REVIEW OF PULMONARY EMBOLISM

Pulmonary embolism is a blockage of main artery or one of its branches of lung by the fat, amniotic fluid, embolisation of air or any other foreign substances. It is also due to formation of thrombus [blood clot] in the arteries of lung. Due to the pulmonary embolism the blood circulation in the body will be effected. Sometimes PE leads to death also by the lacking of breathing. In USA the annual incidence rates per 1000 persons aged 65-69 are 1.3 affected by pulmonary embolism. The diagnosis of pulmonary embolism at the earlier stage will be difficult because the symptoms like difficulty in breathing and chest pain are not easily differentiated from the other diseases like myocardial infarction. The usage of drugs like anti coagulants and thrombolytic cause bleeding problems even though they shows the antagonistic activity of pulmonary embolism at higher doses. Physician responsibility is to successfully avoid bleeding disorders are at the time of prevention of pulmonary embolism. And also by conducting of programs which should strive to coordinate care, by region wide guidelines and by implementing of care programs there is a chance to elaborate knowledge about the pulmonary embolism to the physicians and also there is a chance to bring awareness among the public which may decreases the number deaths due to pulmonary embolism annually. KEY WORDS: Pulmonary embolism, myocardial infraction, intra vascular co agulation, e.t.c

Effect of Selected Acupuncture Points (GB-39, BL-17,LV-13) on Hemoglobin Levels in Nutritional Deficiency Anemia: A Randomized Controlled study

BACKGROUND AND AIM: Anemia is a condition in which there is a marked reduction in proportion of RBC, it can be either reduction of Haemoglobin or any morphological changes in the Red cells. It is a presentation of any underlying condition. WHO classifies Anemia according to the amount of haemoglobin as Mild, Severe and Life threatening. Its prevalence is high among female than male. Anemia affects one-third of the global population. Iron deficiency Anemia is the common type affects female of all age group. 85% of Iron deficiency Anemia is prevalent among female of Adolescence and reproductive age group. Acupuncture is an invasive technique originated from china have many therapeutic values in blood disorders. According to Traditional Chinese medicine, Anemia is considered as blood qi deficiency disease. Though there are only few studies on Acupuncture and anemia, the aim of this study is to evaluate the effect of selected acupuncture points on Hemoglobin level in Anemic subjects. METHODS: 100 Anemic subjects attending Outpatient Department of Government Yoga and Naturopathy Medical College Hospital are recruited for the study and they were screened on the basis of inclusion and exclusion criteria. They were randomly divided into Study group (n=50) and control group (n=50) by computerized randomization. The subjects were blinded about their intervention. In study group the subjects were given needling on selected acupuncture point (BL 17, Lv 13 and GB39) for 30 minutes with manual stimulation of 10 minutes. This intervention was given for 5 days a week for 2 week. The subjects of control group were given Acupuncture on Placebo (sham) points for 30 minutes a day for 2 weeks (5 days in a week). Baseline and post intervention data of Hb, MCV, MCH and RDW were collected a day before intervention and after completion of intervention for 2 weeks. The statistical Analysis was done using Statistical Package of Social services (SPSS) version 16 and the value of p≤0.05 is considered significant. RESULTS: The result of the study showed a significant increase in hemoglobin, MCV, MCH and RDW in study group compared to the control group. Moreover, none of the subjects reported any adverse events during or after the intervention. CONCLUSION: The present study demonstrated that Acupuncture has an effect on increasing haemoglobin level as well as increasing MCV, MCH and RDW levels in anaemic subjects

