before bedtime.

CONCLUSIONS

The study suggests that the consumption of free sugars before bedtime may be an important risk factor for adolescent caries into dentine experience.

The Role of Extracorporeal Septoplasty in Severely Deviated Nasal Septum

Extracorporeal septoplasty is a valuable tool in the armamentarium of the nasal surgeon for the reconstruction of the severely deviated septum. Extracorporeal septoplasty offers the surgeon the opportunity to correct the septum under direct visualization, shape the nasal vault and address the nasal dorsum with the ultimate goal of providing both form and function for the patient with a complex septal deviation. The study was conducted with the aim to measure the outcomes of extracorporeal septoplasty in severely deviated nasal septum, relief of symptoms (nasal obstruction), surgical complications, if any, revision, if any with objective to evaluate the functional outcome and aesthetic aspects of extracorporeal septoplasty. This was a prospective observational study of 35 patients with severe deviated nasal septum with or without external deformity of nose attending the ENT OPD between Jan 2015 and Jan 2016 at Sri Aurobindo Medical College and Post Graduate Institute, Indore (M.P.). In this study, 17 patients (48.57%) shows excellent improvement on VAS scale, out of which 13 patients shows excellent improvement and 4 patients shows good improvement on photographic assessment. 11 patients (31.43%) show good improvement on VAS as well as photographic assessment and 7 patients (20%) show moderate improvement on VAS scale and fair improvement on photographic assessment. Extracorporeal septal reconstruction is an important surgical option for the correction of the markedly deviated nasal septum. Fixation of the straightened and replanted septum at the nasal spine and dorsal septum border with the upper lateral cartilages is essential. Spreader grafts for stabilization of the internal nasal valve and dorsal onlay grafts to prevent dorsal irregularity are strongly encouraged.

Concentrated Insulins: A Review and Recommendations

For diabetes mellitus patients who require higher doses of insulin, pen-delivered concentrated insulins offer smaller volumes and potentially a lower risk of dosing errors.

Antidiabetic agents and cardiovascular outcomes in patients with heart diseases

INTRODUCTION

This article reviews evidence of the benefits and risk of antidiabetic agents in cardiovascular (CV) outcomes, with a focus on medications approved by the FDA since 2008.

STUDY SELECTION

Peer-reviewed articles were identified from MEDLINE and Current Content databases (both 1966 to 1 October 2016) using the search terms insulin, metformin, rosiglitazone, pioglitazone, glyburide, glipizide, glimepiride, acarbose, miglitol, albiglutide, exenatide, liraglutide, lixisenatide, dulaglutide, pramlintide, meglitinide, alogliptin, linagliptin, saxagliptin, sitagliptin, canagliflozin, dapagliflozin, empagliflozin, colesevalam, bromocriptine, mortality, myocardial infarction (MI), heart failure (HF), and stroke. Trials were included if they were randomized clinical trials evaluating adult patients (≥18 years) with type 2 diabetes; had a period of intervention and follow-up of ≥12 months; and assessed CV outcomes (CV death, fatal/non-fatal MI or HF) as endpoints. Twenty-three randomized trials were included. Antidiabetic agents: Of agents approved prior to 2008, metformin has not been associated with measurable harm in patients with diabetes in terms of mortality and CV events (and has a trend of benefit). Controversial results existed with the use of sulfonylureas and thiazolidinediones (TZDs) for CV outcomes. Among agents approved after 2008, liraglutide and empagliflozin have been shown to be superior to placebo in improving CV outcomes.

CONCLUSIONS

The FDA regulatory mandate to demonstrate CV safety in order to approve new diabetes drugs led to an increase in the number of CV outcome trials. However, these trials have placebo-controlled, non-inferiority designs aiming to show absence of CV toxicity. More studies are needed to address other questions, including comparative effectiveness, and longer-term risk versus benefits.

Evaluation of the Use of a Virtual Patient on Student Competence and Confidence in Performing Simulated Clinic Visits

Objective. To assess the effect of incorporating virtual patient activities in a pharmacy skills lab on student competence and confidence when conducting real-time comprehensive clinic visits with mock patients. Methods. Students were randomly assigned to a control or intervention group. The control group completed the clinic visit prior to completing virtual patient activities. The intervention group completed the virtual patient activities prior to the clinic visit. Student proficiency was evaluated in the mock lab. All students completed additional exercises with the virtual patient and were subsequently assessed. Student impressions were assessed via a pre- and post-experience survey. Results. Student performance conducting clinic visits was higher in the intervention group compared to the control group. Overall student performance continued to improve in the subsequent module. There was no change in student confidence from pre- to post-experience. Student rating of the ease of use and realistic simulation of the virtual patient increased; however, student rating of the helpfulness of the virtual patient decreased. Despite student rating of the helpfulness of the virtual patient program, student performance improved. Conclusion. Virtual patient activities enhanced student performance during mock clinic visits. Students felt the virtual patient realistically simulated a real patient. Virtual patients may provide additional learning opportunities for students.

Determination of pesticide and phthalate residues in tea by QuEChERS method and their fate in processing

In this study, the quick, easy, cheap, effective, rugged, and safe (QuEChERS) method was applied for the analysis of the multiclass pesticide residues of 12 organochlorines (OCs), 9 organophosphates (OPs), 11 synthetic pyrethroids (SPs), 4 herbicides, 6 phthalates in raw tea (loose tea, branded tea and herbal tea), and tea infusion in 4 different containers (glass cup, earthen cup, plastic bag and disposal cup). In loose tea and branded tea residues, malathion (0.257 and 0.118 mg kg^-1), cypermethrin (0.065 and 0.030 mg kg^-1), and fenvalerate (0.032 and 0.030 mg kg^-1) were detected, respectively. In herbal tea, residues of only cypermethrin (0.053 mg kg^-1) and fenvalerate (0.045 mg kg^-1) were detected. Tea infusion samples contained in a plastic bag were found to be contaminated with only dibutyl phthalate (DBP) (0.038 mg kg^-1). Disposable cup was found to be contaminated with DBP (0.026 mg kg^-1) and diethyl phthalate (DEP) (0.004 mg kg^-1). Further, to know the processing behavior of pesticides, the spiked raw tea was subjected to tea infusion at different brewing times (2, 5, 10 min). The analysis demonstrated that dimethoate, dichlorvos, and malathion had shown more than 10 % of translocation at 5 min of brewing time. Further brewing for 10 min revealed the reduction in concentration of pesticides. Leaching of phthalate residues from different plastic containers was also studied at 10, 30, and 60 min. DBP, benzyl butyl phthalate (BzBP), and di-2-(ethylhexyl) phthalate (DEHP) were leached in the tea infusion samples packed in plastic bags. On the other hand, in disposable cups, leaching of DBP, DEP, and dimethyl phthalate were found. The concentration of phthalate residues increased with retention time. Pesticide and phthalate contaminants were recorded at low quantities in few samples only.

