IN VITRO COMPARISON OF THE ANTIBACTERIAL ACTIVITY OF ETHANOLIC EXTRACT OF AZADIRACHTA INDICA LEAVES WITH GENTAMYCIN, AMPICILLIN, NITROFURANTOIN, AND COTRIMOXAZOLE ON BACTERIAL PATHOGENS ISOLATED FROM URINARY TRACT INFECTION PATIENTS

  Objective: In vitro comparison of the antibacterial activity of ethanolic extract of Azadirachta indica (neem) leaves with gentamycin, ampicillin, nitrofurantoin, and cotrimoxazole in bacterial pathogens isolated from urinary tract infection (UTI) patients.Methods: Ethanolic extract of neem leaves was prepared by the standard method. The antimicrobial activity against bacteria isolated from UTI patients was determined by agar well diffusion method and then mean zone of inhibition of neem extract was compared with a mean zone of inhibition of gentamycin, ampicillin, nitrofurantoin, and cotrimoxazole.Results: Among 200 samples which were included in the study, bacteria isolated were Escherichia coli (60%), Klebsiella pneumoniae (15%), Pseudomonas aeruginosa (11%), Enterococcus faecalis (5%), Proteus mirabilis (3%), and Staphylococcus aureus (6%). The result obtained was statistically analyzed by unpaired t-test. The difference in the mean diameter of the zone of inhibition between ethanolic extract of Azadirachta indica (neem) leaves and nitrofurantoin was statistically highly significant for K. pneumoniae (p<0.0001) and P. mirabilis (p=0.01) and insignificant for other bacteria. On comparing, the mean diameter of the zone of inhibition of ethanolic extract of A. indica (neem) leaves with ampicillin and cotrimoxazole, it was found to be statistically highly significant for all bacteria E. coli (p<0.0001), K. pneumoniae (p<0.0001), P. aeruginosa (p<0.0001) E. faecalis (p<0.001), and S. aureus (p<0.0001) expect P. mirabilis. The mean diameter of the zone of inhibition of ethanolic extract of A. indica (neem) leaves when compared with gentamycin was statistically highly significant for all the bacteria.Conclusion: The ethanolic extract of A. indica leaves has antibacterial activity. Antibacterial activity of ethanolic extract of A. indica leaves is comparable to nitrofurantoin for bacteria E. coli, P. aeruginosa, E. faecalis, and S. aureus. Ethanolic extract of A. indica leaves has similar antibacterial activity as ampicillin and cotrimoxazole for bacteria P. mirabilis. The antibacterial activity of gentamycin is less as compared to an ethanolic extract of A. indica leaves for all the bacteria

Asymmetric Membrane Capsule: New Prospects in Osmotic Delivery

Osmotic drug delivery remains an area of interest for its potential in answering many formulation related problems. However it suffers from a number of drawbacks which made it difficult to fully unleash this concept. With the advent of new technologies like asymmetric membrane capsules (AMCs); new doors have got opened in this field. Asymmetric membrane capsules are based on the concept of osmotic pressure but are much simpler to manufacture. Further, they can be suitably optimized by varying the parameters like concentration of pore former, polymer, osmotic agents and solubility enhancers to cater the specific needs of a particular formulation. The concept can be utilized to deliver a number of drugs belonging to different pharmacological categories. However the work in this field is still in infancy. Present review emphasizes on the conceptual as well as formulation related aspects of asymmetric capsules. It also addresses the developmental work done in this field.Keywords: Controlled drug delivery, Osmosis, Asymmetric membrane, in situ pore formation, Phase inversion, Wet process

A Technical Review on Energy Efficient Protocol based on PEGASIS and LEACH

A wireless sensor network (WSN) is a new developing technology that enables users to interconnect without any physical arrangement of their geographical location so that sometimes referred to as an arrangement of fewer networks. An ad-hoc network is an adaptive, self-organizing device in mobile, should be able to detect the presence of any other devices that perform necessary set up to facilitate communication, sharing of data and service. The Clustering is used for the network lifetime and it is very important method in Mobile AD Hoc Networks. The scheme is used by the cluster head node which plays a very important role inside the transmitting packet process from one cluster to the other or nearest node. The power resource of each sensor node is limited in the cluster. Minimizing energy dissipation and maximizing network lifetime are important issue in the design of routing protocols for sensor networks. This paper proposes a comparison of LEACH and PEGASIS protocol which is intended to balance the energy consumption of the entire network and extend the lifetime of the network

