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Table of Contents
July-December 2011
Volume 1 | Issue 2
Page Nos. 89-208
Online since Tuesday, August 23, 2011
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EDITORIAL
Invited editorial
p. 89
Mushtaq A Memon
DOI
:10.4103/2231-0738.84185
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REVIEW ARTICLES
Colocasia esculenta
: A potent indigenous plant
p. 90
Rakesh Prajapati, Manisha Kalariya, Rahul Umbarkar, Sachin Parmar, Navin Sheth
DOI
:10.4103/2231-0738.84188
Colocasia esculenta
(CE) Linn. (Family: Araceae) is an annual herbaceous plant with a long history of usage in traditional medicine in several countries across the world, especially in the tropical and subtropical regions. The herb has been known since ancient times for its curative properties and has been utilized for treatment of various ailments such as asthma, arthritis, diarrhea, internal hemorrhage, neurological disorders, and skin disorders. The juice of CE corm is widely used for treatment of body ache and baldness. A wide range of chemical compounds including flavonoids, β-sitosterol, and steroids have been isolated from this species. Extracts from this plant have been found to possess various pharmacological activities. This contribution provides a comprehensive review of its ethnomedical uses, chemical constituents, and the pharmacological profile as a medicinal plant. Particular attention has been given to analgesic, anti-inflammatory, anti-cancer, and hypolipidemic effects presented in this review in order to evaluate the potential use of this plant in pharmaceuticals.
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Counterfeit herbal medicine
p. 97
AR Mullaicharam
DOI
:10.4103/2231-0738.84191
The mass production of fake and substandard medications is growing global problems with deleterious impact on the individuals who ingest them. Estimates of the scale of the global trade in counterfeit medications vary widely. According to the Food and drug administration (FDA), 6%-10% of medicines sold worldwide are counterfeit. The use of herbal remedies, neutraceuticals, and dietary supplements has increased greatly over the past 40 years. Much of the increase in use can be attributed to the common belief that natural ingredients are inherently safer and healthier than synthetic ingredients. Products sold as ''dietary supplements'' are subject to significantly less regulation and are often not required to have safety testing or FDA approval before they enter the market. Without adequate safeguards and quality control mechanisms, there is no assurance that the concentrations of active ingredient are consistent from batch to batch or even that these supplements contain the ingredients they purport to contain. Professional regulation must be open, responsive, and accountable with the emphasis on both the protection of patients and the public rather than being based exclusively on the needs of practitioners. Pharmacists have a responsibility to educate themselves about herbal therapies in order to help patients discern the facts from the fiction, avoid harm, and gain what benefits may be available. Pharmacists must also cope with an environment in which there is relatively little regulation of herbal therapies by FDA.
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Nanoparticles in drug delivery system
p. 103
AR Mullaicharam
DOI
:10.4103/2231-0738.84194
The pharmaceutical field has long been a model for industry, creating best practices in Research and Development, manufacturing, marketing and other disciplines. As such, it also has recorded historic levels of profitability. But an evolving marketplace, changing regulatory standards, increased manufacturing costs and a number of other factors have begun exerting pressure on pharmaceutical producers. One of the bright spots for the industry is nanoparticles technologies, which offer seemingly unlimited potential to help solve health problems and thus grow the pharmaceutical business. In recent years, various nanotechnology platforms in the area of medical biology, including both diagnostics and therapy, have gained remarkable attention. This paper explores the potential success of these particles in the clinic, which relies on consideration of important parameters such as nanoparticles fabrication strategies, their physical properties, drug loading efficiencies, drug release potential, and various therapeutic applications.
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Chemistry and pharmacology of caffeine in different types of tea leaves
p. 110
Nirmala Amaresh, AR Mullaicharam, Mohanned Abdueghafour El-Khider
DOI
:10.4103/2231-0738.84198
"Shai" is the Arabic noun for the English word tea. This substance is widely consumed by the Asian continent initially and later spread out to the rest of the world. The Arabs have another drink which is as popular known "Kahwa" which is coffee in English. The two ways of serving tea in coffee shops and restaurants is either by tea bags which is then dipped in the boiling water for its content to diffuse throughout the water content, or by brewing the loose leafs and serving it. This review article focused on chemistry and pharmacology and various methods of preparation of caffeine in different types of tea leaves.