Deoxycholic Acid (ATX-101) for Reduction of Submental Fat

Objective: To review trials evaluating purified synthetic deoxycholic acid (DCA; ATX-101) for the reduction of submental fat (SMF). Data Sources: A literature search was conducted using MEDLINE (1946 to week 4 of April 2016) and Evidence Based Medicine Database (1974 to 6 May, 2016). Keywords searched included deoxycholic acid, ATX-101, and submental fat. Study Selection and Data Extraction: All human studies published in English that addressed the effects of DCA for the reduction of SMF were selected for analysis. Data Synthesis: Five phase III, multicenter, randomized, double-blinded clinical trials enrolling more than 1700 patients have demonstrated the efficacy of ATX-101 in the reduction of SMF via a variety of validated scales as well as objective measurements. Purified synthetic DCA 2 mg/cm2 injected monthly for 4 to 6 treatment sessions demonstrated improvement in scales evaluated by both clinicians and patients. Improvement in skin caliper measurements of SMF and Magnetic Resonance Imaging (MRI) provide objective evidence of the efficacy of ATX-101. Adverse events (AEs) are very common but are transient and localized to the treatment area. Pain at the injection site is the most common AE, occurring in more than 80% of patients treated. Other common AEs include swelling, bruising, numbness, and induration. Appropriate injection technique is patient specific and requires detailed knowledge of the submental anatomy to minimize AEs. Conclusions: ATX-101 is the first pharmacological intervention approved for the reduction of SMF and offers an alternative to invasive measures to improve the submental profile and positively affect patient self-image.

Ecological implication of variation in the secondary metabolites in Parmelioid lichens with respect to altitude

Lichens are known to synthesize a variety of secondary metabolites having multifunctional activity in response to external environmental condition. Two common lichen extrolites, atranorin and salazinic acid, are known to afford antioxidant as well as photoprotectant nature depending on the abiotic/biotic stress. The present investigation aims to study the influence of altitudinal gradient on the quantitative profile of atranorin and salazinic acid in three lichen species, Bulbothrix setschwanensis (Zahlbr.) Hale, Everniastrum cirrhatum (Fr.) Hale and Parmotrema reticulatum (Taylor) Choisy, Parmeliaceae using liquid chromatography-mass spectrometry (LC-MS/MS) technique. Samples were collected from high-altitude area, usually considered as non-polluted sites of Garhwal Himalaya. Characterization and quantification of the lichen substances in samples were carried out comparing with the standards of atranorin and salazinic acid. Results indicated significant variation in the chemical content with the rising altitude. All the three lichen species showed higher quantities of chemical substances with the altitudinal rise, while among the three lichen species, E. cirrhatum showed the highest quantity of total lichen compounds. The higher abundance and frequency of E. cirrhatum with increasing altitude as compared to B. setschwanensis and P. reticulatum may be attributed due to the presence of higher quantity of photoprotecting/antioxidant chemicals especially salazinic acid. Thus, the present study shows the prominent role of secondary metabolite in wider ecological distribution of Parmelioid lichens at higher altitudes.

Pedalium murex Linn (Pedaliaceae) fruits: a comparative antioxidant activity of its different fractions

OBJECTIVE

To examine the antioxidant activity and total phenolic content of different solvent fractions of Pedalium murex (P. murex) Linn fruits (Family: Pedaliaceae) as well as the correlation between the total antioxidant capacity and total phenolic content.

METHODS

In the present study, the antioxidant activities of P. murex were evaluated using six in-vitro assays, namely total antioxidant assay, DPPH assay, reducing power, nitric oxide scavenging, hydrogen peroxide scavenging and deoxyribose scavenging assays, and total phenol contents were also investigated.

RESULTS

The ethyl acetate (EA) fraction was found to have high levels of phenolic content (298.72±2.09 mg GAE/g). The EA fraction exhibit higher total antioxidant capacity, higher percentage of DPPH radical scavenging activity (135.11±2.95µg/mL), nitric oxide (200.57±4.51µg/mL), hydrogen peroxide (217.91±6.12 µg/mL), deoxyribose (250.01±4.68µg/mL) and higher reducing power. Correlation coefficient (r(2) =0.914) was found to be significant between total phenolic content and total antioxidant activity.

CONCLUSIONS

In general, the results indicate that the EA fractions are rich in phenolic antioxidants with potent free radical scavenging activity implying their importance to human health.

Antidiabetic and in vitro antioxidant potential of Hybanthus enneaspermus (Linn) F. Muell in streptozotocin-induced diabetic rats

OBJECTIVE

To evaluate antidiabetic and antioxidant potential of Hybanthus enneaspermus in different models.

METHODS

The oral glucose tolerance test (OGTT) and normoglycemic effect of alcoholic extract of Hybanthus enneaspermus (AHE) were evaluated at a dose of 125, 250 and 500 mg/kg p.o. while hypoglycemic activity and effect on body weight were tested at 250 and 500 mg/kg p.o. per day for 21 days in Streptozotocin (STZ) induced diabetic rats. Further, glucose uptake by hemidiaphram was also evaluated. The total polyphenolic and flavonoid were determined and their correlation with various antioxidant assays was also determined.

