A study evaluating knowledge, attitude and practices of practitioners in the medicine department of tertiary care teaching rural hospital with respect to antihypertensives

Background: The aim of this study was to evaluate knowledge, attitude and practices of practitioners in the medicine department of tertiary care teaching rural hospital with respect to antihypertensives and find out the disparity between the recommended and actual practices for pharmacological management.Methods: It was survey type of study, carried out using feedback questionnaire related to use of antihypertensives. Total 25 consultants were included in the study.Results: It was found that in mild hypertension single drug and two drugs in combination were preferred by 15 and 10 practitioners respectively. In moderate hypertension single drug, two drugs in combination, and greater than two drugs were preferred by 3, 13, and 7 practitioners respectively. In severe hypertension two drugs in combination and greater than two drugs were preferred by 16 and 9 practitioners respectively; none preferred single drug. Angiotensin converting enzyme inhibitors /angiotensin receptor blockers, beta blockers, Calcium channel blockers, diuretics were preferred as first line drug by 7, 4, 8, and 16 practitioners respectively. Most commonly preferred combination was Losartan and amlodipine by 16 practitioners. In pregnancy nifedipine was preferred as the first line drug while in elderly diuretics were preferred. In hypertensive patients with age less than 40 years all practitioners preferred ACEIs/ARBs. In diabetics ACEIs/ARBs was preferred by all practitioners. Each practitioner claimed to follow Joint National Committee (JNC) 7 criteria. Cost of drug was an important consideration in all their prescribing patterns.Conclusion: The knowledge, attitudes and practices followed by the practitioners of Dhiraj hospital were satisfactory and guidelines oriented.

Role of combination bortezomib and pegylated liposomal doxorubicin in the management of relapsed and/or refractory multiple myeloma

The first in class proteasome inhibitor bortezomib (B) received its initial regulatory approval for therapy of patients with multiple myeloma (MM) in the relapsed/refractory setting. Modulation of proteasome function, however, is also a rational strategy for chemosensitization, and a variety of agents have shown synergistic activity with bortezomib pre-clinically, including anthracyclines. This formed the basis for evaluation of a regimen of bortezomib with pegylated liposomal doxorubicin (PLD). PLD+B, in a phase I study, induced a predictable and manageable toxicity profile, and showed encouraging anti-MM activity. In a recent international, randomized phase III trial, PLD+B demonstrated a superior overall response rate and response quality compared to bortezomib alone, as well as a longer time to progression, duration of response, progression-free survival, and overall survival. Sub-analyses revealed benefits in almost all clinically relevant subgroups, including several which would be considered to have high-risk disease. These findings have led to the establishment of the PLD+B regimen as one of the standards of care for patients with relapsed and/or refractory myeloma. Efforts are now underway to build on this combination further by adding other active anti-myeloma agents. In this review, we will discuss the role of PLD+B as an important addition to our therapeutic armamentarium for patients with MM

Assessment of biochemical and physiological tolerance mechanism of the multipurpose paradise tree (Simarouba amara Aubl.) under zinc and copper stress

Simarouba amara Aubl., commonly known as paradise tree, is a multipurpose, evergreen, poly-gamodioecious, and oil yielding tree. The plant is famous for its seeds containing 55-65% oil, a potent source of biodiesel production and is being utilized in cosmetics, pharmaceuticals, and other industries. The study aimed to evaluate the physiological and biochemical changes that occur in S. amara seedlings under heavy metals stress. Two-month-old S. amara seedlings were exposed to different concentrations of zinc (Zn) and copper (Cu) (Zn and Cu: 10 mg Kg-1, 50 mg Kg-1, 100 mg Kg-1, 200 mg Kg-1). The study indicated that both the heavy metals resulted in a significant decrease in leaf relative water content (LRWC), photosynthetic pigments and an increase in lipid peroxidation and antioxidant levels. Regarding lipid peroxidation, Cu proved to be more toxic to seedlings compared to Zn. However, in terms of LRWC and photosynthetic pigments, Zn showed higher toxic effects than Cu. Proline and cysteine content increased by 234% and 270%, respectively, due to Zn stress and 117% and 102%, respectively, due to Cu stress at 200 mg Kg-1. Among antioxidant enzymes, a maximum increase in glutathione reductase (GR) activity was observed (600% due to Cu stress and 320% due to Zn stress) at 200 mg Kg-1. At the same concentration, a minimum increase was seen in glutathione peroxidase (GPX) activity (60% under Cu stress) and catalase (CAT) activity (69% under Zn stress). The present study revealed that S. amara has a better antioxidant defensive mechanism against oxidative stress and can be used for its large scale cultivation on wastelands

Controlling the supramolecular assembly of redox active dendrimers at molecular printboards by scanning electrochemical microscopy

