AN OBSERVATIONAL STUDY ON THE EFFICACY AND SAFETY FOR THE COMBINATION OF LUTEIN, VITAMIN C, ZEAXANTHIN, ZINC, COPPER, AND VITAMIN E IN INDIAN PATIENTS OF AGE-RELATED MACULAR DEGENERATION (AMD).

Background: Age-related macular degeneration (AMD) is the leading cause of irreversible blindness in the elderly population, particularly those over the age of 65. The progressive decline in visual function experienced by individuals with AMD significantly impacts their daily lives and incurs their social activities and independence. This study aims to conduct a post-marketing investigation of a fixed-dose combination created for patients in India affected with AMD, evaluating its safety and efficiency. Material and Methods: In this research, a total of 450 participants were registered in the span of 10 months. The study was conducted at Anugrah Narayan Magadh Medical College, Gaya, Bihar. During the research, efficacy and safety assessments were conducted on every visit conducted after 3 months. The efficacy assessment involved the use of two parameters, namely vision-related quality of life (VRQOL) and vision impairment score, which were obtained by the administration of a Vision Impairment Questionnaire. Results: Assessing the patients with the help of vision impairment and VRQOL test, the following were the observations- For the VRQOL test, on the 2nd and the 3rd visit, the VRQOL increased by 19% and 33% that compared to the first assessment, this indicates a positive impact of the dosage administered. For the Vision impairment test, on visit 1 the percentage was 23% which further reduced to 15% by the second visit and 11% approx.  Conclusion: After the successful investigation, the combination of Vit C (250 mg), Cu (1 mg), Zn (40 mg), Lutein (5 mg), Vit E (200 IU), and Zeaxanthin (1 mg) per capsule was determined to be both effective and safe in treating age-related macular degeneration (AMD) in Indian patients. Recommendation: It is to consult an eye-care professional as soon as possible if vision changes and also continue to attend routine sight tests with an optometrist

Synergistic induction of heme oxygenase-1 by the components of the antioxidant supplement Protandim. Free Radic.

Protandim is an antioxidant supplement that consists of five ingredients, namely, ashwagandha, bacopa extract, green tea extract, silymarin, and curcumin, each with known therapeutic properties. Protandim was formulated with the objective of combining multiple phytochemicals at low nontoxic doses to gain synergy among them. A recent clinical study demonstrated the in vivo antioxidant effects of Protandim (S.K. Nelson et al., 2006, Free Radic. Biol. Med. 40, 341-347). The objective of the present study was to determine if the components of Protandim induce heme oxygenase-1 (HO-1) in a synergistic manner in cultured MIN6 cells, a mouse β-cell line, and in SK-N-MC cells, a human neuroblastoma cell line. When the components of Protandim were tested alone at low doses, curcumin showed minimal induction, whereas the others were unable to induce the HO-1 promoter, assayed by transient transfection. All components together, however, produced a strongly synergistic induction of around three-to ninefold in a dose-dependent manner, greatly exceeding the sum of the parts. Similar findings were obtained for the expression of HO-1 at the mRNA and protein levels. Protandim-mediated HO-1 induction involved the presence of ARE sites in the HO-1 promoter and nuclear translocalization of the transcription factor Nrf2, which binds to ARE sites. The involvement of multiple signaling pathways, including PI3-kinase/Akt, p38MAPK, and PKCδ, in HO-1 induction seems to be the probable mechanism of synergy between the components of Protandim. There were significant increases in the levels of total glutathione in Protandimtreated cells. These findings suggest that the use of a combination of phytochemicals may be an efficient method for the induction of antioxidant enzymes

Synergistic induction of heme oxygenase-1 by the components of the antioxidant supplement Protandim. Free Radic.

