Randomised comparison of oral and vaginal misoprostol when combined with mifepristone for termination of second trimester pregnancy

Background: Objective of the study was to compare the effectiveness of vaginal (200µg) and oral (400µg) misoprostol when combined with mifepristone (200 mg) in termination of second trimester pregnancy.Methods: 60 women who were pregnant between 13 and 20 weeks were included in the study. They were divided into two groups by random sampling method and they all received 200 mg of mifepristone orally on day 1. 36 hours later they received 200 µg of misoprostol vaginally or 400 µg of misoprostol orally every 3 hours as determined by the random sampling method. Main outcome measures were induction abortion interval, complete abortion rate and side effects.Results: There was a statistical difference in the amount of misoprostol required in the oral and the vaginal group, the total dose being higher in the oral group. The mean induction-abortion interval in the vaginal group was 6.2 hrs  and oral group was 11.6 hrs and this difference was statistically significant. There was no statistical difference in the complete abortion rate of the two groups. There was no difference in the side effects caused by both routes of misoprostol administration.Conclusion: 200 µg misoprostol inserted vaginally is better than 400 µg of oral misoprostol, 36 hours after administration of tab. Mifepristone 200 mg for termination of second trimester pregnancy

A glimpse into the pathology of Parkinson’s Disease - An Ayurvedic Perspective

Parkinson’s disease (PD) is a progressive neuro degenerative disease characterised by a large number of motor and non-motor features that can impact on function to a variable degree. Charaka mentioned Kampa as one among 80 types of Vataja Nanatmaja Vyadhi. Kampa may be a symptom of many diseases. Kampavata is first described as a disease in Basavarajeeyam with cardinal symptoms as Hastapadatala Kampa, Dehabharamana, Dukkha, Nidrabhanga, Matiksheena. Here an effort is made to understand the Nidana Panchakas of Kampavata under the light of Kaphaavarana to all five types of Vata, especially Prana, Udana and Vyana. There is Udanaavruta Vyana and Pranaavruta Samana type of Anyonyaavarana, Majjaavruta Vata, Snayuprapta Vata and Asthimajjagata Vata as pathological processes depending upon the clinical presentation of the patient. The differential diagnosis of PD is also considered here to differentiate it from group of disorders which falls under Parkinsonism

Ayurvedic management of Ducchen’s Muscular Dystrophy - A Case report

Ducchen’s muscular dystrophy is most common X-linked recessive disorder affecting 30 in 100,000 live male births. The primary cause of this disease is mutations in Dystrophin gene which is essential for the structural and functional integrity of muscle. It is a progressive muscle wasting disease in which patients frequently develop contractures and lose the ability to walk between 6 and 12 years of age. With progressive disease most patients succumb to death from respiratory failure and cardiac dysfunction in their twenties. As this is a genetic disorder we can consider it as Adibala Pravritta Vyadhi. As Mamsa Kshaya is seen at some muscles and Mamsa Vriddhi at other this is an Avarana Vata Vyadhi. In both Upsthambha and Nirupasthmbha Vatavyadhi, Basthi is considered as prime choice of treatment. A Variety of Ksheerabasti in the form of Kalabasti is studied in this condition by taking subjective and objective parameters. As this has given better improvement with no adverse effects in the patient, it can be tried in large number of patients

Biochemical quality comparison of forced air dried osmo-dehydrated cashew apple products infused with spice mixture and sugar

Cashew apple is a pseudo-fruit available abundantly during harvest seasons (March to July) and majority of them goes as waste because of their perishability and poor shelf life. However, the absence of distinct exocarp and seeds are some of the potential advantages for processing utility. Hence, in the present study, osmo-dehydrated products were prepared from two maturity stages i.e. breaker and ripe stages using sugar, spice mixture and were referred to as cashew fig and chew, respectively. The drying efficiency and product recovery were conquered by cashew chew and fig, respectively. Based on the biochemical and organoleptic qualities, ripe fruits werefound suitable for preparation of chew and fig. The tannin content responsible for acridity got reduced (chew of ripe stage 1.18 to 0.53 mg/g and chew of breaker stage 1.85 to 0.68 mg/g) during the process of osmo- dehydration. Excluding total antioxidant activity, all other biochemical properties were found to be improved compared to their respective controls

SYNTHESIS, CHARACTERIZATION AND QUANTITATION OF REGIOISOMERIC IMPURITY IN NIMODIPINE BULK AND FORMULATION

Objective: The present research work was directed towards the synthesis characterization and quantitation of regioisomeric impurity of Nimodipine i.e. diethyl 1, 4-dihydro-2,6-dimethyl pyridine dicarboxylate in bulk and tablet formulation, by UV,IR,NMR and GC-MS techniques and a RP-HPLC method was developed as per ICH Q2B guidelines for quantitation of 1, 4-Dihydro-2, 6-Dimethyl-4-(p-nitro phenyl) pyridine-3,5 dicarboxylate (NI) from bulk and formulation. Methods: The synthesis of NI was carried out by Hantzch pyridine synthesis, by using p-nitrobenzaldehyde, ethylacetoacetate, in presence of ammonia and methanol as a catalyst. The percentage yield was found to be 89.29%. Recrystallization and purification of NI was done. The preliminary evaluation was done on laboratory scale via melting point, elemental analysis and TLC. Results: The melting point of impurity was found to be 156-1580C. The TLC of impurity was carried by using Chloroform: Methanol (9:1) and the Rf was found to be 0.79. The confirmation of structure of NI was carried out by using sophisticated techniques i.e., FT-IR, NMR (13C and 1H), GC-MS etc. The RP-HPLC method was developed to quantify the NI in Nimodipine bulk and formulation as per ICH Q2B guidelines. The method validation was done as per ICH guidelines. Conclusion: The validated optimized method was found to be linear, précised, robust, rugged and accurate. Finally NI was quantified from bulk Nimodipine and its marketed tablet formulation. It was concluded that the amount of NI, present in tablet was found to be 0.1% and in the bulk 0.067% respectively. Thus it was revealed that the NI was found to be within the limit laid down ICH guidelines (Not more than 0.1 %)

