EXPLORATION OF BIOACTIVE COMPONENTS OF THUNBERGIA COCCINEA, ITS PHARMACOGNOSTIC, ANTIOXIDANT, GCMS AND ANTIHYPERGLYCEMIC STUDIES

Objective: An effort currently made to appraise the preliminary phytochemical, pharmacognostic criteria, antioxidant, GCMS and antihyperglycemic investigations of the Thunbergia coccinea leaves. Thunbergia coccinea (T. coccinea) is an ornamental plant considerably practiced by the tribes of forest areas of Assam (INDIA) as an analgesic, antipyretic, anti-inflammatory, antidote, hepatoprotective, antidiabetic and detoxificant substance. Methods: A comprehensive literature survey was conducted to recognize the ethnomedicinal value of T. coccinea, which is currently grown practically in all provinces. The physicochemical constants like moisture content, ash values especially total ash, insoluble acid ash, water-soluble ash and foreign organic matter were determined for the assessment of the drug. Pharmacognostic parameters like fluorescence examination and microscopic characters of the leaf were studied that would serve to verify for contamination. The extract secured by maceration was subjected to the phytochemical inquiry to determine the existence of substances and their antioxidant activity. The antihyperglycemic characteristic of alcoholic extract of the leaf was examined with the inhibition of α-amylase and α-glucosidase enzymes. Gas Chromatography-Mass Spectrometry (GCMS) studies of alcoholic extract of the plant leaf have undertaken to get an insight into the therapeutic properties of the molecules present based on online PASS prediction. Results: Various physicochemical, microscopic parameters studied gave a clear distinguishing and identifying features of T. coccinea leaf. Phytochemical screening gave an insight into the secondary metabolites existing in the plant leaf through picturizing its therapeutic properties against various ailments. Both extracts of T. coccinea leaf showed enhanced antioxidant activities. Nevertheless, the alcoholic leaf extract has shown significant antioxidant activity with an IC50 of 171.38±2.51 μg/ml and AQTC an IC50 value of 206.29±4.5 μg/ml respectively by DPPH method. Further, ACTC showed a better-reducing potential with an IC50 value of 105.74±0.61 μg/ml in comparison with AQTC IC50 value of 203.702±0.97 μg/ml by FRP method. The inhibition potentiality of α-amylase and α-glucosidase was found to be 71.66 % and 83.74 %, respectively at 500 µg/ml that rationally an adequate remedy in the treatment of type-2 diabetes. GCMS studies of the alcoholic extract unveiled the presence of different molecules like Glycerol, tris (trimethylsilyl) ether, 3,7,11,15-Tetramethyl-2-hexadecen-1-ol, Undecanoic acid, Ethyl ester, Phytol in comparison with NIST library, thereby giving its predicted therapeutic properties like sugar phosphatase inhibitor, antifungal, phobic disorders treatment, antiviral and so on. Conclusion: The selected plant had many proven therapeutic traits and, possibly, successively united on to the sort of potential therapeutic plants. Besides, isolation and discoveries will lead to the detection of certain novel compounds, which will be of potential medicinal value

Drug utilization 90%: an innovative method in assessing quality of drug prescription with specific reference to non-steroidal anti-inflammatory drugs prescription

Background: DU90% is useful tool for assessing drug prescribing pattern. In this, drugs constituting 90% of the prescription volume are identified. Size of the DU90% segment helps us to assess rational prescribing. Large number of drugs in the DU90% segment indicates less rational prescribing, whereas small number suggests more rational prescribing.Methods: Study was carried out in orthopaedic out-patient department (OPD) for a period of three months. Only OPD based NSAID containing prescriptions were included. Data was analyzed based on demographic parameters, prescription indices, fixed dose combinations (FDC) and co-prescription of gastro-protective agents (GPA). DU90% was calculated based on defined daily dose (DDD) with their respective value in Anatomical Therapeutic Chemical (ATC) classification code. Defined daily dose is calculated as DDD/1000/day.Results: Diclofenac (38%) was the commonest NSAID prescribed. Diclofenac +chymotrypsin (25%) was the commonest FDC prescribed. Piroxicam (19%) was the commonest NSAID prescribed in monotherapy form.  Co-prescription of GPA was high (96%). 5 of the 7 prescribed NSAIDs constitute to DU90% segment.Conclusions: Preferential cyclooxygenase-2 (COX-2) inhibitor NSAIDs were more preferred. Number of prescribed NSAIDs constituting to DU90% is more, thus prescription pattern needs further rationalization. Further large scale study is required to bring out more details about NSAID prescription pattern and its rational use