Study on HELLP syndrome - maternal and perinatal outcome

Background: HELLP Syndrome is a serious obstetric complication in pregnancy characterised by haemolysis, elevated liver enzymes and low platelet count. Incidence is 0.5-0.9% of all pregnancies and in 10-20% of cases with severe preeclampsia and eclampsia. The aim of the study was to study the incidence, different clinical presentations and diagnosis of HELLP syndrome in Pre eclampsia and Eclampsia and to analyze the severity, complications, maternal and perinatal outcome.Methods: It is a 16 months period retrospective study of 102 cases of preeclampsia and eclampsia admitted in NRIMC and GH in OBGY Department with more than 28 weeks gestation. Of these, 91 cases had preeclampsia and 11 cases had eclampsia. Out of these, 15 cases developed HELLP Syndrome. The available history, clinical data, detailed laboratory investigations were studied and categorized by Mississippi classification for better analysis of complications and outcome in HELLP syndrome.Results: Of 91 cases of Preeclampsia, 12 cases (13.18%) developed HELLP syndrome and out of 11 cases of Eclampsia, 3 cases (27.27%) had HELLP Syndrome. Majority of the cases belonged to 21-25years age group and were mostly from lower Socio economic status. The present study showed 60% maternal morbidity and 6.6% maternal mortality and the perinatal morbidity and mortality was 46.6% each.Conclusions: HELLP Syndrome is a severe variant and a dreadful complication of Preeclampsia and Eclampsia, it needs early diagnosis and timely intervention in the form of termination of pregnancy to arrest further progress of pathophysiology leading to complications

PHARMACOGNOSTIC AND HPTLC BASED COMPARATIVE STUDY ON LEAVES OF MERREMIA EMARGINATA BURM. F. AND CENTELLA ASIATICA (L.) URBAN

Objective: In this study, an attempt was made to generate information based on botanical, physicochemical and HPTLC data needed for proper identification and authentication of M. emarginata and C. asiatica belonging to two different families. Methods: Botanical study comprises of macroscopy, microscopy and powder microscopy of leaves of both crude drugs. The physicochemical parameters such as water-soluble extractive, alcohol soluble extractive and loss on drying at 105℃, total ash, acid insoluble ash, and volatile oil were determined according to standard methods. HPTLC studies of chloroform extracts of leaves of both drugs were conducted at 254 nm, 366 nm and 575 nm after derivatisation using vanillin-sulphuric acid and the results were documented. Results: The present study reveals that microscopy and most of the physicochemical parameters of both the plant materials are different. Anatomy of the leaves showed two main characteristic differences. First plenty of trichome with trichome base and calcium oxalate crystal is common in M. emarginata, which is not observed in C. asiatica. Both plants have different venation patterns and leaf constants. The total ash content and the solubility in alcohol and water for leaves of C. asiatica are higher than that of M. emarginata. The HPTLC fingerprinting pattern obtained for both drugs are different. Conclusion: All the results obtained from this study help in determining differences and similarities of leaves of M. emarginata and C. asiatica and thereby preventing adulteration and substitution and emphasizing the importance of standardization

Identification of Artocarpus hirsutus and Garcinia gummi-gutta as the sources of trypsin inhibitory proteins

Natural trypsin inhibitors from plant tissues are emerging with promising therapeutic uses. They have profound applications in medicine and biotechnology and are extensively used in the food and medicine industry. Their activities are affected by detergents, metal ions, and reducing or chelating agents that are commonly used in these industries. Artocarpus hirsutus and Garcinia gummi-gutta are two tropical trees wherein most of the plant parts except the seeds were extensively studied and proved to possess medicinal properties. In the present study, the seeds of these tropical plants are proved to possess trypsin inhibitory activity. We report here the partial purification of trypsin inhibitory proteins from mature seed extracts of A. hirsutus and G.gummi-gutta in 50 mM phosphate buffer (pH 7.6). The partial purification was done by ammonium sulphate precipitation. Modulation of activity of A. hirsutus and G. gummi-gutta TIs by thermal stabilisers, metal ions and detergents were analysed. There was a significant fold of purification, in both cases. The thermal stabilisers, metal ions and detergents modulate the activities of the two TIs in their way. The study effectively provides choices of optimal additives to be used, where industrial processing of these TIs is required for therapeutic applications

Identification of Artocarpus hirsutus and Garcinia gummi-gutta as the sources of trypsin inhibitory proteins