Cardiometabolic Risk Markers in Indian Children: Comparison with UK Indian and White European Children

Objective: UK Indian adults have higher risks of coronary heart disease and type 2 diabetes than Indian and UK European adults. With growing evidence that these diseases originate in early life, we compared cardiometabolic risk markers in Indian, UK Indian and white European children.Methods: Comparisons were based on the Mysore Parthenon Birth Cohort Study (MPBCS), India and the Child Heart Health Study in England (CHASE), which studied 9–10 year-old children (538 Indian, 483 UK Indian, 1375 white European) using similar methods. Analyses adjusted for study differences in age and sex.Results: Compared with Mysore Indians, UK Indians had markedly higher BMI (% difference 21%, 95%CI 18 to 24%), skinfold thickness (% difference 34%, 95%CI 26 to 42%), LDL-cholesterol (mean difference 0.48, 95%CI 0.38 to 0.57 mmol/L), systolic BP (mean difference 10.3, 95% CI 8.9 to 11.8 mmHg) and fasting insulin (% difference 145%, 95%CI 124 to 168%). These differences (similar in both sexes and little affected by adiposity adjustment) were larger than those between UK Indians and white Europeans. Compared with white Europeans, UK Indians had higher skinfold thickness (% difference 6.0%, 95%CI 1.5 to 10.7%), fasting insulin (% difference 31%, 95%CI 22 to 40%), triglyceride (% difference 13%, 95%CI 8 to 18%) and LDL-cholesterol (mean difference 0.12 mmol/L, 95%CI 0.04 to 0.19 mmol/L).Conclusions: UK Indian children have an adverse cardiometabolic risk profile, especially compared to Indian children. These differences, not simply reflecting greater adiposity, emphasize the need for prevention strategies starting in childhood or earlier

First record of grooved razor fish Centriscus scutatus Linnaeus, 1758 from Visakhapatnam waters

A spinner dolphin, Stenella longirostris , locally called ‘handi meenu’ was noticed in dead condition floating near the marine cage farm of CMFRI, Karwar, approximately 600 m away, from sea shore of Aligadda village in the evening hours on 31st August 2012. The specimen was an adult female of 175 cm total length and 55 kg weight. The animal had a small injury near its left eye probably as a result of getting entangled in fishing nets or got injured in purse-seine operation which resulted in its death

First record of two-spot razorfish, Iniistius bimaculatus (Rüppell, 1829) from Visakhapatnam waters

The two-spot razorfish, Iniistius bimaculatus (Rüppell, 1829), of the family Labridae is being reported for the first time from Visakhapatnam waters. A single specimen was collected from the fishing harbour at Visakhapatnam on 22 March, 2012. The total length and the weight of the recorded specimen were 196 mm and 43.7 g. Morphometric and meristic measurements were taken, photographed and the specimen was deposited in the Museum of Visakhapatnam Regional Centre of CMFRI. The present finding highlights the occurrence of this species in Visakhapatnam waters

Cachexia, Chorea, and Pain in Chronic Nonbacterial Osteitis and Inflammatory Bowel Disease: A Case Report

BACKGROUND: Inflammatory bowel disease is an inflammatory disorder that primarily impacts the gastrointestinal tract, leading to malnutrition and chronic microscopic intestinal blood loss. Uncontrolled systemic inflammation can impact other parts of the body, known as extraintestinal manifestations. Up to 25% of patients with inflammatory bowel disease are reported to have these complications in their skin, joints, bones, eyes, liver, lung, and pancreas (Rogler et al. in Gastroenterology 161(4):1118-1132, 2021). Neurologic involvement as extraintestinal manifestations are less common, reported at 3-19%, including neuropathies, demyelination, and cerebrovascular events (Morís in World J Gastroenterol. 20(5):1228-1237, 2014). CASE PRESENTATION: A 13-year-old Caucasian boy presented with 1 month of progressive lower-extremity pain, weakness, and weight loss. His physical examination was notable for cachexia, lower-extremity weakness, and chorea. Labs revealed normocytic anemia and systemic inflammation. Imaging revealed symmetric abnormal marrow signal in the pelvis and upper femurs. Pathologic examination of the bone revealed chronic inflammation consistent with chronic nonbacterial osteitis. Endoscopy revealed colonic inflammation consistent with inflammatory bowel disease. CONCLUSIONS: Children and adolescents with musculoskeletal pain lasting more than 2 weeks with systemic signs or symptoms like weight loss should prompt evaluation for systemic inflammatory disorders such as chronic nonbacterial osteitis, which can occur in isolation or associated with inflammatory bowel disease. This patient also had a nonspecific neurologic abnormality, chorea, which resolved with treatment of underlying inflammatory disorder. These extraintestinal manifestations may be concurrent with or precede intestinal inflammation, requiring a high index of suspicion when investigating nonspecific systemic inflammation