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Effect of metformin combined therapy in patients with polycystic ovary syndrome
p. 116
Dhanalakshmi Ganesan, Sumathi Palaniswamy, Pasupathy Palanisamy, Babu Shankar Ponnusha, Ambika Athimoolam
DOI
:10.4103/2231-0738.84201
Polycystic ovary syndrome (PCOS) is a common and heterogeneous disorder of women of reproductive age, characterized by hyperandrogenism and chronic anovulation. Metformin may lower the androgen level in follicular fluid, affecting local levels of IGF (Insulin like growth factor)s, and may produce improved ovarian stimulation. Metformin is used in PCOS cases in order to decrease plasma luteinizing hormone (LH), hyperinsulinemia, and ovarian androgen levels. Metformin increases the ovulatory rate, cervical scores and pregnancy rate. This review article focuses on the combined effect of metformin administration in PCOS patients.
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Adverse effects of botulinum neurotoxin A in spasticity management
p. 126
Tapan N Joshi, Sonal Joshi
DOI
:10.4103/2231-0738.84202
Over the last few decades, Botulinum neurotoxin has evolved from a well-publicized public health threat of food-borne illness, due to contaminated foods, to a widely used therapeutic measure. Botulinum neurotoxin A is one of the seven distinct neurotoxins produced by Clostridium botulinum. The mechanism of action is to block the transmission of overactive nerve impulses to the targeted muscle by selectively preventing the release of the neurotransmitter acetylcholine at the neuromuscular junction. Its efficacy is evident in the treatment of both adults and children with spasticity of various causes. It is considered a safe therapy with most of the adverse events being self-limited and transient. Serious side effects like unwanted muscle weakness and suboptimal response to therapy mainly due to antibody formation are uncommon, but possible. This article gives an in-depth review of the possible adverse effects of botulinum toxin A and their pathogenesis for spasticity management. Physicians should carefully perform a detailed clinical assessment of every patient individually, for a benefit-risk profile, while making treatment decisions, to prevent such adverse events.
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Process advantages and product benefits of interesterification in oils and fats
p. 134
Mohammad Asif
DOI
:10.4103/2231-0738.84203
The physical properties of oils and fats depend on their chemical properties, such as unsaturation, saturation, chain length, and distribution of the three hydroxyl groups of glycerol in the fatty acids. These characteristics change by hydrogenation, fractionation, blending, and interesterification (IE), hence improving the spectrum for the application of the oils and fats. IE is a process where the fatty acids have been moved from one triglyceride molecule to another and it does not alter the fatty acids. IE (chemical and enzymatic) is used to deal with the problems of plastic fat products such as granular development, texture breakdown, lumpy appearance, post hardening, consistency, melting point, and rancidity and create oil more suitable for deep frying or making margarine with good taste and low content of saturated fatty acids, etc. Nutritionally, IE contributes in eliminating or reducing trans fatty acids, providing a higher essential fatty acid activity. Trans and hydrogenated fats increase the coronary heart disease risk factors.
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ORIGINAL ARTICLES
1-methyl 4 -phenyl 1,2,3,6-tetrahydropyridine is a potent neurotoxin: Gamma-tocopherol recuperate behavior, dopamine, and oxidative stress on Parkinsonic mice
p. 139
Kalaivani Karunanithi, Anandhan Annadurai, Mohankumar Krishnamoorthy, Preetham Elumalai, Tamilarasan Manivasagam
DOI
:10.4103/2231-0738.84204
Aim
: The present study was designed to investigate the neuroprotective effect of gamma-tocopherol on MPTP induced Parkinsonic mice.
