A PRELIMINARY INVESTIGATION OF THE SHODHANA (DETOXIFICATION) OF ROOTS OF PLUMBAGO INDICA L. IN AYURVEDA

Plumbago indica L. (Plumbaginaceae) is a medicinal herb, credited with a number of therapeutic properties. It is widely used in Sri Lankan traditional medicine and in Ayurveda. In Sri Lanka, Ayurveda formulations which incorporate the roots of P. indica L. are prepared using commercially available air dried material after subjecting it to a detoxification with limewater prepared from commercially available milk of lime. The detoxification process is referred to as “Shodhanaâ€. According to the Ayurveda, this process is done to remove toxicity associated with the roots and, it can be surmised that it is done to remove toxicity associated with plumbagin, the predominant toxic naphthoquinone in P. indica L.. Shodhana of roots results in a deep maroon coloured extract arising from the calcium salt of plumbagin. Here, we report a qualitative and quantitative study of the Shodhana of roots of P. indica L. using Ultra Violet-Visible spectrophotometric and chromatographic methods to give a scientific basis for this process. A method for the quantitative extraction of plumbagin from root samples was optimized. A calibration curve for plumbagin in hexane was developed using the absorption values at 258 nm. The plumbagin content of 8.7 ± 0.1 mg/g in a fresh root sample was lowered by 19.4% to 7.0 ± 0.1 mg/g upon subjecting to Shodhana. It was found that a commercial dried root sample of P. indica L. root contained a much lower level (0.55 ± 0.05 mg/g) of plumbagin. To better understand the changes in the level of plumbagin in roots of P. indica L. during drying, a study was carried out by drying the root samples for five weeks subjecting them to analysis periodically by TLC and Ultra Violet-Visible spectrophotometric methods. The amount of plumbagin (8.6 ± 0.1 mg/g) present in fresh untreated roots at the beginning of the study was reduced by 62.7% to 3.2 ± 0.1 mg/g after one week. There was no measurable change in the plumbagin level thereafter up to week 5. The amount of plumbagin in dried roots can be further reduced by Shodhana. The total reduction of plumbagin by drying and Shodhana was 87.7%. Our results show that Shodhana of the fresh undried roots does not reduce the plumbagin content substantially, and that air drying followed by Shodhana is the most effective method to reduce the plumbagin content to a non-toxic level, supporting the currently used processing method

Dual roles for LUBAC signaling in thymic epithelial cell development and survival

Thymic epithelial cells (TECs) form a unique microenvironment that orchestrates T cell differentiation and immunological tolerance. Despite the importance of TECs for adaptive immunity, there is an incomplete understanding of the signalling networks that support their differentiation and survival. We report that the linear ubiquitin chain assembly complex (LUBAC) is essential for medullary TEC (mTEC) differentiation, cortical TEC survival and prevention of premature thymic atrophy. TEC-specific loss of LUBAC proteins, HOIL-1 or HOIP, severely impaired expansion of the thymic medulla and AIRE-expressing cells. Furthermore, HOIL-1-deficiency caused early thymic atrophy due to Caspase-8/MLKL-dependent apoptosis/necroptosis of cortical TECs. By contrast, deficiency in the LUBAC component, SHARPIN, caused relatively mild defects only in mTECs. These distinct roles for LUBAC components in TECs correlate with their function in linear ubiquitination, NFκB activation and cell survival. Thus, our findings reveal dual roles for LUBAC signaling in TEC differentiation and survival

Randomised controlled trial of GP-led in-hospital management of homeless people ('Pathway')

The study was funded by the National Institute for Health Researc

Research Methodologies and Business Discourse Teaching

This chapter will:; ; ; Define English for specific purposes and indicate the specific ways in which it has been influential on business discourse teaching;; ; ; Discuss the most relevant approaches to genre analysis that have been used in business discourse teaching;; ; ; Explore the most relevant approaches to critical discourse analysis and organizational rhetoric for business discourse teaching;; ; ; Identify the most relevant aspects of multimodal discourse analysis for business discourse teaching;; ; ; Provide a case study that illustrates the use of one approach to business discourse teaching, showing how practitioners can incorporate it into their classroom- or consultancy-based ideas

Pancreatic enzyme replacement therapy in patients with pancreatic cancer: A national prospective study

Objective: UK national guidelines recommend pancreatic enzyme replacement therapy (PERT) in pancreatic cancer. Over 80% of pancreatic cancers are unresectable and managed in non-surgical units. The aim was to assess variation in PERT prescribing, determine factors associated with its use and identify potential actions to improve prescription rates. Design: RICOCHET was a national prospective audit of malignant pancreatic, peri-ampullary lesions or malignant biliary obstruction between April and August 2018. This analysis focuses on pancreatic cancer patients and is reported to STROBE guidelines. Multivariable regression analysis was undertaken to assess factors associated with PERT prescribing. Results: Rates of PERT prescribing varied among the 1350 patients included. 74.4% of patients with potentially resectable disease were prescribed PERT compared to 45.3% with unresectable disease. PERT prescription varied across surgical hospitals but high prescribing rates did not disseminate out to the respective referring network. PERT prescription appeared to be related to the treatment aim for the patient and the amount of clinician contact a patient has. PERT prescription in potentially resectable patients was positively associated with dietitian referral (p = 0.001) and management at hepaticopancreaticobiliary (p = 0.049) or pancreatic unit (p = 0.009). Prescription in unresectable patients also had a negative association with Charlson comorbidity score 5–7 (p = 0.045) or >7 (p = 0.010) and a positive association with clinical nurse specialist review (p = 0.028). Conclusion: Despite national guidance, wide variation and under-treatment with PERT exists. Given that most patients with pancreatic cancer have unresectable disease and are treated in non-surgical hospitals, where prescribing is lowest, strategies to disseminate best practice and overcome barriers to prescribing are urgently required

Estimating the Global Clinical Burden of Plasmodium falciparum Malaria in 2007

Simon Hay and colleagues derive contemporary estimates of the global clinical burden of Plasmodium falciparum malaria (the deadliest form of malaria) using cartography-based techniques