RESULTS

The results showed high level of phenolic content in AHE. AHE also exhibited higher total antioxidant capacity, good reducing power and a significant scavenger of reactive oxygen species like DPPH radical, nitric oxide, hydrogen peroxide and deoxyribose. Furthermore there was a significant increase in the body weight and decrease in the blood glucose level on treatment with the AHE. AHE increased glucose uptake on isolated rat hemi-diaphragm compared to control group.

CONCLUSIONS

AHE reduce blood glucose level in STZ-induced diabetic model. It does not show significant effect in normoglycemic study but showes significant effect in OGT. AHE has significant antioxidant activity, which may be attributed to high phenolic content.

Past, Present, and Future Research Avenues for Metformin: A Literature Review

Objective: To review why metformin is considered first-line therapy for type 2 diabetes mellitus (T2DM) and review newer avenues of research currently being evaluated. Data Sources: The Cochrane Library and Medline (to January 2014) were searched for case-control and cohort studies, clinical trials, and systematic reviews and meta-analyses involving metformin for any indication. Study Selection and Data Extraction: The literature search found 5 major avenues of research for metformin: reduction in mortality, delayed-onset or prevention of T2DM in the presence of prediabetes, nonalcoholic fatty liver disease (NAFLD), polycystic ovarian syndrome (PCOS), and decreased cancer risk. When available, multi-center, double-blind, controlled clinical trials or meta-analyses thereof were selected for review. If these types of studies did not exist, other types of studies were chosen for review. Data Synthesis: Metformin significantly decreases all-cause and diabetes-related mortality in overweight and obese patients with T2DM. It may also decrease risk of progression to T2DM in patients with prediabetes. Metformin has been studied for the treatment of NAFLD though data are limited. Metformin alone or combined with clomiphene may increase pregnancy and ovulation rates but has not yet been shown to increase live-birth rates in patients with PCOS. Metformin may decrease risk of colorectal cancer but not all-cancer risk. Conclusions: Metformin's clinical role in T2DM and prediabetes is well established. Other avenues of research being evaluated at this time are NAFLD, PCOS, and reduced risk of cancer; more data are needed before it has a clinical role in these indications.

Reproductive toxicity of lead, cadmium, and phthalate exposure in men

Environmental toxicants viz lead or cadmium and phthalate esters (di(2-ethylhexyl) phthalate [DEHP], dibutyl phthalate [DBP], and diethyl phthalate [DEP]) widely found in different environmental strata are linked to deteriorating male reproductive health. The objective was to assess the relationships between the seminal lead, cadmium, and phthalate (DEHP, DBP, DEP) concentrations at environmental level and serum hormone levels and semen quality in non-occupationally exposed men and specify the effect of individual and combined exposure of toxicants on semen quality. A study of 60 male partners of couples attending the Andrology Laboratory of the Reproductive Biology Department, All India Institute of Medical Sciences (AIIMS), New Delhi, India for semen analysis to assess their inability to achieve a pregnancy was selected for the study. The results of univariate and stepwise multiple regression analysis in the unadjusted model showed a significant correlation between lead or cadmium and phthalates DEHP/DBP/DEP and sperm motility, sperm concentration, and DNA damage. After adjusting for potential confounders, an association with lead or DEHP was only observed. The present data shows that lead (Pb) or cadmium (Cd) or phthalates might independently contribute to decline in semen quality and induce DNA damage. Phthalates might influence reproductive hormone testosterone. These findings are significant in light of the fact that men are exposed to a volley of chemicals; however, due to the small sample size, our finding needs to be confirmed in a larger population.

A comparative analysis of avoidable causes of childhood blindness in Malaysia with low income, middle income and high income countries

To determine the avoidable causes of childhood blindness in Malaysia and to compare this to other middle income countries, low income countries and high income countries. Data were obtained from a school of the blind study by Patel et al. and analysed for avoidable causes of childhood blindness. Six other studies with previously published data on childhood blindness in Bangladesh, Ethiopia, Nigeria, Indonesia, China and the United Kingdom were reviewed for avoidable causes. Comparisons of data and limitations of the studies are described. Prevalence of avoidable causes of childhood blindness in Malaysia is 50.5 % of all the cases of childhood blindness, whilst in the poor income countries such as Bangladesh, Ethiopia, Nigeria and Indonesia, the prevalence was in excess of 60 %. China had a low prevalence, but this is largely due to the fact that most schools were urban, and thus did not represent the situation of the country. High income countries had the lowest prevalence of avoidable childhood blindness. In middle income countries, such as Malaysia, cataract and retinopathy of prematurity are the main causes of avoidable childhood blindness. Low income countries continue to struggle with infections such as measles and nutritional deficiencies, such as vitamin A, both of which are the main contributors to childhood blindness. In high income countries, such as the United Kingdom, these problems are almost non-existent.

Hybanthus enneaspermus (L.) F. Muell: a concise report on its phytopharmacological aspects

Hybanthus enneaspermus (L.) F. Muell belonging to the family Violaceae, popularly known as Ratanpurus (Hindi) is a herb or a shrub distributed in the tropical and subtropical regions of the world. In the Ayurvedic literature, the plant is reported to cure conditions of "Kapha" and "Pitta", urinary calculi, strangury, painful dysentery, vomiting, burning sensation, wandering of the mind, urethral discharge, blood trouble, asthma, epilepsy, cough, and to give tone to the breasts. Phytochemically, the plant contains a considerable amount of dipeptide alkaloids, aurantiamide acetate, isoarborinol, and β-sitosterol, sugars, flavonoids, steroids, triterpenes, phenols, flavones, catachins, tannins, anthraquinones and amino acids. Pharmacologically, the plant is reported to possess antidiabetic, antiplasmodial, antimicrobial, anticonvulsant, nephroprotective, aphrodisiac, hepatoprotective, antiinflammatory, aldose reductase inhibitory and free radical scavenging activities. The information provided in this review will be worthwhile to know the applicability of H. enneaspermus for the treatment of various acute or chronic diseases with a diverse nature of phytoconstituents. The overall data in this review article were collected from various scientific sources on the research of H. enneaspermus.