Protandim is an antioxidant supplement that consists of five ingredients, namely, ashwagandha, bacopa extract, green tea extract, silymarin, and curcumin, each with known therapeutic properties. Protandim was formulated with the objective of combining multiple phytochemicals at low nontoxic doses to gain synergy among them. A recent clinical study demonstrated the in vivo antioxidant effects of Protandim (S.K. Nelson et al., 2006, Free Radic. Biol. Med. 40, 341-347). The objective of the present study was to determine if the components of Protandim induce heme oxygenase-1 (HO-1) in a synergistic manner in cultured MIN6 cells, a mouse β-cell line, and in SK-N-MC cells, a human neuroblastoma cell line. When the components of Protandim were tested alone at low doses, curcumin showed minimal induction, whereas the others were unable to induce the HO-1 promoter, assayed by transient transfection. All components together, however, produced a strongly synergistic induction of around three-to ninefold in a dose-dependent manner, greatly exceeding the sum of the parts. Similar findings were obtained for the expression of HO-1 at the mRNA and protein levels. Protandim-mediated HO-1 induction involved the presence of ARE sites in the HO-1 promoter and nuclear translocalization of the transcription factor Nrf2, which binds to ARE sites. The involvement of multiple signaling pathways, including PI3-kinase/Akt, p38MAPK, and PKCδ, in HO-1 induction seems to be the probable mechanism of synergy between the components of Protandim. There were significant increases in the levels of total glutathione in Protandimtreated cells. These findings suggest that the use of a combination of phytochemicals may be an efficient method for the induction of antioxidant enzymes

SURVEY BASE STUDY ON CURRENT TREND OF TREATMENT OF COMMUNITY-ACQUIRED PNEUMONIA IN KARACHI

Objective: Community-acquired pneumonia (CAP) is a potentially serious infection that results in various general physicians (GP) visits and hospital admission every year. The prime objective of this research was to find the current trend of treatment of community-acquired pneumonia in Karachi.Methods: It was a prospective survey conducted in all districts of Karachi. A Questionnaire was filled by distinctive specialities of doctors in an outpatient setting in Karachi. A preliminary test questionnaire was used to collect the data directly from distinctive specialities of doctors in outpatient setting in Karachi. Total 500 doctors were selected from distinct districts of Karachi with convenient random sampling.Results: Majority (33.8%) of the respondents recommended complete blood count and chest x-ray for diagnosis of community-acquired pneumonia in an outpatient setting. Most (76%) of the respondents recommended nebulization for the management of community-acquired pneumonia in an outpatient setting. 31% and 25.4% of the physicians recommended clarithromycin as 1st line antibiotic therapy in adults and children for the management of a community-acquired pneumonia patients in outpatient setting.55.6% of the physicians recommended two-week duration of antibiotic therapy for the management of CAP in outpatient setting.Conclusion: This is clearly indicated by this study that deviation from the standard guideline is observed in the management of community-acquired pneumonia in Karachi. These deviations from the highly recommended guideline can results excess cost and inappropriateness of the management of the disease of community-acquired pneumonia. There is a need that the physician should take a decision of therapy according to the standard guidelines for the treatment of CAP in an outpatient setting.Â

Distinct repeat motifs at the C-terminal region of CagA of Helicobacter pylori strains isolated from diseased patients and asymptomatic individuals in West Bengal, India

Background: Infection with Helicobacter pylori strains that express CagA is associated with gastritis, peptic ulcer disease, and gastric adenocarcinoma. The biological function of CagA depends on tyrosine phosphorylation by a cellular kinase. The phosphate acceptor tyrosine moiety is present within the EPIYA motif at the C-terminal region of the protein. This region is highly polymorphic due to variations in the number of EPIYA motifs and the polymorphism found in spacer regions among EPIYA motifs. The aim of this study was to analyze the polymorphism at the C-terminal end of CagA and to evaluate its association with the clinical status of the host in West Bengal, India. Results: Seventy-seven H. pylori strains isolated from patients with various clinical statuses were used to characterize the C-ternimal polymorphic region of CagA. Our analysis showed that there is no correlation between the previously described CagA types and various disease outcomes in Indian context. Further analyses of different CagA structures revealed that the repeat units in the spacer sequences within the EPIYA motifs are actually more discrete than the previously proposed models of CagA variants. Conclusion: Our analyses suggest that EPIYA motifs as well as the spacer sequence units are present as distinct insertions and deletions, which possibly have arisen from extensive recombination events. Moreover, we have identified several new CagA types, which could not be typed by the existing systems and therefore, we have proposed a new typing system. We hypothesize that a cagA gene encoding higher number EPIYA motifs may perhaps have arisen from cagA genes that encode lesser EPIYA motifs by acquisition of DNA segments through recombination events