195-201Natural trypsin inhibitors from plant tissues are emerging with promising therapeutic uses. They have profound applications in medicine and biotechnology and are extensively used in the food and medicine industry. Their activities are affected by detergents, metal ions, and reducing or chelating agents that are commonly used in these industries. Artocarpus hirsutus and Garcinia gummi-gutta are two tropical trees wherein most of the plant parts except the seeds were extensively studied and proved to possess medicinal properties. In the present study, the seeds of these tropical plants are proved to possess trypsin inhibitory activity. We report here the partial purification of trypsin inhibitory proteins from mature seed extracts of A. hirsutus and G.gummi-gutta in 50 mM phosphate buffer (pH 7.6). The partial purification was done by ammonium sulphate precipitation. Modulation of activity of A. hirsutus and G. gummi-gutta TIs by thermal stabilisers, metal ions and detergents were analysed. There was a significant fold of purification, in both cases. The thermal stabilisers, metal ions and detergents modulate the activities of the two TIs in their way. The study effectively provides choices of optimal additives to be used, where industrial processing of these TIs is required for therapeutic applications

Arm-specific dynamics of chromosome evolution in malaria mosquitoes

<p>Abstract</p> <p>Background</p> <p>The malaria mosquito species of subgenus <it>Cellia </it>have rich inversion polymorphisms that correlate with environmental variables. Polymorphic inversions tend to cluster on the chromosomal arms 2R and 2L but not on X, 3R and 3L in <it>Anopheles gambiae </it>and homologous arms in other species. However, it is unknown whether polymorphic inversions on homologous chromosomal arms of distantly related species from subgenus <it>Cellia </it>nonrandomly share similar sets of genes. It is also unclear if the evolutionary breakage of inversion-poor chromosomal arms is under constraints.</p> <p>Results</p> <p>To gain a better understanding of the arm-specific differences in the rates of genome rearrangements, we compared gene orders and established syntenic relationships among <it>Anopheles gambiae, Anopheles funestus</it>, and <it>Anopheles stephensi</it>. We provided evidence that polymorphic inversions on the 2R arms in these three species nonrandomly captured similar sets of genes. This nonrandom distribution of genes was not only a result of preservation of ancestral gene order but also an outcome of extensive reshuffling of gene orders that created new combinations of homologous genes within independently originated polymorphic inversions. The statistical analysis of distribution of conserved gene orders demonstrated that the autosomal arms differ in their tolerance to generating evolutionary breakpoints. The fastest evolving 2R autosomal arm was enriched with gene blocks conserved between only a pair of species. In contrast, all identified syntenic blocks were preserved on the slowly evolving 3R arm of <it>An. gambiae </it>and on the homologous arms of <it>An. funestus </it>and <it>An. stephensi</it>.</p> <p>Conclusions</p> <p>Our results suggest that natural selection favors specific gene combinations within polymorphic inversions when distant species are exposed to similar environmental pressures. This knowledge could be useful for the discovery of genes responsible for an association of inversion polymorphisms with phenotypic variations in multiple species. Our data support the chromosomal arm specificity in rates of gene order disruption during mosquito evolution. We conclude that the distribution of breakpoint regions is evolutionary conserved on slowly evolving arms and tends to be lineage-specific on rapidly evolving arms.</p

Natural flavonoids as potential multifunctional agents in prevention of diabetic cataract

Cataract is one of the earliest secondary complications of diabetes mellitus. The lens is a closed system with limited capability to repair or regenerate itself. Current evidence supports the view that cataractogenesis is a multifactorial process. Mechanisms related to glucose toxicity, namely oxidative stress, processes of non-enzymatic glycation and enhanced polyol pathway significantly contribute to the development of eye lens opacity under conditions of diabetes. There is an urgent need for inexpensive, non-surgical approaches to the treatment of cataract. Recently, considerable attention has been devoted to the search for phytochemical therapeutics. Several pharmacological actions of natural flavonoids may operate in the prevention of cataract since flavonoids are capable of affecting multiple mechanisms or etiological factors responsible for the development of diabetic cataract. In the present paper, natural flavonoids are reviewed as potential agents that could reduce the risk of cataract formation via affecting multiple pathways pertinent to eye lens opacification. In addition, the bioavailability of flavonoids for the lens is considered