Materials and Methods:
Oral administration of γ-tocopherol (48 mg/kg BW) in C57BL/6 mice for seven days. Parkinson's disease was induced by four intraperitoneal injections (from 4th to 7th day) of MPTP (30 mg/kg BW). On the end of experiment (8th day), behavioral studies were performed to understand motor skill abnormalities and then animals were sacrificed to procure midbrain and striatum. Subsequently, homogenized and centrifuged to get postmitochondrial supernatant which was used to assay a) Neurochemical -- Dopamine, DOPAC, HVA b) Biochemical -- TBARS, GSH, GPx, SOD, and Catalase.
Results:
Pretreatment of γ-tocopherol (48 mg/kg BW) significantly attenuated the MPTP induced behavioral (rotarod performance, open field test, narrow beam walk test and hang test), neurochemical, biochemical alterations in mice suggesting their free-radical scavenging potential.
Conclusions:
Our results demonstrate that γ-tocopherol confers potent neuroprotection against MPTP-induced toxicity of dopaminergic neurons, and may become a potential therapeutic strategy for neurodegenerative disorder such as Parkinson's disease.
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Tephrosia purpurea
Linn leaves attenuate pain and inflammation in experimental animals
p. 146
Vishal Gulecha, Thangavel Sivakumar, Aman Upaganlawar, Rakesh Khandare, Chandrashekhar Upasani
DOI
:10.4103/2231-0738.84205
Aim
: Present study evaluates the analgesic and anti-inflammatory activities of different fractions of
Tephrosia purpurea
using various experimental models.
Materials and Methods:
The analgesic activity of
T. purpurea
carried out using acetic acid-induced writhing in mice and tail flick test in rats. The anti-inflammatory activity was evaluated using carrageenan-induced rat paw edema and cotton pellet-granuloma formation in rats. The effects of the administration of reference standard (Ibuprofen and hydrocortisone) were also evaluated.
Results:
Five different fractions (TPI, TPII, TPIII, TPIV, and TPV) of
T. purpurea
at the dose level of 20 and 40 mg/kg, p.o. were tested. The fraction TPI (40 mg/kg, p.o.) and TPIII (40 mg/kg, p.o.) were found to be more effective in preventing carrageenan induced rat paw edema, cotton pellet granuloma formation and acetic acid-induced writhing; however, TPI (20 mg/kg, p.o.) and TPIII (20 mg/kg, p.o.) were found to be more effective in increasing latency period in tail flick method.
Conclusions:
Out of five different fractions of
T. purpurea
tested, TPI and TPIII possess potent analgesic and anti-inflammatory activities against different models of inflammation and pain.
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Antidepressant like activity of
Lagenaria siceraria
(Molina) Standley fruits by evaluation of the forced swim behavior in rats
p. 152
Rakesh Prajapati, Rahul Umbarkar, Sachin Parmar, Navin Sheth
DOI
:10.4103/2231-0738.84206
Context
: In current stressful routine life, depression has become the second most common chronic condition in clinical psychology practice.
Lagenaria siceraria
(Molina) Standley (LS), commonly known as ''bottle gourd'' (English), possesses several medicinal properties; little is known about its traditional use as nerve tonic.
Objective:
The purpose of the study was to evaluate the antidepressant activity of methanolic extract of
Lagenaria siceraria
(Molina) Standley fruits (MLSF) using forced swim (behavior despair) models.
Materials and Methods:
LS fruit slices were dried and extracted with methanol in Soxhlet apparatus for 5-6 h. Adult Wistar albino rats were subjected to behavior despair test. Imipramine was used as reference standard drug.
Results and Discussion:
The MLSF (50, 100, and 200 mg/kg, p.o.) showed dose-dependent significant reduction in duration of immobility (
P
< 0.01) in behavior despair test. The phytochemical screening revealed the presence of phytoconstituents, such as flavonoids, saponins, and sterols in the fruits.
Conclusions:
The results of the study for show that the plant possesses antidepressant activity, confirming the traditional claims. Future research should focus on the isolation and identification of the phytoconstituents responsible for the antidepressant activity of LS .