Niosomes as vesicular carriers for delivery of proteins and biologicals

Over the past several years, treatment of infectious diseases and immunization has undergone a paradigm shift. Stemming from the nanobiotechnology research, not only a large number of disease-specific biologicals have been developed, but also enormous efforts have been made to effectively deliver these biologicals. Niosomes are vesicular systems prepared from self-assembly of hydrated non-ionic surfactants. Opinions of the usefulness of niosomes in delivery of proteins and biologicals range from unsubstantiated optimism to undeserved pessimism. This article reviews the current deepening and widening of interest of niosomes in many scientific disciplines, and their application in medicine particularly for the delivery of proteins (insulin, cyclosporine, bacitracin, trypsin), vaccines and antigens (bovine serum albumin, antigen tetanus toxoid, haemagglutinin). This article also presents an overview of techniques of noisome preparation, characterization of niosomes and their applications.Keywords: Niosomes, Proteins, Biologicals, Vaccines, Oral deliver

Niosomes as vesicular carriers for delivery of proteins and biologicals

Over the past several years, treatment of infectious diseases and immunization has undergone a paradigm shift. Stemming from the nanobiotechnology research, not only a large number of disease-specific biologicals have been developed, but also enormous efforts have been made to effectively deliver these biologicals. Niosomes are vesicular systems prepared from self-assembly of hydrated non-ionic surfactants. Opinions of the usefulness of niosomes in delivery of proteins and biologicals range from unsubstantiated optimism to undeserved pessimism. This article reviews the current deepening and widening of interest of niosomes in many scientific disciplines, and their application in medicine particularly for the delivery of proteins (insulin, cyclosporine, bacitracin, trypsin), vaccines and antigens (bovine serum albumin, antigen tetanus toxoid, haemagglutinin). This article also presents an overview of techniques of noisome preparation, characterization of niosomes and their applications.Keywords: Niosomes, Proteins, Biologicals, Vaccines, Oral deliver

Pregnancy with third degree uterine prolapse: a rare case report

Occurrence of prolapse of uterus during pregnancy is an extremely rare event. Less than 300 cases have been reported in the literature till date. Incidence of uterine prolapse in pregnancy is 1 in 10,000-15,000 deliveries worldwide. A 35 year old G5P3L1A1 with history of five months amenorrhea was referred to our hospital in view of uterine prolapse. On enquiring she gave history of something coming out of vagina since one month. On local examination, third degree uterovaginal prolapse with cord prolapse seen. Patient went into labour spontaneously and expelled an abortus. She was discharged next day with advice regarding follow up visit after six weeks. Uterine prolapse during pregnancy is a rare occurrence which increases both maternal and fetal morbidity. There are many etiological factors which have been cited to be responsible for this condition, important ones are: Multiparity, vaginal delivery, advanced maternal age, increased body mass index. Elective caesarean section can be planned in cases with edematous and elongated cervix. Individualized approach and careful monitoring is the key to manage such patients. Uterine prolapse during pregnancy is a rare event. While managing such patients, an obstetrician should keep in mind threats of spontaneous abortion, preterm labour, cervical dystocia, etc