Fetal hemoglobin and alpha thalassemia modulate the phenotypic expression of HbSD-Punjab

INTRODUCTION

HbSD-Punjab (HbSD) is a less common form of sickle cell disease (SCD) and discrimination between HbSD and HbSS is not possible on alkaline electrophoresis because the two variants overlap in the compound heterozygous state. There are only a few publications consisting mostly of case reports. Thus, the phenotypic expression of HbSD and its modifiers has not been studied.

METHODS

We studied the phenotypic expression of 42 cases of HbSD (the largest number of subjects ever included in this kind of study) and compared them with 84 HbSS cases matched for age, sex, and caste. Further, we evaluated the influence of HbF concentration and alpha thalassemia on the phenotypic expressions of HbSD, namely the frequency of VOC and degree of hemolysis.

RESULTS

The frequencies of VOC were similar in both the groups. The markers of hemolysis such as total bilirubin, unconjugated bilirubin, and LDH were higher where as HbF concentration was significantly low in HbSD. There was a negative correlation between HbF concentration and risk of VOC in the HbSD. The total hemoglobin level and hematocrit were significantly high, and the MCV and MCH were significantly low in HbSD with alpha thalassemia. Alpha thalassemia had no influence on the frequency of VOC and severity of hemolysis in HbSD.

CONCLUSION

HbF reduced the frequency of VOC but had no influence on the hemolytic markers in HbSD. HbSD with alpha thalassemia was associated with hypohromic and microcytic features of red blood cells.

Clinical and molecular characterization of Hb Hofu in eastern India

INTRODUCTION

Hb Hofu (HBB:c. 380T>A) is a rare inherited hemoglobin abnormality with few case reports in the world literature.

METHODS

Screening for the sickle cell gene mutation and other hemoglobinopathies was carried out using the sickle slide test, Hb electrophoresis, and HPLC under an ongoing central government project.

RESULTS

We detected twelve Hb Hofu heterozygotes and three sickle Hb Hofu compound heterozygotes. The heterozygotes were asymptomatic except for one individual who had chronic kidney disease and moderate anemia. Only one HbS-Hofu case was symptomatic and presented with intermittent attacks of painful crisis. In the carrier state, the Hb Hofu eluted as a hump at the beginning of the HbA(0) window. But in HbS-Hofu cases, Hb Hofu eluted as a single peak in the HbA(0) window, with the HbA(2) levels being >4% consistently.

CONCLUSION

HbS-Hofu has a variable clinical presentation. The retention time of Hb Hofu on HPLC is very close to that of HbA(0) and often elutes in the A0 window. Thus, there is every possibility of the HbS-Hofu chromatogram to be misinterpreted as that of a sickle cell trait/transfused sickle cell-beta-thalassemia case. This is the first time where Hb Hofu has been detected by HPLC, which is the widely accepted screening technique for hemoglobinopathies around the world.

Angiotensin II type 1 receptor blocker-induced immune thrombocytopenia: a case report

INTRODUCTION

The development of thrombocytopenia after a dose increase in losartan and subsequently after switching the patient to valsartan is reported.

CASE PRESENTATION

A 61-year-old Caucasian man presented with epistaxis and gingival bleeding of three weeks duration. Laboratory evaluation revealed a hemoglobin level of 144g/L, a leukocyte count of 16.2×109 cells/L (72.51% neutrophils, 20.1% lymphocytes, 6.8% monocytes, 0.4% eosinophils, 0.2% bands), and a platelet count of 15.0×109 cells/L. Flow cytometry of his peripheral blood showed normal CD4:CD8 ratio and no evidence of any lymphoproliferative disorder. A peripheral smear showed decreased platelets with a few areas of clumping. Four weeks before presentation to the emergency room, his losartan dose was increased to 100mg once daily due to continuously elevated blood pressure readings. He had been maintained on losartan 50mg once daily for five years and previous routine laboratory measurements revealed a baseline platelet count of 248.0×109 cells/L.The patient began receiving an oral prednisone taper and his platelet count returned to a stable value of >200×109 cells/L. Because there was no other probable cause, he was thought to have developed immune thrombocytopenia from the increased losartan dose. Losartan was discontinued and one week later he was switched to valsartan 160mg once daily.Forty-seven days after starting valsartan, the patient presented once again to the emergency room with intermittent epistaxis and gingival bleeding while brushing his teeth of two weeks duration. Laboratory measurement revealed a platelet count of 37×109 cells/L. Valsartan was held and another prednisone taper was initiated. The patient's platelet count recovered upon valsartan discontinuation and in four weeks, his platelet count improved to 214×109 cells/L.

CONCLUSIONS

A 61-year-old Caucasian man developed immune thrombocytopenia after an increase in losartan dose and developed immune thrombocytopenia again after he was switched to valsartan.

Analysis of imidacloprid residues in fruits, vegetables, cereals, fruit juices, and baby foods, and daily intake estimation in and around Lucknow, India

A total of 250 samples-including fruits, fruit juices, and baby foods (50 samples each), vegetables (70 samples), and cereals (30 samples)-were collected from Lucknow, India, and analyzed for the presence of imidacloprid residues. The QuEChERS (quick, easy, cheap, effective, rugged, and safe) method of extraction coupled with high-performance liquid chromatographic analysis were carried out, and imidacloprid residues were qualitatively confirmed by liquid chromatography-mass spectrometry. Imidacloprid was not detected in samples of fruit juices and baby foods. It was, however, detected in 38 samples of fruits, vegetables, and cereals, which is about 15.20% of the total samples. Of samples of fruits, 22% showed the presence of imidacloprid, and 2% of samples showed residues above the maximal residue limit. Although imidacloprid was detected in 24% of vegetable samples, only 5.71% showed the presence of imidacloprid above the maximal residue limit. However, 33% of cereal samples showed the presence of imidacloprid, and about 3% of samples were above the maximal residue limit. The calculated estimated daily intake ranged between 0.004 and 0.131 µg/kg body weight, and the hazard indices ranged from 0.007 to 0.218 for these food commodities. It is therefore indicated that lifetime consumption of vegetables, fruits, fruit juices, baby foods, wheat, rice, and pulses may not pose a health hazard for the population of Lucknow because the hazard indices for imidacloprid residues were below one.