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Studies on the nutritional supplement of mulberry leaves with Cowpeas (
Vigna unguiculata
) to the silk worm
Bombyx mori
(L) (Lepidoptera: Bombycidae) upon the activities of midgut digestive enzymes
p. 157
Saravanan Manjula, Selvi Sabhanayakam, Veeranarayanan Mathivanan, Nadanam Saravanan
DOI
:10.4103/2231-0738.84207
Aim
: To evaluate the changes in the activities of midgut digestive enzymes activities of silkworm fed with mulberry leaves supplemented with Cowpeas (
Vigna unguiculata
).
Materials and Method:
Finely powdered
Vigna unguiculata
was dissolved in distilled water and diluted to 2.5%, 5%, 7.5%, and 10% concentrations. Fresh mulberry leaves (
Morus alba L.
) were sprayed by each concentration and were fed to silkworms, from third to fifth instar, five feedings/day. Group 1 larvae received mulberry leaves sprayed with distilled water and served as control, group 2 larvae received 2.5%
Vigna unguiculata
sprayed mulberry leaves, group 3 larvae received 5%
Vigna unguiculata
sprayed mulberry leaves, group 4 larvae received 7.5%
Vigna unguiculata
sprayed mulberry leaves and group 5 larvae received 10%
Vigna unguiculata
sprayed mulberry leaves.
Result:
Silkworm larvae fed on
Morus alba L.
(mulberry) leaves enriched with 7.5% concentrations of
Vigna unguiculata
, significantly gained more pupa weight, silk length and silk weight as compared to those fed on normal MR
2
mulberry leaves. Hence, 7.5% dose was fixed as an effective dose. Further, same study was conducted to find out the changes in the digestive enzymes activities in the midgut occurred in the fourth day of fourth instar larvae. There was a significant increase in the midgut urease, amylase, sucrase, and protease activities. But midgut trehalase activity was significantly decreased.
Conclusions:
The results suggest that supplementation of
Vigna unguiculata
with mulberry leaves at a concentration of 7.5% has enhanced the digestion of ingested food which in turn reflects in the quantity of silk produced.
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Effect of N-phthaloyl gamma-aminobutyric acid on lipid peroxidation, antioxidants and liver markers in constant light exposed rats
p. 163
Selvaraju Subash, Perumal Subramanian
DOI
:10.4103/2231-0738.84208
Introduction & Materials and Methods
: The effect of N-Phthaloyl GABA on the levels of circulatory lipid peroxidation products such as TBARS (thiobarbituric acid reactive substances), antioxidants: SOD (superoxide dimutase), CAT (catalase), GSH (reduced glutathione), and GPx (glutathione peroxidase), liver markers such as AST (aspartate transaminase), ALT (alanine transaminase), and ALP (alkaline phosphatase), were studied for its protective effect during constant light (LL) exposure in rats.
Results:
A significant increase in the levels of circulatory TBARS, AST, ALT, and ALP were found in LL exposed rats. These changes were significantly decreased in N-Phthaloyl GABA and LL-exposed rats. The levels of antioxidants were significantly decreased in LL-exposed rats and administration of GABA normalized these changes.
Conclusions:
Our results indicated that NPhthaloyl GABA offered protection by influencing the levels of the lipid peroxidation products, antioxidants, and liver markers during LL-exposed stress. This might be due to the antistress, anticonvulsant, antinociceptive, and antiulcer activities of N-Phthaloyl GABA. The exact mechanism remains to be explored and further research is needed.
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Coumarin protects 7,12-dimethylbenz(a)anthracene-induced genotoxicity in the bone marrow cells of golden Syrian hamsters
p. 167
Nagarethinam Baskaran, Duraisamy Rajasekaran, Shanmugam Manoharan
DOI
:10.4103/2231-0738.84209
Aim
: Aim of the present study was to evaluate the antigenotoxic effect of coumarin by measuring the frequencies of micronuclei and the degree of DNA damage in the bone marrow cells of hamster treated with 7,12-dimethylbenz(a)anthracene (DMBA).