Redox-active ferrocenyl (Fc)-functionalized poly(propylenimine) (PPI) dendrimers solubilized in aqueous media by complexation of the Fc end groups with β-cyclodextrin (βCD) were immobilized at monolayers of βCD on glass (“molecular printboards”) via multiple host−guest interactions. The directed immobilization of the third-generation dendrimer−βCD assembly G3-PPI−(Fc)16−(βCD)16 at the printboard was achieved by supramolecular microcontact printing. The redox activity of the patterned dendrimers was mapped by scanning electrochemical microscopy (SECM) in the positive feedback mode using [IrCl6]3- as a mediator. Local oxidation of the Fc−dendrimers by the microelectrode-generated [IrCl6]2- resulted in an effective removal of the Fc−dendrimers from the host surface since the oxidation of Fc to the oxidized form (Fc+) leads to a concomitant loss of affinity for βCD. Thus, SECM provided a way not only to image the surface, but also to control the binding of the Fc-terminated dendrimers at the molecular printboard. Additionally, the electrochemical desorption process could be monitored in time as the dendrimer patterns were gradually erased upon multiple scan

In vitro i in vivo protuupalna, antibakterijska i farmakokinetička svojstva baikaleina

Baicalein is a bioactive flavone originally isolated from the roots of Scutellaria baicalensis, Scutellariala teriflora and Oroxylum indicum. The in vitro and in vivo anti-inflammatory and antibacterial properties of baicalein and pharmacokinetics after its single intramuscular administration were studied in Wistar rats. The in vitro anti-inflammatory activity of baicalein (10, 50 and 100 µM) was tested for its ability to inhibit the COX-2 enzyme by measuring PGE2 levels and determination of nitric oxide (NO) production in lipopolysaccharide (LPS) treated RAW 264.7 macrophage cells, in which baicalein was found to have significant inhibition of NO and PGE2 production in RAW 264.7 macrophage cells as compared with the LPS control group. The in vivo anti-inflammatory activity of baicalein (200 mg/kg) was assessed using the carrageenan-induced rat paw oedema model, following intramuscular injection. A significant percentage of inhibition of oedema volume was observed when compared with the carrageenan control group. In vitro and in vivo antibacterial activities of baicalein were determined by the micro broth dilution technique and neutropenic rat thigh infection model, wherein baicalein did not show any antibacterial property. Concentrations of baicalein were determined in rat plasma by high performance liquid chromatography (HPLC) after a single intramuscular administration at a dose of 200 mg/kg body weight, in which the mean peak plasma drug concentration (Cmax) of 0.77 ± 0.02 μg/mL was achieved at 0.08 h. The mean elimination half-life (t½β), the apparent volume of distribution (Vd(area)), total body clearance (Cl(B)) and mean residence time (MRT) were observed as 0.63 ± 0.06 h, 601.03 ± 28.18 L/kg, 677.39 ± 35.36 L/h/kg and 0.76 ± 0.06 h, respectively. Conclusively, in the present study, baicalein did not show in vitro or in vivo antibacterial property, but proved to have good anti-inflammatory activity. The available anti-inflammatory drugs have proved to have side effects in veterinary and human therapeutics. In this situation, baicalein may become an effective alternative to non-steroidal anti-inflammatory drugs and should also be studied in target animal species. Further research should be carried out to improve the solubility and bioavailability of baicalein through injectable routes.Baikalein je bioaktivni flavon izvorno izoliran iz korijena biljaka Scutellaria baicalensis, Scutellariala teriflora i Oroxylum indicum. U ovom su radu istraživana in vitro i in vivo protuupalna i antibakterijska svojstva baikaleina te farmakokinetika nakon njegove pojedinačne intramuskularne primjene u wistar štakora. In vitro protuupalno djelovanje baikaleina (10, 50 i 100 µM) analizirano je s obzirom na sposobnost inhibicije enzima COX-2 mjerenjem razine PGE2 i određivanjem proizvodnje dušikova oksida (NO) u makrofagnim stanicama RAW 264,7 tretiranim lipopolisaharidom (LPS). Ustanovljeno je da baikalein znakovito inhibira proizvodnju NO i PGE2 u makrofagnim stanicama RAW 264,7 u usporedbi s LPS kontrolnom skupinom. In vivo protuupalno djelovanje baikaleina (200 mg/ kg) procijenjeno je pomoću modela za mjerenje edema šape nakon intramuskularne injekcije karagenana, te je uočena znakovita inhibicija volumena edema u usporedbi s kontrolnom skupinom. In vitro i in vivo antibakterijsko djelovanje baikaleina određeno je metodom razrjeđivanja mikrobujona te modelom infekcije bedra neutropeničnog štakora, pri čemu baikalein nije pokazao antibakterijska svojstva. Koncentracije baikaleina utvrđene su u plazmi štakora tekućinskom kromatografijom visoke djelotvornosti (HPLC) nakon pojedinačne intramuskularne primjene u dozi od 200 mg/kg tjelesne mase u kojoj je prosječna vršna koncentracija lijeka (Cmax) bila 0,77 ± 0,02 μg/mL, a postignuta je za 0,08 h. Prosječan poluživot eliminacije (t½β) bio je 0,63 ± 0,06 h, providni volumen distribucije (Vd(površina)) 601,03 ± 28,18 L/kg, ukupni tjelesni klirens (Cl(B)) 677.39 ± 35.36 L/h/kg, a prosječno vrijeme zadržavanja (MRT) 0,76 ± 0,06 h. Zaključeno je da u ovom istraživanju baikalein nije pokazao in vitro i in vivo antibakterijska svojstva, ali je pokazao dobro protuupalno djelovanje. S obzirom na to da dostupni protuupalni lijekovi imaju nuspojave u liječenju ljudi i životinja, baikalein bi mogao biti učinkovita alternativa nesteroidnim protuupalnim lijekovima te bi ga trebalo istražiti i kod ciljanih životinjskih vrsta. Potrebna su daljnja istraživanja kojima bi se poboljšala topljivost i bioraspoloživost baikaleina injekcijskom primjenom

