PHYTO-PHARMACOLOGICAL PROPERTIES OF SIDA CORDIFOLIA: A REVIEW OF FOLKLORE USE AND PHARMACOLOGICAL ACTIVITIES

ABSTRACTPlants have been considered to be useful as a medicine for treating different ailments and improving health conditions, since ancient times. Theplants as herbal drugs lay down an important foundation of different, well recognized, ancient, and traditional healthcare systems in India as well asother parts of the world. In India, plants constitute an important and indispensable role in different ancient healthcare systems such as Ayurveda,Siddha, Unani, Naturopathy, and Homeopathy. In Ayurveda system of medicine, one of the Rasayana plants having a great medicinal importance isSida cordifolia belonging to the family Malvaceae. It is an annual undershrub found throughout the tropical and subtropical regions of India. It hasbeen used since ancient times for various ailments in Ayurveda system of medicine. It has numerous folklore uses in different pathological conditions.The plant also reported to possess a number of important pharmacological activities. The present review focused on all these folklore use of this herbalong with its reported pharmacological activities.Keywords: Sida cordifolia, Ayurveda, Parkinson's disease, Analgesic, Anti-inflammatory

Obstetric and neonatal outcomes of the pregnancies complicated with thrombocytopenia

Background: Thrombocytopenia is second most common hematological abnormality in pregnancy after anemia (Incidence 8-10%). The aim of this study is to observe the obstetric and neonatal outcomes of pregnancies complicated with thrombocytopenia and to compare its maternal and fetal outcomes.Methods: The prospective observational study was conducted at tertiary care institute over period of one and half year and 100 cases of thrombocytopenia in present pregnancy were included after fulfilling inclusion and exclusion criteria and obtaining written informed valid consent. Complete history, physical examination and relevant investigations of the patient were documented. Patients were followed up to delivery and outcomes (obstetric, maternal, fetal, neonatal) were studied. The data obtained for all the patients was analyzed with SPSS (SPSS Inc, Chicago) software packages. Statistical comparisons were performed with Pearson’s Chi- square where appropriate with p-value of 37 weeks of gestation. Most (53%) had moderate thrombocytopenia. Incidence of maternal complications was statically significant (P-value 0.038) with most common complication being caesarian section site oozing (9%) followed by placental abruption (4%). There was no statistical significance in degree of thrombocytopenia and need for blood and blood product transfusion (P-value 0.67). Only (2%) neonates of thrombocytopenic mothers had thrombocytopenia and both required treatment.Conclusions: Most common cause of thrombocytopenia in pregnancy was gestational thrombocytopenia with uneventful pregnancy and perinatal outcomes. Few severe cases associated with medical or systematic causes leads to serious catastrophic events which can be avoided by increasing antenatal surveillance and appropriate management by multidisciplinary team of obstetrician, hematologist, anesthesiologist, neonatologist and physician

Evaluation of endometrial causes of postmenopausal bleeding with it's correlation with endometrial thickness and hysteroscopy findings and endometrial tissue histopathology

Background: Postmenopausal bleeding (PMB)accounts for 5% of gynecology visit. All with unexpected uterine bleeding should be evaluated for endometrial carcinoma since this potentially lethal disease is the cause of bleeding in approximately 10 percent patients (range 1 to 25 percent, depending upon risk factors). The aim of the study was to evaluate endometrial causes of postmenopausal bleeding (PMB) with it's correlation with endometrial thickness (ET)and hysteroscopy findings and endometrial tissue histopathology.Methods: A total 50 consecutive cases of PMB fulfilling the inclusion and exclusion criteria and giving informed consent were selected. Each patient was subjected to transvaginal sonography (TVS) in which uterus, adnexa and endometrial thickness (ET) was assessed. Then hysteroscopy and/or dilation and curettage was scheduled at subsequent visit. Endometrial sample was sent for histopathological examination. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and diagnostic accuracy was calculated for ET by TVS and hysteroscopy findings, considering histopathological diagnosis as the gold standard.Results: Most common endometrial cause of PMB was atrophic endometrium (44%). The other causes were endometrial carcinoma (18%), endometrial hyperplasia (18%), endometrial polyp (12%), endometritis (4%), and leiomyoma (4%). The diagnostic accuracy of ET by TVS at a cut-off point of 5 mm was 94% with sensitivity 89.3%, specificity 100%, PPV 100% and NPV 88%. The diagnostic accuracy of hysteroscopy was 98% with sensitivity 96.4%, specificity 100%, PPV 100% and NPV 95.7%.Conclusions: Being relatively cheap, easily accessible, non-invasive, TVS with ET measurement should first line investigation in the evaluation of women with postmenopausal bleeding with suspected endometrial pathology. Although hysteroscopy is more specific and sensitive, in poor resource settings it should be limited to cases with ill-defined endometrial lining, recurrent/ persistent bleeding and cases with endometrial thickness greater than 5 mm irrespective of endometrial echotexture

Study of perinatal outcome of labour complicated with meconium stained liquor

Background: Meconium stained amniotic fluid occurs in 9 to 20% of deliveries. It has long been implicated as a factor influencing foetal wellbeing during the intrapartum and postpartum period. Many authors have suggested that the type and the time of passage of meconium are most significant factors affecting foetal outcome. This study was carried out to find out the effect of meconium stained liquor during labour and its perinatal outcome.Methods: This prospective cross sectional and comparative study was carried out in a tertiary care hospital over a period of 1 year. The study group comprised of 118 women having MSAF during labour and the comparative group of 118 women with clear amniotic fluid which were randomly selected. The demographic data, obstetrical history, intrapartum findings and Apgar score were documented on predesigned proforma. Data collected was analysed using student t-test, chi square test, Z test for comparison of proportions and coefficient of variation for comparison of consistency of distributions.Results: Out of 1192 cases studied 118 cases showed presence of meconium stained liquor (9.89%). Caesarean section was performed in 41.52% cases with meconium stained liquor versus 31.35% in clear liquor group. Apgar score at 1 minute was significantly lower in meconium stained liquor (p0.05).Conclusions: Meconium staining is a commonly observed phenomenon. labour complicated with thick meconium stained liquor should ideally be categorised in to high risk obstetrics and managed in tertiary care with consultant obstetrician, consultant neonatologist and NICU in order to improve the perinatal outcome