Drug utilization pattern in out-patients with respiratory tract infections in a rural teaching hospital: a prospective observational study

Background: Respiratory tract infections are common clinical problems in the general population. Antimicrobials are the mainstay in the management and irrational use of them may increase resistance to bacteria and the total cost of treatment. Objectives: To evaluate the pattern of drug prescriptions for respiratory tract infections in Medicine and Pediatric outpatient departments of a rural teaching hospital.Methods: Over a period of 18 months, 391 prescriptions of outpatients with respiratory tract infection were collected. The drugs prescribed, their dose and duration of treatment were recorded. DU 90% was calculated.Results: The mean (±SEM) age of the patients was38.55±0.9 years and there were 204 (52.1%) men and 187 (42.1%) women. The most common disorder among the patients was acute rhinitis (61.1%) while the least common was acute bronchitis (1.3%). Microbial culture and sensitivity was done in 23 patients and Klebsiella pneumonia (8.2%) and enterococcus (0.07%) was the most common and least common organism respectively. Penicillins (50.9%), cephalosporins (26.7%), antitubercular drugs (8.5%), macrolides (4.8) constituted DU 90%. Monotherapy was advocated in 91.7% and multidrug therapy in 8.3% of patients. The average number of antimicrobials prescribed per prescription was 0.52. Two thirds (67.6%) of the prescribed drugs were from the national list of essential medicines 2011 (NLEM).Conclusions: Penicillins and cephalosporins were the commonly used antibiotics for respiratory tract infection in outpatients of a rural teaching hospital and two thirds of the prescribed drugs were essential medicines

PREVENTIVE EFFECTS OF THE AQUEOUS EXTRACT OF CINNAMOMUM ZEYLANICUM BARK ON DEXAMETHASONE INDUCED INSULIN RESISTANCE IN WISTAR ALBINO RATS

Objectives: To evaluate the preventive effects of aqueous extract of Cinnamomum zeylanicum bark on dexamethasone induced insulin resistance and to compare it with rosiglitazone. Methods: The animals were categorized into two series of dexamethasone (dexamethasone 4mg/kg, dexamethasone 8mg/kg series) with 5 groups in each [plain control, dexamethasone 4/8mg/kg as per series, rosiglitazone 8mg/kg and 16mg/kg, cinnamon bark extract (CZE) 250mg/kg BW]. Six animals were studied in each group. In a12 day study period, rosiglitazone and CZE groups received respective drug treatments and dexamethasone dosing (4mg/kg or 8mg/kg) was started from day 7onwards. On day 12, fasting blood, urine and post IPGTT blood samples were collected and processed for glucose, insulin and ketone estimations. Results: In both series, CZE 250mg/kg treatment showed significant reduction in mean fasting glucose and insulin compared to rosiglitazone 8mg/kg and 16mg/kg groups and dexamethasone controls (4mg/kg, 8mg/kg groups) (P<0.05). The fall in glucose and insulin levels observed with CZE treatment at 30, 60 min post IPGTT in both series were significant compared to rosiglitazone and dexamethasone treatment groups (P<0.05). Glycosuria and ketonuria were absent in CZE groups, whereas these were reduced significantly in rosiglitazone groups compared to dexamethasone groups (P<0.05). Conclusion: The aqueous extract of C. zeylanicum bark prevented the insulin resistance as evidenced by reduced fasting and post IPGTT glucose and insulin levels in steroid induced insulin resistance model. KEYWORDS: Glucose uptake; Cinnamon bark; Rosiglitazone; Hyperinsulinemia; Hyperglycemia