Materials and Methods:
Genotoxicity was induced in experimental hamsters by single intraperitoneal injection of DMBA (30 mg/kg b.w.). The frequency of micronucleated polychromatic erythrocytes (MnPCEs) and DNA damage were assessed in the bone marrow cells of experimental hamsters. The status of lipid peroxidation, antioxidants and phase I and II detoxification agents were utilized as biochemical end points to assess the dose-dependent antigenotoxic potential of coumarin in DMBA-induced genotoxicity.
Results:
Increase in micronuclei frequency was accompanied by increase in tail length, percent of tail DNA, tail movement and olive tail movement in the bone marrow cells of hamsters treated with DMBA alone. A significant increase in the levels of thiobarbituric acid reactive substances, antioxidants and phase I and II detoxification agents were also noticed in hamsters treated with DMBA alone. Oral pretreatment of coumarin at a dose of 100 mg/kg b.w to hamsters treated with DMBA significantly decreased the frequency of MnPCEs and DNA damage in the bone marrow cells. Also, coumarin restored the status of biochemical variables in the plasma and liver of hamsters treated with DMBA.
Conclusions:
Present study demonstrated the antigenotoxic effect of coumarin in DMBA-induced genotoxicity. The antigenotoxic potential of coumarin is probably due to its antioxidant potential and modulating effect on detoxification cascade during DMBA-induced genotoxicity.
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Impact of morin (a bioflavonoid) on ammonium chloride-mediated oxidative damage in rat kidney
p. 174
Selvaraju Subash, Perumal Subramanian
DOI
:10.4103/2231-0738.84210
Introduction
: Hyperammonemia is a major contributing factor to neurological abnormalities observed in hepatic encephalopathy and in congenital defects of ammonia detoxification. Ammonia toxicity results in free radical generation that leads to oxidative stress and tissue damage. Morin is a bioflavonoid, a constituent of many herbs and fruits that are used as herbal medicines and also several biological activities. Our aim is to investigate the effect of morin on blood ammonia and plasma urea as well as kidney lipid peroxidation, and the antioxidant status in ammonium chloride-induced hyperammonemic rats.
Materials and Methods:
Male albino Wistar rats weighing 180 - 200 g were used for the study. Hyperammonemia was induced by interaperitonial injection of ammonium chloride (100 mg / kg body weight). The rats were treated with morin (30 mg / kg body weight) via oral administration. Administration of morin in hyperammonemic rats reduced the levels of ammonia and urea. The antioxidant property of morin was studied by assessing the activities of thiobarbituric acid reactive substances (TBARS), hydroperoxides (HP), conjugated dienes (CD), and antioxidants superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GPx) and reduced glutathione (GSH) in ammonium chloride-treated rats.
Results and Conclusions:
Kidney oxidative stress was effectively modulated by morin administration. Morin significantly improved the status of kidney antioxidants and decreased the levels of ammonia, urea, TBARS, HP, and CD, as compared to the ammonium chloride-treated group. The study offers evidence for the antihyperammonemic and antioxidant effects of morin against oxidative stress in the kidney, induced by ammonium chloride.
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A pathomorphological study of the sublethal toxicity of cypermethrin in Sprague Dawley rats
p. 179
Remya R Nair, Mammen J Abraham, CR Lalithakunjamma, N Divakaran Nair, CM Aravindakshan
DOI
:10.4103/2231-0738.84211
Introduction
: A study was undertaken to investigate the potential toxic effects of cypermethrin in adult Sprague Dawley male rats, with particular emphasis on its effect on the nervous and digestive systems.
Materials and Methods:
The clinical signs, gross and histological alterations were analyzed, to study the effects of different doses of cypermethrin.