Insulin Degludec: A Novel Basal Insulin Analogue

OBJECTIVE:

To review the pharmacology, pharmacokinetics, clinical trial data, adverse effects, and potential role in therapy of insulin degludec.

DATA SOURCES:

Articles were identified using the MEDLINE database (January 1996-December 2012). Abstracts and posters were identified from respective congressional websites and published supplements of the American Diabetes Association, the European Association for the Study of Diabetes, and the American Association of Clinical Endocrinologists (January 2008-December 2012). Clinicaltrials.gov was used to identify any ongoing clinical trials or completed trials whose results had not been presented or published.

STUDY SELECTION AND DATA EXTRACTION:

All available studies were reviewed for inclusion; pharmacokinetic studies were limited to those reporting human data.

DATA SYNTHESIS:

Insulin degludec is a novel, ultra-long-acting basal insulin analogue that has a similar safety and efficacy profile when compared with insulin glargine in patients with type 1 or type 2 diabetes. Clinical trials have indicated that there is less hypoglycemia, particularly nocturnal hypoglycemia, associated with this agent.

CONCLUSIONS:

If insulin degludec is approved, it may offer an alternative basal insulin for patients needing more flexible dosing, having a history of nocturnal hypoglycemia, or those with severe insulin resistance needing a higher concentration of basal insulin.

Temporal distribution of fine particulates (PM₂.₅:PM₁₀), potentially toxic metals, PAHs and Metal-bound carcinogenic risk in the population of Lucknow City, India

Ubiquitous fine particulates can readily be bound to toxic metals and polycyclic aromatic hydrocarbons and are considered to be a great threat to human health. The purpose of this study was to assess the magnitude of air pollution risks to public health by determining four crucial parameters- inhalable particulates, metals in particulates and PAHs which are associated with PM₁₀ in the air environment of Lucknow, India during 2007-09. The values of PM₁₀ and PM₂.₅ ranged between 102.3-240.5 and 28.0-196.9 μg/m³ whilst the average PM₁₀ was 1.7 times and PM was 1.5 times higher than their respective NAAQS of 100 and 60 μg/m³ respectively. The estimated relative death rate and hospital admissions for each increase in the PM₁₀ levels of 10 μg/m³ ranged from 1.5-8% and from 3.9-8.0% (as per APHEA2 1990) respectively in persons > 65 yrs. Among the locations; AQ, AQ and AQ (with diversified activities and heavy traffic) recorded higher concentrations of both the particulate fractions than the AQ (residential area with low traffic). The average concentrations of Fe, Pb, Ni, Cu, Cr, Cd in PM₁₀ were 219.4, 40.6, 35.1, 27.3, 22.2 and 16.2 ng/m³ and that in PM₂.₅ were 54.3, 33.9, 38.5, 29.4, 8.4, and 1.17 ng/m³ respectively Regression analysis revealed that correlation of metals with PM₂.₅ was stronger than PM. The ratio of metals adsorbed on surface of particles (PM₂.₅:PM₁₀) reveals that PM₂.₅ has more affinity for Ni, Cu and Pb and PM₁₀ for Cd, Fe and Cr. Health risk due to carcinogenic metals bound to respirable particulates was predicted by estimating excess cancer risk (ECR). The highest ECR value was estimated for Cr, 266.70 × 10⁻⁶, which was associated with PM10 and 100.92 × 10⁻⁶ which was associated with PM₂.₅, whereas lead has the lowest ECR value. Amongst PAHs, benzo(a)pyrene (51.96 ± 19.71 ng/m) was maximum in PM₁₀ samples. Maximum concentrations of PM₁₀, PM₂.₅, metals and PAHs were detected during winter, and the lowest was during monsoon. The higher prevalence of diseases among the population may be due to high concentration of particulates coated with toxic metals and PAHs present in air environment.

Physiological attributes of lichen, Phaeophyscia hispidula in heavy metal rich sites of Dehra Dun, India

Phaeophyscia hispidula (Ach.) Moberg, foliose lichen is widespread in Garhwal Himalayas and grows luxuriantly on different substratum in polluted as well as non polluted sites, where no other macrolichens are able to colonize. The elemental concentration and biochemical parameters in P. hispidula collected from Dehra Dun city were analyzed to assess its tolerance to heavy metals. The major source of pollution in the city is automobiles. Among the biochemical parameters protein was significantly and negatively correlated with pigment concentrations (r = -0.3838 (Chl.b); -0.5809 (Carotenoid); -0.5034 (OD)) however it is significantly positively correlated with Cd (r = 0.6822: P < 0.01). Among heavy metals, Cd was negatively correlated with Cu (r = -0.4639), Fe (r = -0.2676), and Zn (r = -0.0549). It was observed that the chlorophyll and protein content increased parallel to the level of metallic pollutants indicating the mechanism of stress tolerance in P. hispidula. The study shows that P. hispidula is tolerant to inorganic pollution and a useful tool for biomonitoring of air quality in the Himalayan region.

An unusual presentation of gestational thrombocytopenia

Thrombocytopenia is classically defined as a platelet count of less than 150 000/µl. Counts from 100 000 to 150 000/µl are considered mildly depressed, 50 000 to 100 000/µl moderately depressed, and less than 50 000/µl severely depressed. Thrombocytopenia occurs in about 10% of pregnant women. Gestational thrombocytopenia (GT) is a diagnosis of exclusion and considered the most prevalent cause of thrombocytopenia in pregnancy. GT accounts for almost 75% of cases of thrombocytopenia in pregnancy. The cause of GT is unclear, although existing studies denote the possibility of accelerated platelet consumption and the increased plasma volume during pregnancy. The presence of antiplatelet antibodies is not specific to GT. The degree of thrombocytopenia in GT is usually mild to moderate, usually remaining greater than 70 000/µl. Patients are asymptomatic with no evidence of bleeding and rarely preconception history of thrombocytopenia. The platelet count returns to normal within 2-12 weeks post partum. We wish to report a unique case of GT presenting as blurred vision due to retinal hemorrhages.