Significant association of the dupA gene of Helicobacter pylori with duodenal ulcer development in a South-east Indian population

A novel virulence factor, duodenal ulcer-promoting gene A (dupA), in Helicobacter pylori has been found to be associated with disease in certain populations but not in others. This study analysed a South-east Indian population as part of the debate about the relevance of dupA for the prediction of clinical outcomes. A total of 140 H. pylori strains isolated from duodenal ulcer (DU) (n=83) and non-ulcer dyspepsia (NUD) patients (n=57) were screened by PCR and dot-blot hybridization to determine the presence of the ORFs jhp0917 and jhp0918. Part of jhp0917-jhp0918 was sequenced to search for the C/T insertion that characterizes dupA and the levels of dupA transcripts were also assessed. The PCR and dot-blot results indicated the presence of jhp0917 and jhp0918 in 37.3% (31/83) and 12.2% (7/57) of H. pylori strains isolated from DU and NUD patients, respectively. Sequencing analysis showed insertion of a C at nt 1386 in the 3' region of jhp0917, forming the dupA gene in 35 strains. RT-PCR analysis detected the dupA transcript in 28 of these 35 strains. The expression level of the dupA transcript varied from strain to strain, as shown by real-time PCR. The results demonstrated that analysis based on PCR only for dupA may produce an erroneous interpretation. The prevalence of dupA was significantly greater among strains isolated from patients with DU than from patients with NUD in this population (P=0.001, odds ratio=4.26, confidence interval=1.60-11.74). Based on these findings, dupA can be considered a biomarker for DU patients in India. The reported discrepancies for this putative virulence marker in different populations may be due to the genome plasticity of H. pylori

CYTOCHROME F FROM PLANTS AND CYANOBACTERIA

Existing methods of isolation and purification of cytochrome f were modified to give extraction yields of close to 100 percent and purification yields of 80 to 90 percent. This procedure was successfully applied to cyanobacteria, a eukaryotic alga, and higher plants. In addition schemes were developed to obtain both monomeric and aggregated cytochrome f from the same organism. The first 81 residues of Spirulina maxima cytochrome f and the first 78 residues of spinach cytochrome f were determined by automated sequencing of fragments produced by chemical and proteolytic digestion. Fifty-nine of the eighty-one residues of the cyanobacterial cytochrome f are conserved in the eukaryotic protein. The heme binding site is located in this region. A low potential cytochrome, cytochrome c(,550), occasionally found in various species of cyanobacteria and eukaryotic algae and considered to be a proteolytic product of cytochrome f was isolated and purified by conventional and high performance liquid chromatography. N-Terminal amino acid sequence analysis proves the distinctness of this protein from cytochrome f. Indeed, cytochrome c(,550), the high potential cytochrome c(,553), and cyanobacterial cytochrome f are not antigenically related as determined by immunodiffusion experiments using antibodies raised against each cytochrome. Modification of intact and disrupted spinach thylakoid membranes with diazonium benzene sulfonic acid (DABS) was employed to investigate the location of plastocyanin and cytochrome f relative to the bilayer. The labeling patterns for plastocyanin and cytochrome f were dependent on the state of the membranes. Similar patterns were observed with thylakoids either incubated in the dark or exposed to light. Comparison with data obtained earlier for the labelling of cytochrome oxidase under similar conditions suggests that parts of the cytochrome f polypeptide chain are exposed at both sides of the photosynthetic membrane