Results:
Medium and high doses produced nervous signs in animals. Gross lesions were observed in the intoxicated groups, such as, bloat, congestion of lungs, heart, brain, pulmonary haemorrhage, and degenerative changes in the liver and kidneys. Microscopically effects on all organs were mild-to moderate degenerative changes at the low-dose level. Medium- and high-dose intoxicated groups revealed necrotic changes, extensive haemorrhages, congestion in organs like liver, kidney, and lungs apart from the changes observed in low-dose group animals.
Conclusions:
The text to abstract): The present study reveals that cypermenthrin can produce toxic effects in mammals at sublethal doses.
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Prevalence of anemia in the school children of Kattankulathur, Tamil Nadu, India
p. 184
B Sudhagandhi, Sivapatham Sundaresan, W Ebenezer William, A Prema
DOI
:10.4103/2231-0738.84212
Anemia is the most widespread nutrition problem in the world and has predominance in developing countries like India, particularly in children and women. The magnitude of the anemia has been well-documented in pregnant women and infants, however, there is no data on the prevailing occurrence of anemia in school children. The main objective of this study was to estimate the prevalence of anemia and its correlation to variables such as age, gender and body mass index in school children of Kattangulathur, Tamil Nadu, India. A total of 900 children in the age group of 8-16 years were included in this study. Parental consent was obtained in the written format. Blood was collected by finger prick and the hemoglobin was determined by cyanmethemoglobin method. A preplanned questionnaire was used to collect the health details of the children. The children were grouped according to the age. Prevalence of anemia as per the World Health Organization (WHO) recommended cutoff value of hemoglobin, among these children was 52.88%. The frequency of the prevalence of anemia was significantly higher amongst girls as compared to the boys. Results of the study population reveal that 52.88% were anemic, girls (67.77%) were 32.2% higher than the boys (35.55%) and anemic children were underweight. Therefore our study results suggest that all the school children should be screened periodically and appropriate measures should be taken..
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Antihyperglycemic effect of
Coscinium fenestratum
and
Catharanthus roseus
in alloxan-induced diabetic rats
p. 189
Shanmugam Manoharan, S Umadevi, S Jayanthi, N Baskaran
DOI
:10.4103/2231-0738.84213
Introduction
: Diabetes mellitus, the life-threatening endocrine disorder, affects 170 million people worldwide every year. Statistical projections about India suggest that 57 million Indians will be affected by diabetes mellitus by the year 2025, making the country with highest number of diabetics in the world. Alloxan-induced diabetes mellitus in experimental animals is commonly used to evaluate the antidiabetic effect of medicinal plants and their constituents. The present study has investigated the antidiabetic efficacy of ethanolic extract of
Coscinium fenestratum
stem and
Catharanthus roseus
leaves in alloxan-induced diabetic rats.
Materials and Methods:
Diabetes mellitus was induced in overnight fasted (>8 hours) Wistar rats by single intraperitoneal injection of freshly prepared alloxan monohydrate (150 mg/kg bw) solution in physiological saline. The mechanistic pathway for the antidiabetic potential of these plants was evaluated by analyzing the status of glucose, insulin, C-peptide, glycosylated hemoglobin, activities of carbohydrate-metabolizing enzymes, and glycogen content. The antidiabetic effect of these plant products was also compared with the standard reference drug, glibenclamide.
Results:
The study revealed that the ethanolic extract of
C. fenestratum
stem and
C. roseus
leaves have potent antidiabetic efficacy in alloxan-induced diabetic rats. The antidiabetic efficacy was also much comparable with that of glibenclamide.
Conclusions:
The present study concludes that the ethanolic extract of C.
fenestratum
stem and C.
roseus
leaves have potent antihyperglycemic effect in alloxan-induced diabetic rats.
C. fenestratum
and
C. roseus
could therefore be used as an alternative remedy for diabetes mellitus and its complications.
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Clinical and bacteriological spectrum of community-acquired acute bacterial meningitis in adults at a tertiary care hospital in northern India
p. 194
P Madhumita, N Gupta
DOI
:10.4103/2231-0738.84214
Objective
: To evaluate the clinical and bacteriological spectrum of community-acquired acute bacterial meningitis (ABM) in an adult population at Lok Nayak Hospital, New Delhi, a tertiary care hospital in northern India.