Evaluation of in vitro aldose reductase inhibitory potential of different fraction of Hybanthus enneaspermus Linn F. Muell

OBJECTIVE

To evaluate the aldose reductase inhibitory (ARI) activity of different fractions of Hybanthus enneaspermus for potential use in diabetic cataract.

METHODS

Total phenol and flavonoid content of different fractions was determined. ARI activity of different fractions in rat lens was investigated in vitro.

RESULTS

The results showed significant level of phenolic and flavonoid content in ethyl acetate fraction [total phenol (212.15±0.79 mg/g), total flavonoid (39.11±2.27 mg/g)] and aqueous fraction [total phenol (140.62±0.57 mg/g), total flavonoid (26.07±1.49 mg/g)] as compared with the chloroform fraction [total phenol (68.56±0.51 mg/g), total flavonoid (13.41±0.82 mg/g)] and petrolium ether fraction [total phenol (36.68±0.43 mg/g), total flavonoid (11.55±1.06 mg/g)]. There was a significant difference in the ARI activity of each fraction, and it was found to be the highest in ethyl acetate fraction [IC50 (49.26±1.76 µg/mL)] followed by aqueous extract [IC50 (70.83±2.82 µg/mL)] and it was least in the petroleum ether fraction [IC50 (118.89±0.71 µg/mL)]. Chloroform fraction showed moderate activity [IC50 (98.52±1.80 µg/mL)].

CONCLUSIONS

Different fractions showed significanct amount of ARI activity, where in ethyl acetate fraction it was found to be maximum which may be due to its high phenolic and flavonoid content. The extract after further evaluation may be used in the treatment of diabetic cataract.

Rinodina sophodes (Ach.) Massal.: a bioaccumulator of polycyclic aromatic hydrocarbons (PAHs) in Kanpur City, India

The aim of this study is to determine the possibility of using Rinodina sophodes (Ach.) Massal., a crustose lichen as polycyclic aromatic hydrocarbons (PAHs) bioaccumulator for evaluation of atmospheric pollution in tropical areas of India, where few species of lichens are able to grow. PAHs were identified, quantified and compared to evaluate the potential utility of R. sophodes. The limit of detection for different PAHs was found to be 0.008-0.050 μg g( - 1). The total PAHs in different sites were ranged between 0.189 ± 0.029 and 0.494 ± 0.105 μg g( - 1). The major sources of PAHs were combustion of organic materials, traffic and vehicular exhaust (diesel and gasoline engine). Significantly higher concentration of acenaphthylene and phenanthrene indicates road traffic as major source of PAH pollution in the city. Two-way ANOVA also confirms that all PAHs content showed significant differences between all sampling sites (P 1%). This study establishes the utility of R. sophodes in monitoring the PAHs accumulation potentiality for development of effective tool and explores the most potential traits resistant to the hazardous environmental conditions in the tropical regions of north India, where no such other effective way of biomonitoring is known so far.

Multiple approaches to evaluate the toxicity of the biomass fuel cow dung (kanda) smoke

Cow dung (Kanda) is a major source of energy in rural and urban population of developing countries and is burnt in traditional open stoves in confined space of kitchen without proper ventilation. In epidemiological studies, biomass fuel smoke has been reported to be responsible for several respiratory disorders in exposed population. In a laboratory experiment, female wistar rats were exposed to kanda smoke for 60 min/day over a period of 12 weeks. Chemical analysis of smoke showed the presence of PAHs. The increase in CYP1A1, GST-ya, GST-yc expression was found in 12 week exposed lung tissues as compared with controls. The exposure to smoke resulted in significant alteration in the BALF cells in the form of clustering of alveolar macrophages and giant cell formation with vacuolated cytoplasm. The macrophages also showed thickness and villi like projections on the cell surface thus reducing their phagocytic activities. Histopathological changes in lung tissue were manifested in the form of damage to bronchiolar epithelium, edema and thickening of alveolar septa and emphysema after 4 and 8 week of exposure. These findings suggest that exposure to kanda smoke increases pulmonary tissue damage and may result in various forms of respiratory infections in the exposed popultion.

Assessment of association of exposure to polycyclic aromatic hydrocarbons with bronchial asthma and oxidative stress in children: A case control study

Background:

Polycyclic aromatic hydrocarbons (PAH) originate from the incomplete combustion of organic matter and ambient air pollution by these is increasing. There is also an increase in the global prevalence of asthma, for which environmental pollution has been recognized as one of the important factors. Exposure to pollutants and other allergens induces chronic airway inflammation by generation of reactive oxygen species, causing oxidative stress. Therefore, the objective of the present study was to assess association, if any, between exposure to PAH and asthma as well as oxidative stress in children.

Method:

In this hospital-based case control study, cases of bronchial asthma aged 1–14 years and healthy matched controls were included. Oxidative stress was measured by assessing the levels of enzymes catalase, superoxide dismutase, malondialdehyde (MDA), and reduced glutathione (GSH).

Results:

Forty-two cases and 20 controls were enrolled. Mean blood level of phenanthrene, a PAH, was 63.11 ppb ± 115.62 and 4.20 ppb ± 10.68 ppb in cases and controls, respectively (P = 0.02). Mean blood levels of GSH was significantly lower in cases and controls (27.39 μg/ml ± 11.09 versus 47.39 g/ml ± 13.83; P-value = 0.001). Likewise, mean blood level of MDA in nanomole/ml was significantly higher in asthma as compared with controls (12.85 ± 5.40 versus 8.19 ± 5.16; P-value = 0.002), suggestive of increased oxidative stress.

Conclusions:

Because elevated blood level of phenanthrene is associated with bronchial asthma as well as with oxidative stress, measures to reduce exposure to PAH may possibly lead to reduced incidence and severity of bronchial asthma.

Childhood blindness and severe visual impairment in Malaysia: a nationwide study

AIM

To determine the causes of childhood blindness and severe visual impairment (BL/SVI) in schools for the blind in Malaysia.