Open Reduction and Internal Fixation in Pediatric Mandibular Fracture

INTRODUCTION: Maxillofacial fractures in the pediatric age group are relatively uncommon, yet they are no less important .The impact of craniofacial trauma in pediatric population is minimized due to the light weight and small size of the facial skeleton. The force of impact is absorbed by the forehead and the skull rather than the face since the ratio of cranial volume to facial volume is greater in children than adults (8:1 at birth, 4:1 at 5 years, versus 2:1 in adults). Pediatric facial bones are more resistant to fractures due to Higher elasticity, Poor pneumatization by the sinuses, Thick surrounding adipose tissue and Stabilization of the mandible and maxilla by the unerrupted teeth. Excluding the nasal bones, the mandible is the most frequently fractured facial bone in the pediatric patients .One third of pediatric trauma patients with facial fractures have mandibular fracture. AIM OF THE STUDY: The aim of this study was to prospectively analyze the effect of open reduction and internal fixation for treating various pediatric mandibular fractures and evaluating the advantages and disadvantages of ORIF along with the assessment of any complications. OBJECTIVES: The pattern of mandible fractures seen in children and adults varies with evolving skeletal anatomy and socio environmental factors. The general principle of treating fractures are same in children and adults: Anatomic reduction is combined with adequate stabilization to maintain the bony fragment in position until bony union is achieved. But recognition of some of the differences between adults and children’s fracture healing is seen. It is important with regards to long term facial esthetics and functional facial rehabilitation. The objective of this study is to evaluate the use of open reduction and internal fixation in displaced pediatric mandibular fractures. MATERIAL AND METHODS: The present study “Open Reduction and Rigid fixation in pediatric mandibular fractures” was undertaken in the Department of Oral & Maxillofacial Surgery, Rajas Dental College, Kavalkinaru. The criteria for selection of cases being: 1. Patients Below 14 years of age, 2. Gross Displacement of the fracture segments, 3. Patients without any medical problems. The study included total number of 11 patients reported during the period between 2009-2012 out of which 7 patients were boys & 4 were girls. The youngest of patients age being 6 years & oldest was 12 years. The causes included RTA, fall from cycle & sports injuries. All 11 patients were the subjects of this follow up study. Each patient was given the following evaluation: 1. Extra oral & Intraoral clinical examination. 2. Periapical radiographs of the affected site. 3. Lateral oblique view where required. 4. Pre operative and post operative OPG. 5. Routine blood investigation. 6. Chest x-ray. 7. ECG. 8. All the diagnostic procedures were performed without medication or sedation. All 11 patients were advised treatment by open reduction and internal fixation. Average time for surgery was 45-70 minutes. RESULTS: Post operative pain was calculated based on the following grading: Not Present, Mild, Moderate, Severe. The results were tabulated (Graph D & E). One case of infection (Table iv) was reported at the site of fracture along the suture line .Of the 11 patients,1 fracture of the angle of the mandible was approached through an extra oral incision to reach the lower border of the mandible (table x), and for perpendicular angulations of the screws. Hence extra oral scar was seen in 1 of the patients. There was no scar hypertrophy. An orthodontist evaluated the occlusion on the first and second post operative visit and at 6 months and found it to be ideal in all patients There was no mobility of the segments post operatively. (Table iv) Return to function and patient comfort was the major concern. Most of the patients showed impressively rapid recovery and return to their normal activity within a week. SUMMARY & CONCLUSION: Management of mandibular fractures in children differs somewhat from that in adults because of anatomic variation, rapidity of healing, degree of patient cooperation and the potential for interference with mandibular growth. Therefore these patients require a different surgical approach. According to our study results we currently believe that certain principles in the management of these injuries can be outlined, recognizing that they may require modification as additional experience accumulates. These management principles are as follows: 1. Be as conservative as possible. 2. If indicated do open reduction & stable fixation as inadequate reduction and fixation will lead to malunion and contour deformities. 3. Minimal exposure & stripping of periosteum, as excessive periosteal stripping can cause scarring & growth retardation. 4. Employing methods of fixation that adequately stabilize the facial skeleton without rigidly immobilizing long segments

Lactate dehydrogenase levels in preeclampsia and its correlation with maternal and perinatal outcome