Materials and Methods:
Cerebrospinal fluid (CSF) samples from 120 clinically suspected cases of pyogenic meningitis were processed for cell counts, differential counts, bacterial stain and culture, antibiotic susceptibility test, and bacterial antigen detection by latex agglutination test (LAT) in CSF, serum and urine.
Results
: CSF LAT was positive in 56/120 cases of ABM.
Streptococcus pneumoniae
was the predominant pathogen in 41 of these 120 cases i.e. 34.0% of all cases.
Neisseria meningitidis
accounted for 24 cases i.e. 20% of all cases.
Staphylococcus aureus
was isolated in one case. Bacterial cultures were positive in 22 (18.3%) cases only.
Conclusions:
Evidence for presence of microbial activity could be detected in 44.1% cases by LAT, whereas a direct microbiological confirmation could be documented in only 22 cases i.e. 18.3%.
Streptococcus pneumoniae
remains the major etiological agent of ABM in our study. Penicillin resistance was detected in 50% of cases among the isolates which came positive by culture.
Neisseria meningitidis
was detected in 24 cases. But since none were cultured, sensitivity patterns could not be correlated. LAT is a convenient and rapid test to support bacterial etiology in ABM. In remote situations, their use in serum or urine needs to be considered after evaluation in longer studies. Further research should focus on the preventable aspects of ABM, especially pneumococcal and meningococcal vaccines, to potentially protect susceptible groups.
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CASE REPORTS
HoffMann's syndrome: A rare neurological presentation of hypothyroidism
p. 201
K.A.S. Praveen, Sarfaraz Aslam, TK Dutta
DOI
:10.4103/2231-0738.84215
The neurological manifestations of hypothyroidism are very unusual to see as initial symptoms and they usually occur late in the course of disease. Muscle hypertrophy is an extremely rare finding in hypothyroid patients. Hypothyroidism presenting as muscle stiffness and muscle pseudo hypertrophy in adults is known as Hoffmann's syndrome. Laboratory investigation in hypothyroid myopathy generally shows increased levels of muscle enzyme. The electrophysiological study may reveal features suggestive of myopathy, neuropathy or mixed pattern. The symptoms and also the serum levels of enzymes return to normal with hormone replacement therapy. We report a case of hypothyroidism with calf muscle hypertrophy and proximal myopathy as the initial symptoms.
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A rare cause of Guillain-Barre syndrome
p. 204
K.A.S. Praveen, D.K.S. Subrahmanyam
DOI
:10.4103/2231-0738.84216
The Guillain-Barre syndrome (GBS) is an acute, acquired, autoimmune disorder of the peripheral nervous system, triggered by infections and other immunogenic stimuli; however, the exact cause of this disease is not fully understood. The malarial parasite as a cause of GBS is very rare and there are only few reports in the literature. Here, we report a case of acute flaccid quadriparesis with generalized areflexia following malaria caused by
Plasmodium vivax
, which improved with plasmapheresis.
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The magnetic resonance imaging "wine glass" sign of amyotrophic lateral sclerosis
p. 206
Umesh C Parashari, Sachin Khanduri, Samarjit Bhadury, Divyanka Srivastava, Sugandha Saxena
DOI
:10.4103/2231-0738.84217
Amyotrophic lateral sclerosis is a disease of neurons characterized by progressive muscular paralysis due to degeneration of motor neurons in the primary motor cortex, corticospinal tracts, brainstem, and spinal cord. We present the case of a 40-year-old patient having progressive muscle weakness, limb and truncal atrophy, and bulbar signs and with classical finding of "wine glass" appearance on magnetic resonance imaging.
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© International Journal of Nutrition, Pharmacology, Neurological Diseases | Published by Wolters Kluwer -
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Online since 20
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September, 2010