METHODS

All children ≤ 15 years attending 24 schools for the blind throughout the country were examined using the WHO Prevention of Blindness Programme (WHO/PBL) eye examination record for children, and visual loss was classified according to the International Classification of Disease (ICD).

RESULTS

In all, 469 children were examined, of whom 448 (95.6%) had BL/SVI. The major causes of visual loss were retinal disorders (n=148, 33%; mainly retinopathy of prematurity (n=78, 17.4%)), cataract/pseudophakia/aphakia (n=77, 17.2%), and anomalies affecting the whole globe. (n=86, 19.2%). The major underlying etiology was undetermined (n = 193, 43.1%), followed by hereditary factors, 21.7% (mainly retinal dystrophies), and perinatal factors, 20.5%. More than 34 (7.6%) cases were considered potentially preventable and 192 (42.9%) potentially treatable.

CONCLUSION

Diseases of the retina are the major cause of visual impairment, with retinopathy of prematurity being an important avoidable cause. This reflects expansion of neonatal services in Malaysia, and improved survival of very low birth weight and preterm babies. Lens-related causes of visual impairment reflect the need to further improve pediatric ophthalmology services in Malaysia.

Blood levels of Polycyclic Aromatic Hydrocarbons in Women with Benign and Malignant Breast Lesions: A case-control study

Objective: As part of our program to investigate the possible role of environmental pollutants in the incidence of breast cancer in India, we conducted for the first time a hospital based case-control study where blood polycyclic aromatic hydrocarbons (PAHs) levels were determined in women suffering from benign and malignant breast lesions, and compared with those of disease free controls drawn from similar socioeconomic environment residing in and around New Delhi, India. Material & Methods: Anthracene, phenanthrene, fluoranthene, naphthalene, pyrene, benzo (a) pyrene, benzo (k) fluoranthene and dibenzo (a,h) anthracene were determined by HPLC-FD. Results: Level of total PAHs in control, benign and malignant groups (30 numbers in each) were 142.05 ± 50.84, 185.99 ± 61.97 and 200.74 ± 55.05 μg / L respectively. Mean levels of naphthalene, phenanthrene, pyrene and benzo (k) fluoranthene were higher in both malignant and benign groups than in control but the difference was not statistically significant. Of the total PAHs, 3–ringed compounds were found much higher (89%) in controls than in benign (52%) and malignant groups (54%). However, the percentage sum of 2, 4 and 5-ringed PAHs were much higher in malignant (46%) and benign (48%) groups when compared with those of controls (11%). Conclusion: Results of the present study indicate that higher levels of PAHs (especially non-carcinogenic), though statistically non-significant, were present in cases with benign and malignant breast lesions than in those of controls. Key Words: Polycyclic Aromatic Hydrocarbons; Breast cancer; Benign lesions; HPLC-FD  DOI: 10.3126/ajms.v1i2.2924Asian Journal of Medical Sciences 1 (2010) 80-86

Wound healing activity of Withania coagulans in streptozotocin-induced diabetic rats

CONTEXT

Withania coagulans Dunal. (Solanaceae) has been shown to possess hypoglycemic, free radical scavenging and wound healing activity. Therefore, it may be worthwhile to study the effect of Withania coagulans in diabetic wound healing.

OBJECTIVE

This study included determination of rate of wound contraction and estimation of various biochemical parameters such as collagen, hexosamine, total protein, total DNA, SOD and CAT levels in the granulation tissues.

MATERIALS AND METHODS

The hydroalcoholic fraction of the methanolic extract (standardized by withaferin-A using high performance thin layer chromatography (HPTLC) )of Withania coagulans in the form of 10% w/w ointment topically and at a dose of 500 mg/kg per oral (p.o.) was administered to streptozotocin-induced diabetic rats. The results obtained were compared with diabetic control and Aloe barbadensis Miller (syn. Aloe vera L.) (Liliaceae) was used as a reference drug.

RESULTS

The amount of withaferin-A present in the methanolic extract was 3.67 mg/g of the extract. The hydroalcoholic fraction in both the forms, i.e., topical (10% w/w ointment) and oral (500 mg/kg, p.o.) showed a significant increase in the rate of wound contraction (83.02% topical and 65.14% oral) topical and 93.18% oral) when compared to diabetic control (66 which was further justified with significant increase in the levels of collagen, protein, DNA, SOD, CAT, and decreased level of hexosamine.

DISCUSSION AND CONCLUSION

The hydroalcoholic fraction of Withania coagulans in oral form is found to be more effective than the topical form. However, further studies are in progress to find the lead molecules responsible for the wound healing effect.

Face mask application as a tool to diminish the particulate matter mediated heavy metal exposure among citizens of Lucknow, India

Traffic related fine particulate emissions, enriched in metal contents, are directly linked to respiratory disorders in human subjects. In view of the growing traffic related emissions in India, the present study was undertaken to estimate the heavy metal exposure among non-occupationally exposed two vehicle riders of Lucknow City and related health effects via application of face masks (FMs) fitted with cellulose nitrate filters and measuring the peak respiratory flow rate (PEFR). Carefully selected 200 volunteers (asymptomatic n=154 and symptomatic n=46) were advised to use FMs during their deriving time for 30 days and PEFR test was conducted on each subject at the beginning, i.e. 0 day, and at end of the study period, i.e. 30 days. On completion of the prescribed study period, filters from the used FMs were collected, acid leached and analyzed for Fe, Mn, Cu, Zn, Pb, Ni, Cr and Cd. Asymptomatic and symptomatic subject groups were further divided into two age groups of 15-40 years and 41-68. Pb, Cu and Cd were significantly higher in lower age group (15-40) of symptomatic group and Cr was in asymptomatic group. Negative associations were observed between metals viz. Pb (r=-0.39, p<0.001), Cd (r=-0.26, p<0.001), Fe (r=-0.37, p<0.001), Mn (r=-0.15, p<0.05) and the lung functioning. 30 days PEFR of all subjects were higher by nearly 10% than 0 day in all 200 samples irrespective of age and symptomatic nature of the subject. The improvement could also be due to metals and other organic species, not analyzed herein. Nevertheless the results indicate that FM usage has a role to play for immediate, if not ultimate, improvement in public health and need further studies.