Co-Crystallization Techniques for Improving Nutraceutical Absorption and Bioavailability

Nutraceuticals is an umbrella term for therapeutic leads derived from plants, animals and/or microbial species. Being synthesized in nature’s own laboratory a nutraceuticals have structural and functional features for interacting with an array of physiological targets. However, because of this very structural complexity and diversified nature, nutraceuticals often suffer from diminished gastrointestinal (GI) absorption and limited systemic bioavailability. Thus, in-spite of having an obvious edge over synthetic molecules, pharmaceutical applicability of nutraceuticals play second fiddle in the present pharmaceutical prospective. In this regard, co-crystallization of nutraceuticals have evolved as an attractive prospect. Co-crystallization causes stoichiometric non-covalent binding between nutraceutical API (active pharmaceutical ingredient) and a pharmaceutically acceptable co-former creating a single-phase crystalline material. Nutraceutical co-crystals thus created possess excellent absorption and bioavailability attributes. The principal aim of the current chapter is to highlight co-crystallization as the means of nutraceutical ascendancy over toxic synthetic drugs currently dominating the pharmaceutical market. In the current chapter the authors provide a detail exposition on the methods and application of co-crystallization in context of nutraceutical absorption and bioavailability. Herein, we discuss in detail about the constituents, characteristics, mechanism of action and protocol for preparation of nutraceutical co-crystals with relevant references from current and past studies

Trichophyton ajelloi: A rare case of Tinea cruris

Diseases caused by fungi can be divided into three broad groups: superficial mycosis, subcutaneous mycosis, and systemic mycosis. The superficial infection caused by the dermatophytes is called dermatophytosis and the term dermatomycosis refers to the infection from any of the fungi. Superficial fungal infections are some of the most common dermatologic diseases seen worldwide. Among superficial mycosis, dermatophytosis is the most common contagious infection. Dermatophytosis is a term used to describe mycotic infections caused by a group of fungi that usually remain localized to the superficial layers of the skin, hair, or nails. These fungi are classified in the anamorphic genera Epidermophyton, Microsporum, and Trichophyton. While T. rubrum is the most common agent. As T. ajelloi is an unusual isolate of superficial dermatophytosis, so the case is presented. The prevalence of an individual species in a given geographic location, and hence the disease it causes, is dependent on a number of factors including population migration patterns, lifestyle practices, primary host range, secondary host susceptibility, standard of living, and climatic preference. The present case was 47 year old male, laborer by occupation came in the skin outpatient department with history of itchy, hyperpigmented scaly lesions on buttocks and groin since 2 months. He had history of antifungal treatment (Clotrimazole 1%) candid cream but never used topical steroids. The diagnosis was done by studying the macroscopic and microscopic characteristics of their culture. Texture, rate of growth, topography, and pigmentation of the front and the reverse side of the cultures were employed to characterize fungi macroscopically. Lactophenol cotton blue mount of each fungal isolate was used to characterize fungal isolates microscopically. Many mycological laboratory texts and manuals were used as reference materials in process of identification

Hemimandibular hyperplasia

An asymmetric variation of facial structures is commonly seen in the general population. Hemimandibular hyperplasia (HH) is a gross asymmetry of facial structures, characterized by unilateral enlargement of hard and soft tissues. The etiology of HH remains unknown; however, abnormalities involving the hormones, neural system, vascular, lymphatic, and mechanical influences have been proposed. The condition does not warrant any active intervention, except for cosmetic reasons. A case of a 22-year-old male showing characteristic features of HH is reported with insight on differential diagnosis. The case is presented to supplement existing clinical knowledge

Assessment of bioavailability of gold bhasma in human participants – A pilot study

Bioavailability of the well-known Ayurvedic drug Swarnabhasma (gold bhasma or calcined gold) is unknown. It is orally administered either sublingually or directly with various Anupanas like black pepper powder (Piper nigrum Linn.) and cow ghee in the dose range of 15–240 mg by Ayurvedic physicians. Study of bioavailability of Swarnabhasma is necessary as this metal-derived drug is administered for long duration for rejuvenation. The pilot study was carried out in healthy human male participants to assess bioavailability of Swarnabhasma in three doses, viz. 30 mg plain sublingual, 30 mg oral dose mixed with black pepper powder (250 mg) and cow ghee (2.5 gm); and 240 mg oral dose mixed with black pepper powder (250 mg) and cow ghee (2.5 gm). Blood samples were withdrawn at 0, 1, 2 and 4 h after administration of dose. Estimation of gold levels in blood was carried out by inductively coupled plasma mass spectrometry (ICP-MS). Results show that gold is absorbed in traces from single dose of Swarnabhasma. Maximum concentration of gold was bioavailable from 30 mg sublingual dose with Cmax 0.983 μg/L at 2 h (Tmax). Oral dose of 30 mg Swarnabhasma mixed with black pepper powder and ghee showed faster absorption with Tmax at 1 h and Cmax 0.867 μg/L, and 240 mg dose with black pepper and ghee showed Cmax 0.668 μg/L and Tmax at 2 h