Nintedanib for Systemic Sclerosis-Associated Interstitial Lung Disease

BACKGROUND: Interstitial lung disease (ILD) is a common manifestation of systemic sclerosis and a leading cause of systemic sclerosis-related death. Nintedanib, a tyrosine kinase inhibitor, has been shown to have antifibrotic and antiinflammatory effects in preclinical models of systemic sclerosis and ILD. METHODS: We conducted a randomized, double-blind, placebo-controlled trial to investigate the efficacy and safety of nintedanib in patients with ILD associated with systemic sclerosis. Patients who had systemic sclerosis with an onset of the first non-Raynaud's symptom within the past 7 years and a high-resolution computed tomographic scan that showed fibrosis affecting at least 10% of the lungs were randomly assigned, in a 1:1 ratio, to receive 150 mg of nintedanib, administered orally twice daily, or placebo. The primary end point was the annual rate of decline in forced vital capacity (FVC), assessed over a 52-week period. Key secondary end points were absolute changes from baseline in the modified Rodnan skin score and in the total score on the St. George's Respiratory Questionnaire (SGRQ) at week 52. RESULTS: A total of 576 patients received at least one dose of nintedanib or placebo; 51.9% had diffuse cutaneous systemic sclerosis, and 48.4% were receiving mycophenolate at baseline. In the primary end-point analysis, the adjusted annual rate of change in FVC was 1252.4 ml per year in the nintedanib group and 1293.3 ml per year in the placebo group (difference, 41.0 ml per year; 95% confidence interval [CI], 2.9 to 79.0; P=0.04). Sensitivity analyses based on multiple imputation for missing data yielded P values for the primary end point ranging from 0.06 to 0.10. The change from baseline in the modified Rodnan skin score and the total score on the SGRQ at week 52 did not differ significantly between the trial groups, with differences of 120.21 (95% CI, 120.94 to 0.53; P=0.58) and 1.69 (95% CI, 120.73 to 4.12 [not adjusted for multiple comparisons]), respectively. Diarrhea, the most common adverse event, was reported in 75.7% of the patients in the nintedanib group and in 31.6% of those in the placebo group. CONCLUSIONS: Among patients with ILD associated with systemic sclerosis, the annual rate of decline in FVC was lower with nintedanib than with placebo; no clinical benefit of nintedanib was observed for other manifestations of systemic sclerosis. The adverse-event profile of nintedanib observed in this trial was similar to that observed in patients with idiopathic pulmonary fibrosis; gastrointestinal adverse events, including diarrhea, were more common with nintedanib than with placebo

Comparison of Bone Volume Changes and Implant Stability in Mandibular Posterior Immediate Extraction Sockets With and Without Bone Graft and L-PRF: A Randomized Controlled Clinical Trial

AIM OF THE STUDY: To evaluate and compare the bone volume changes and implant stability in mandibular posterior immediate extraction sockets with and without bone graft and L-PRF. MATERIALS AND METHODS: Parallel randomized controlled clinical trial was conducted from 2020 to 2021. Eight patients who had ten hopeless mandibular posterior immediate extraction sites were randomly allotted to Group A –immediate implant alone (without graft & L-PRF) or Group B –immediate implant with graft and L-PRF mixture. Horizontal and vertical bone volume changes using segmental CBCT, implant stability using Bredent Penguin RFA assessment was made at baseline (on the day of implant placement) and 6 months post healing. RESULTS: Bone volume changes in buccal and lingual aspect were measured at 5 different levels, 0mm (the level of implant platform), 1mm, 2mm, 4mm & 6 mm. There was a statistical significant difference in horizontal bone volume changes in the buccal aspect at all levels between groups (p=0.04), with Group A (without graft) showing more bone loss than Group B (with graft & L-PRF mixture). Both groups experienced similar bone loss in lingual aspect as well as in the mesial and the distal aspect. There was a significant improvement in implant stability from baseline to 6 months in both groups (group A p=0.003 and group B p=0.003). But there was no significant change between groups at baseline (p=0.17) and at 6 months (p=0.37). CONCLUSION: Bone grafting procedures significantly preserves the buccal bone volume but did not have any significance on lingual or mesial and distal bone volumes. Both groups demonstrated clinically acceptable implant stability after 6 months. Thus, combining bone graft with L-PRF is a predictable option to preserve buccal bone volume in immediate implant cases