PREVENTIVE EFFECTS OF THE AQUEOUS EXTRACT OF CINNAMOMUM ZEYLANICUM BARK ON DEXAMETHASONE INDUCED INSULIN RESISTANCE IN WISTAR ALBINO RATS

Objectives: To evaluate the preventive effects of aqueous extract of Cinnamomum zeylanicum bark on dexamethasone induced insulin resistance and to compare it with rosiglitazone. Methods: The animals were categorized into two series of dexamethasone (dexamethasone 4mg/kg, dexamethasone 8mg/kg series) with 5 groups in each [plain control, dexamethasone 4/8mg/kg as per series, rosiglitazone 8mg/kg and 16mg/kg, cinnamon bark extract (CZE) 250mg/kg BW]. Six animals were studied in each group. In a12 day study period, rosiglitazone and CZE groups received respective drug treatments and dexamethasone dosing (4mg/kg or 8mg/kg) was started from day 7onwards. On day 12, fasting blood, urine and post IPGTT blood samples were collected and processed for glucose, insulin and ketone estimations. Results: In both series, CZE 250mg/kg treatment showed significant reduction in mean fasting glucose and insulin compared to rosiglitazone 8mg/kg and 16mg/kg groups and dexamethasone controls (4mg/kg, 8mg/kg groups) (P<0.05). The fall in glucose and insulin levels observed with CZE treatment at 30, 60 min post IPGTT in both series were significant compared to rosiglitazone and dexamethasone treatment groups (P<0.05). Glycosuria and ketonuria were absent in CZE groups, whereas these were reduced significantly in rosiglitazone groups compared to dexamethasone groups (P<0.05). Conclusion: The aqueous extract of C. zeylanicum bark prevented the insulin resistance as evidenced by reduced fasting and post IPGTT glucose and insulin levels in steroid induced insulin resistance model. KEYWORDS: Glucose uptake; Cinnamon bark; Rosiglitazone; Hyperinsulinemia; Hyperglycemia

Gastrotomy for Retrieval of Thoracic Oesophageal Foriegn Body Using Long Forceps Technique in Three Dogs

Three dogs age between 3- 6 years old was presented to the Department of Veterinary Surgery and Radiology with the history of anorexia, attempt for vomiting, regurgitation, dysphagia, gagging, mild salivation after taking a piece of bone. Clinical examination revealed heart rate and respiratory were within physiological limits. Lateral plain radiograph of thorax revealed radio opaque foreign body was lodged between heart and diaphragm. Surgical invention was planned to retrieve thoracic oesophageal foreign body through gastrotomy incision. This clinical paper reports the successful surgical management of thoracic oesophageal foreign body through gastrotomy incision using long forceps without complication

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Summary Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030

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Not AvailableIn India, among various diseases that limit livestock production, Foot and Mouth Disease (FMD) stands first and affects thousands of animals every year. The estimation of loss due to FMD is of paramount importance for designing appropriate control plans. The economic impact studies on various livestock diseases including FMD are very minimal and hence this study assessed the economic loss due to FMD in cattle and buffaloes in few states and overall loss in the country. The total loss estimated comprise of milk yield reduction, unavailability of draught power, distress sale, treatment cost, mortality and opportunity cost of labour based on primary survey undertaken in 10 states and one Union territory. The results revealed that there was variation in loss levels between species and among the study states due to variation in disease incidence and severity levels, productive capacity of the animals, animal health infrastructure in the respective states, etc. The total estimated loss due to FMD in cattle and buffalo was INR 20,897 crore during 2013–14 with wide variation in magnitude across the states studied. The study provided empirical evidence of loss due to FMD in cattle and buffaloes in few states and overall loss in the country.Not Availabl