CLINICAL OUTCOME OF PATIENTS WITH ACUTE SCROTAL PAIN AT A TERTIARY RURAL CENTRE IN MAHARASHTRA

Introduction: Acute scrotum is a common reason for emergency consultation. Early scrotal exploration is mandatory if torsion of the testis suspected clinically. Objectives: To study management and clinical outcome of patients admitted with acute scrotal condition. Methods: This was a prospective observational study involving 60 patients hospitalized for Acute scrotum at tertiary rural centre, from September 2014 to September 2016. Patients admitted with complaints of acute pain and swelling of scrotum irrespective of age and gender were included in the study. Patient with painless scrotal swelling and those with chronic scrotal pain were excluded from the study. Patients were monitored post-operatively till discharge and followed for 1 month for any complications. Results: Of the 60 patients in our study, acute epididymo-orchitis (36.6%) was the dominant cause of acute scrotal swelling followed by scrotal abscess (23.3%). 51.6% of the patients were managed conservatively, which were diagnosed as epididymoorchitis and haematocele. 14 patients underwent incision and drainage who diagnosed as scrotal abscess; 7 patients diagnosed as fournier\u27s underwent debridement; 5 underwent orchidectomy or orchidopexy while 3 underwent B/L orchidopexy. Out of 8 cases of torsion of testis, bilateral orchidopexy was done in 3 cases (37.5%) in which we were able to salvage the affected testis. Out of the 60 patients, maximum patients (41 patients) required a hospital stay of 1-10 days. All patients were followed up for a period of 1month after discharge. None of the patients had any serious complications. Conclusion: Acute scrotum can be successfully managed by consevative methods after exclusion of Torsion of testis. Early exploration can salvage the testis in cases of torsion of testis. Key words: Acute orchiepididymitis; Acute scrotal swelling; Fournier\u27s gangrene; Orchidectomy; Orchidopexy; Torsion of testis

Shatkriyakala Concept and its Importance in Disease Diagnosis and Treatment: A Review

Ayurveda aims towards the maintenance of health of a healthy person and helps to curing the diseases of diseased person. Ayurveda suggested various therapeutic approaches for maintaining balances of Dosha, Dhatu and Mala. Similarly ayurveda described mentioned different modalities of disease diagnosis and Kriyakala is one such modality which helps to recognize various stages of disease progression. The concept of Kriyakala provides benefits to plant appropriate treatment according to the stage of disease progression. The appropriate measures can be taken to correct the balances of Doshas in particular stages of disease. Ayurveda explored the concept of Shatkriyakala as a “six stages of disease progression” in which the pathogenesis of disease can be assessed in different stages. This article explained six stages of Shatkriyakala, its importance in disease diagnosis and treatment. The modern correlation of Shatkriyakala also described in present article

CLINICAL OUTCOME OF PATIENTS WITH ACUTE SCROTAL PAIN AT A TERTIARY RURAL CENTRE IN MAHARASHTRA

Introduction: Acute scrotum is a common reason for emergency consultation. Early scrotal exploration is mandatory if torsion of the testis suspected clinically. Objectives: To study management and clinical outcome of patients admitted with acute scrotal condition. Methods: This was a prospective observational study involving 60 patients hospitalized for Acute scrotum at tertiary rural centre, from September 2014 to September 2016. Patients admitted with complaints of acute pain and swelling of scrotum irrespective of age and gender were included in the study. Patient with painless scrotal swelling and those with chronic scrotal pain were excluded from the study. Patients were monitored post-operatively till discharge and followed for 1 month for any complications. Results: Of the 60 patients in our study, acute epididymo-orchitis (36.6%) was the dominant cause of acute scrotal swelling followed by scrotal abscess (23.3%). 51.6% of the patients were managed conservatively, which were diagnosed as epididymoorchitis and haematocele. 14 patients underwent incision and drainage who diagnosed as scrotal abscess; 7 patients diagnosed as fournier's underwent debridement; 5 underwent orchidectomy or orchidopexy while 3 underwent B/L orchidopexy. Out of 8 cases of torsion of testis, bilateral orchidopexy was done in 3 cases (37.5%) in which we were able to salvage the affected testis. Out of the 60 patients, maximum patients (41 patients) required a hospital stay of 1-10 days. All patients were followed up for a period of 1month after discharge. None of the patients had any serious complications. Conclusion: Acute scrotum can be successfully managed by consevative methods after exclusion of Torsion of testis. Early exploration can salvage the testis in cases of torsion of testis. Key words: Acute orchiepididymitis; Acute scrotal swelling; Fournier's gangrene; Orchidectomy; Orchidopexy; Torsion of testis