Background: Hypertensive disorder of pregnancy occurs in approximately 6-8% of all pregnancies. The most serious consequences for the mother and the baby are the result of preeclampsia and eclampsia. Lactate Dehydrogenase (LDH) is an intracellular enzyme. Recently LDH has been suggested as potential marker to predict severity of pre-eclampsia. The objective of the present study was to compare the serum lactate dehydrogenase levels in women with preeclampsia and normal pregnant women and to correlate lactate dehydrogenase levels with maternal and perinatal outcome in preeclampsia.Methods: An observational prospective study was conducted on 200 antenatal women attending the labour room emergency. Women with singleton pregnancy and cephalic presentation, from 28 weeks onwards were enrolled in the study. Out of 200, 100 were normal pregnant women and 100 were preeclamptic women. Serum LDH levels were measured in all women and maternal and perinatal outcome was assessed in terms of LDH levels.Results: Higher levels of LDH was observed in pregnant women with preeclampsia (627.38±230.04 IU/l) as compared to normal pregnant women (224.43±116.61 IU/l). The maternal complications were found to be maximum in women with LDH > 800 IU/l.  Abruption was the most common complication. The perinatal mortality and neonatal deaths were found to have significant correlation with high LDH levels.Conclusions: Maternal and perinatal complications were associated with higher LDH levels in preeclampsia patients. Serum LDH levels can be offered to all patients of preeclampsia and can be used to predict the prognosis of preeclampsia

A retrospective analysis of ectopic pregnancy at a tertiary care centre: one year study

Background: Ectopic pregnancy is an important cause of maternal morbidity and mortality especially in developing countries where the majority of patients present late with rupture and hemodynamic compromise. The aim of this study was to determine the risk factors, clinical profile of the patients and management options for ruptured ectopic pregnancies.Methods: We conducted a retrospective study about ectopic pregnancy at obstetrics and gynaecology department over a period of one year, from 01 January 2015 to 31 December 2015. Information on the biosocial data, clinical symptoms and signs, risk factors for the disease, site of ectopic pregnancy and treatment options, quantity of hemoperitoneum and need for blood transfusion was extracted. The data was analyzed and presented in frequency tables and charts.Results: Frequency of ectopic pregnancy was 1.6% of total 10235 deliveries. 131 (89.1%) cases were of ruptured ectopic pregnancy. 147 patients underwent laparotomy while 22 patients were managed conservatively. All patients were symptomatic at presentation. Majority (86, 50.8%) of the patients were in the age group of 20-24 years. 33 (19.5%) patients were nulliparous. Risk factors were found in 86 (50.8%) patients. Majority (38, 44.1%) had history of previous tubal surgery (tubal sterilization and/or recanalisation) as risk factor. The highest number of ruptured ectopic occurred between 7-12 weeks of gestation. Most common surgical procedure employed was salpingectomy in 140 (95.2%) patients.  There was no maternal mortality due to ectopic pregnancy.Conclusions: Ectopic pregnancy is still a major life threatening emergency condition which if treated early has good prognosis. Most cases present late making tubal conservation inapplicable. Efforts should be made towards woman education, improved hospital accessibility and better diagnostic skills

EFFICACY OF DHANYAMLA SARVANGA DHARA IN THE MANAGEMENT OF OBESITY: AN ANALYTICAL REVIEW

Obesity consist a major nutritional health problem in developed and developing countries, which has reached epidemic proportions. It is a medical condition of excessive fat accumulation to the extent that it may have negative effect on health. Obesity are major causes of co-morbidities, including type 2 diabetes, cardiovascular disease, various cancer and other health problem like obstructive sleep apnea, osteoarthritis and depression. Obesity is most commonly caused by a combination of excessive food intake, lack of physical activity. Leptin enzyme is responsible for controlling appetite through its action on CNS, TNF alpha is also link factor between fat accumulation and metabolic disorders. The body mass index (BMI) is an internationally accepted index to estimate body weight. Taking medication like Sibutramine, Orlistat as an option for treatment of obesity can be given, because it is associated with many side effects. Bariatric surgery may be performed to reduce weight, but it is not very useful treatment. Diet, life style modification, physical activity can achieve the desired loss of body fat. In Ayurveda best treatment for Sthaulya defined by Acharyacharak and Sushruta and Vagbhatt. Dhanyamalasarvangadhara is highly effective in Vata associated with Ama and Kapha. Dhanyamla sarvanga dhara eliminates the body toxins, establishes health and tones up the joints and soft tissues. The drug will act soon as the medicine touches the skin surface. Due to Vasodilation property blood flow will increase through the area, increasing metabolism further eliminating the toxins, which will help in reducing the obesity. Dhanyamala sarvanga dhara controls the disease process and may cause long lasting relief