Modification of Sheep Plasma Kininogen by Free Radicals

Riboflavin sensitized photodynamic modifications of high molecular weight Kininogen (HMWK) isolated from sheep (Avis-arias) plasma leads to inactivation of antiproteinase activity and formation of aggregated products. A continued disappearance of the inhibitory activity towards papain and formation of high molecular weight adducts was observed with increasing concentration of riboflavin and varying time periods of incubation reaching a maximum value of over 85% (loss in activity). Aggregates resisted dissociation upon heating at 100 degrees C in 1% SDS. Aggregation and photoinactivation of HMWK was promoted by the substitution of H2O for deuterium oxide (D2O), which is known to prolong the life span of singlet oxygen, and suppressed by sodium azide a known singlet oxygen quencher. Mannitol and thiourea (hydroxyl radical scavenger) did not protect the antiproteinase activity of HMWK. Treatment with reducing agent resulted in decrease of the aggregated products suggesting the possible involvement of disulfide linkages in protein crosslinking. Tryptophan fluorescence was completely lost and significant production of dityrosine was detected in photoinactivated HMWK aggregates. Changes in the far Ultra violet circular dichroism (u.v.c.d.) spectrum of HMWK was indicative of loss of secondary structure. Analysis of modifications induced in HMWK by riboflavin reveals that the processes proceed via a singlet oxygen mediated pathway. It is concluded that the susceptibility of HMWK to oxidation may arise from oxidative modifications by reactive oxygen species generated in plasma.

The level of polyaromatic hydrocarbons in kajal and surma of major Indian brands

Kajal and surma are eye cosmetics extensively used in Indian subcontinent. Kajal is prepared by burning of vegetable oil and butter oil while surma by grinding of the stones. High performance liquid chromatography and gas chromatography-mass spectrometry instruments were used for quantification and confirmation of 16 polyaromatic hydrocarbons (PAHs). Significant concentration of PAH was found in all the samples examined. The median concentration of PAH ranged from 0.14 (lowest, anthracene) to 31.18 microg g(-1) [dibenz(a,h)anthracene] in kajal sample and from not detectable concentration (naphthalene) to 197.47 microg g(-1) of benzo(a)pyrene in surma sample. Fifteen PAHs were detected in all the samples. Therefore the use of kajal and surma in eye should be strictly restricted.

Isolation and characterization of bacterial strains Paenibacillus sp. and Bacillus sp. for kraft lignin decolorization from pulp paper mill waste

Eight aerobic bacterial strains were isolated from pulp paper mill waste and screened for tolerance of kraft lignin (KL) using the nutrient enrichment technique in mineral salt media (MSM) agar plate (15 g/L) amended with different concentrations of KL (100, 200, 300, 400, 500, 600 ppm) along with 1% glucose and 0.5% peptone (w/v) as additional carbon and nitrogen sources. The strains ITRC S6 and ITRC S8 were found to have the most potential for tolerance of the highest concentration of KL. These organisms were characterized by biochemical tests and further 16S rRNA gene (rDNA) sequencing, which showed 96.5% and 95% sequence similarity of ITRC S(6) and ITRC S(8) and confirmed them as Paenibacillus sp. and Bacillus sp., respectively. KL decolorization was routinely monitored with a spectrophotometer and further confirmed by HPLC analysis. Among eight strains, ITRC S(6) and ITRC S(8) were found to degrade 500 mg/L of KL up to 47.97% and 65.58%, respectively, within 144 h of incubation in the presence of 1% glucose and 0.5% (w/v) peptone as a supplementary source of carbon and nitrogen. In the absence of glucose and peptone, these bacteria were unable to utilize KL. The analysis of lignin degradation products by GC-MS analysis revealed the formation of various acids as lignin monomers which resulted in a decrease in pH and a major change in the chromatographic profile of the bacterial degraded sample as compared to the control clear indications of biochemical modification of KL due to the bacterial ligninolytic system by ITRC S(6), namely, acetic acid, propanoic acid, butanoic acid, guaiacol, hexanoic acid, and ITRC S(8), namely acetic acid, propanoic acid, ethanedioic acid, furan carboxylic acid, 2-propanoic acid, butanoic acid, 3-acetoxybutyric acid, propanedioic acid, acetoguiacone, 1,2,3-thiadiazole, 5-carboxaldixime, 4-hydroxy-3,5-dimethoxyphenol, and dibutyl phthalate, indicating the bacterium characteristic to degrade G and S units of lignin polymer.

Investigation of the biotransformation of pentachlorophenol and pulp paper mill effluent decolorisation by the bacterial strains in a mixed culture

Mixed culture of two bacterial strains Bacillus sp. and Serratia marcescens showed potential pentachlorophenol (PCP) degradation and decolorisation of pulp paper mill effluent. The physico-chemical quality of pulp paper mill effluent has been analyzed after 168 h incubation period degraded by mixed culture. The study revealed that it has decreased high load of BOD, COD, TS, TDS, TSS, sulphate, phosphate, total nitrogen, total phenols, metals and different salts (i.e. chloride, sodium, nitrate, potassium) at 168 h incubation period. PCP degradation in pulp paper mill effluent was confirmed by HPLC analysis. Mixed culture was found to degrade PCP up to (94%) present in pulp paper mill effluent with 1% glucose and 0.5% peptone (w/v) at 30+/-1 degrees C, pH 8.0+/-0.2 at 120 rpm in 168 h incubation period. The simultaneous release of chloride ion up to 1,200 mg/l at 168 h emphasized the bacterial dechlorination in the medium. The pulp paper mill effluent degradation was also supported by decline in pH, AOX (absorbable organic halides), color, D.O., BOD, COD and PCP. The analysis of pulp paper mill effluent degradation products by GC-MS analysis revealed the formation of low molecular weight compound like 2-chlorophenol (RT=3.8 min) and tetrachlorohydroquinone (RT=11.86 min) from PCP extracted degraded sample. Further, mixed culture may be used for bioremediation of PCP containing pulp paper mill waste in the environment.