EVALUATION OF THE INTERACTION OF PIPERINE WITH ANTIDEPRESSANT SERTRALINE AND ANALGESIC PENTAZOCINE, USING DIFFERENT ROUTES OF ADMINISTRATION IN ALBINO MICE

ABSTRACTObjective: To evaluate the effect of piperine on the antidepressant activity of sertraline and analgesic activity of pentazocine and to explore the effectof using oral and parenteral routes of administration on the possible interactions.Methods: Piperine was isolated from commercially obtained Piper nigrum extract. Swiss albino mice of either sex were divided into 8 groups (n=6)receiving: 2% gum acacia (oral, intraperitoneally [i.p.]), standard drug (oral, i.p.), standard drug + piperine (oral, i.p.), piperine (oral, i.p.). Tailsuspension test (TST) was used for antidepressant effect and Eddy's hot plate method for analgesic effect. Sertraline and pentazocine were used asstandard drugs (5 mg/kg) and piperine at 10 mg/kg.Result: In the TST, piperine alone (both routes) decreased immobility time, but the effect was statistically insignificant. Both combination groups(oral and i.p.) showed significantly better activity compared to sertraline oral and i.p. groups, respectively (p<0.05). Oral combination showed activitycomparable to i.p. combination (p>0.05). Piperine did not show any analgesic activity of its own (both routes). Piperine with pentazocine orallyshowed significantly better activity compared to pentazocine (oral) at 1, 2, and 4 hrs, and analgesia at 0.5 hr which pentazocine oral did not. Parenteralcombination was significantly better than pentazocine (i.p.) group at 2 and 4 hrs and better than oral combination at 4 hrs.Conclusion: Piperine has potential to be used in combination with pentazocine due to its bioenhancing effect and with sertraline due to a potentiating/additive effect which can help reduce dose and adverse effects of these drugs.Keywords: Piperine, Pentazocine, Sertraline, Albino mice, Bio enhancement, Potentiation

A COMPARATIVE STUDY OF STEREOCHEMICAL EFFECTS OF ANTI-PROSTATE AGENTS BY MOLECULAR DOCKING

Objective: A comparative study of anti-prostate agents to investigate the stereochemical influences on binding affinity by molecular docking.Methods: Structures of enantiomers (R and S stereoisomers) for known anti-prostate cancer (PCa) agents were drawn using ChemBioDraw 2D software. Thereafter, they were converted to 3D structures using the ChemBioDraw 3D software in which they were subjected to energy minimization using the MM2 method and then saved as PDB extension files which can be accessed using the ADT interface. AutoDock Vina (ADT) 1.5.6 software version was used for molecular docking study.Results: A total of 12 different anti-PCa agents were selected and drawn including well-known drug R-bicalutamide. All molecules showed the binding affinity with respect to the nature of stereochemistry. R-stereoisomers showed better interaction as well as binding affinity toward 1z95 (mutated androgen receptor protein involved in the progression of PCa) whereas their S-stereoisomers were found inferior in comparison.Conclusion: This study showed that CB1-R and R-bicalutamide (with R-stereochemistry) were better in binding affinity comparative to their counterpart CB1-S and S-Bicalutamide (with S-stereochemistry). All the selected anti-PCa agents were showing the effect of stereochemical center; therefore, we must choose the right kind of stereochemistry while planning to develop the newer anti-PCa agents

Diagnostic Dilemma in an Unusual Case of Common Bile Duct Obstruction

Biliary obstructions are rarely caused by a foreign body and have received sparse attention. We present an unusual case with pruritis and abdominal pain caused by impacted full length surgical gauze within the common bile duct. The patient had previously undergone an open cholecystectomy. Radiological investigations were inconclusive and suggestive of either a calculus or a cholangiocarcinoma. Surgical exploration revealed full length surgical gauze within the common bile duct. Because imaging modalities are often non-determinant, the possibility of biliary tract obstruction from a foreign body should be borne in mind for patients with unusual presentations, especially those who have previously undergone surgery

CHANGING TRENDS IN MICROBIAL FLORA AND THEIR ANTIBIOTIC SENSITIVITY

Microbial resistance is a burning issue in the medical world from last few decades. Irrationale use of antibiotics in the treatment of infectious diseases has led to emergence of resistant strains of microorganisms; incapacitating the most potent weapon against infections. Thus, the present study was conducted to evaluate the trends in microbial flora and their antibiotic sensitivity. A retrospective study of five hundred twelve patients admitted in various hospitals attached to Dr. S. N Medical College, Jodhpur with various infections was conducted. The blood culture reports were screened to study microbial organisms and their antibiotic sensitivity pattern. The most common organisms isolated were staph aureus accounting for 29.5% of the isolates and followed by Klebsiella (13.87%), Enterococci (7.81%) and Citrobacter (7.42%). At the end of the study, it was observed that there were constant changes in the pattern of organisms and antibiotics in patients. Based on this study, it is suggested that before prescribing antibiotics, clinicians should be aware of recent trends of prevalent organisms and their sensitivity patterns. This would reduce emergence of resistant organisms and favour patient’s wellbeing

Influence of organic molecules on the aggregation of TiO2 nanoparticles in acidic conditions

Engineered nanoparticles released into the environment may interact with natural organic matter (NOM). Surface complexation affects the surface potential, which in turn may lead to aggregation of the particles. Aggregation of synthetic TiO2 (anatase) nanoparticles in aqueous suspension was investigated at pH 2.8 as a function of time in the presence of various organic molecules and Suwannee River fulvic acid (SRFA), using dynamic light scattering (DLS) and high-resolution transmission electron microscopy (TEM). Results showed that the average hydrodynamic diameter and ?-potential were dependent on both concentration and molecular structure of the organic molecule. Results were also compared with those of quantitative batch adsorption experiments. Further, a time study of the aggregation of TiO2 nanoparticles in the presence of 2,3-dihydroxybenzoic acid (2,3-DHBA) and SRFA, respectively, was performed in order to observe changes in ?-potential and particle size over a time period of 9 months. In the 2,3-DHBA-TiO2 system, ?-potentials decreased with time resulting in charge neutralization and/or inversion depending on ligand concentration. Aggregate sizes increased initially to the micrometer size range, followed by disaggregation after several months. No or very little interaction between SRFA and TiO2 occurred at the lowest concentrations tested. However, at the higher concentrations of SRFA, there was an increase in both aggregate size and the amount of SRFA adsorbed to the TiO2 surface. This was in correlation with the ?-potential that decreased with increased SRFA concentration, leading to destabilization of the system. These results stress the importance of performing studies over both short and long time periods to better understand and predict the long-term effects of nanoparticles in the environment

COMPARISON OF ANTI-DIABETIC AND ANTI-OXIDANT ACTIVITY OF WILD AND CULTIVATED VARIETY OF RAUWOLFIA SERPENTINA

Objectives: About 80% of world populations are still dependent on herbal plants. Rauwolfia is also one of the wonder drugs of India, which is used since ancient time. It contains a variety of compounds with antioxidant activity and other health benefits. A wild variety of rauwolfia is became endangered due to indiscriminate use. Hence, its cultivation and collection have been started to complete the demand of rauwolfia. Therefore, the study was designed to evaluate and compare the in vitro antioxidant and antidiabetic activity of the wild and cultivated plant of rauwolfia. Methods: The methanolic extract of wild and cultivated plant was subjected to the DPPH and alpha-amylase inhibition activity for antioxidant and antidiabetic activity, respectively. Result: The study revealed that the wild and cultivated variety of Rauwolfia serpentina does not have a significant difference in their antidiabetic and antioxidant activities. Conclusion: On the basis of the in-vitro studies, it can be concluded that cultivated variety of the plant can be used as a substitute for a wild variety of R. serpentina

Nanoformulations of quercetin: a potential phytochemical for the treatment of uv radiation induced skin damages

The continuous prolonged exposures of sun light especially the ultra violet (UV) radiation present in it, cause not only the risk of skin cancer but also it may cause premature skin aging, photodermatoses and actinic keratoses. Flavonoids (including Flavane, Flavanone, Flavone, Flavonol, Isoflavone, Neoflavone etc.) having potent antioxidant activity, used as topical applications for protection against UV induced skin damages as well as for skin care. Most commonly used flavonoid is quercetin (Flavonol), which is present in fruits, vegetables, and herbs. We aim to review the research focused on development of different novel formulations to treat UV radiations induced skin diseases. In this review, several formulations of flavonoid quercetin were discussed and their outcomes were compiled and compared in context to solubility, stability and efficiency of application. On the basis this comparative analysis we have concluded that three formulations, namely glycerosomes, nanostructured lipid carriers and deformable liposomes hold good applications for future aspects for topical delivery of quercetin. These formulations showed enhanced stability, increased quercetin accumulation in different skin layers, facilitated drug permeation in skin and long-lasting drug release