Neurofilament Heavy Polypeptide Regulates the Akt-β-Catenin Pathway in Human Esophageal Squamous Cell Carcinoma

Aerobic glycolysis and mitochondrial dysfunction are common features of aggressive cancer growth. We observed promoter methylation and loss of expression in neurofilament heavy polypeptide (NEFH) in a significant proportion of primary esophageal squamous cell carcinoma (ESCC) samples that were of a high tumor grade and advanced stage. RNA interference-mediated knockdown of NEFH accelerated ESCC cell growth in culture and increased tumorigenicity in vivo, whereas forced expression of NEFH significantly inhibited cell growth and colony formation. Loss of NEFH caused up-regulation of pyruvate kinase-M2 type and down-regulation of pyruvate dehydrogenase, via activation of the Akt/β-catenin pathway, resulting in enhanced aerobic glycolysis and mitochondrial dysfunction. The acceleration of glycolysis and mitochondrial dysfunction in NEFH-knockdown cells was suppressed in the absence of β-catenin expression, and was decreased by the treatment of 2-Deoxyglucose, a glycolytic inhibitor, or API-2, an Akt inhibitor. Loss of NEFH activates the Akt/β-catenin pathway and increases glycolysis and mitochondrial dysfunction. Cancer cells with methylated NEFH can be targeted for destruction with specific inhibitors of deregulated downstream pathways

Integrated Pest Management in Major Legume Crops

Integrated pest management (IPM) is the basic concept in the containment of a pest below economically damaging levels using the combination of feasible control measures with environmental and operational safety. The term was earlier used as “integrated control” by Bartlett (Bartlett, 1956) and was further elucidated by Stern and coworkers (Stern et al., 1959). Various national, international organizations and NGOs support and promote IPM because of its safety for the environment and public health. However, there is no universally agreed definition of IPM. (Alstair, 2003). In principle, IPM may be defined as a principle and holistic approach but in a recent IPM pyramid presented by (Stenberg, 2017) identified the lack of a holistic approach that uses traditional and modern tools. Previous models of IPM mainly focused on ecological and to some extent on the evolutionary aspects of pest management (Peterson et al., 2018)

Effects of an active warm-up on variation in bench press and back squat (upper and lower body measures).

The present study investigated the magnitude of diurnal variation in back squat and bench press using the MuscleLab linear encoder over three different loads and assessed the benefit of an active warm-up to establish whether diurnal variation could be negated. Ten resistance-trained males underwent (mean ± SD: age 21.0 ± 1.3 years, height 1.77 ± 0.06 m, and body mass 82.8 ± 14.9 kg) three sessions. These included control morning (M, 07:30 h) and evening (E, 17:30 h) sessions (5-min standardized warm-up at 150 W, on a cycle ergometer), and one further session consisting of an extended active warm-up morning trial (ME, 07:30 h) until rectal temperature (Trec) reached previously recorded resting evening levels (at 150 W, on a cycle ergometer). All sessions included handgrip, followed by a defined program of bench press (at 20, 40, and 60 kg) and back squat (at 30, 50, and 70 kg) exercises. A linear encoder was attached to an Olympic bar used for the exercises and average force (AF), peak velocity (PV), and time to peak velocity (tPV) were measured (MuscleLab software; MuscleLab Technology, Langesund, Norway) during the concentric phase of the movements. Values for Trec were higher in the E session compared to values in the M session (Δ0.53 °C, P  0.05) to increase from M to E levels. Therefore, MuscleLab linear encoder could detect meaningful differences between the morning and evening for all variables. However, the diurnal variation in bench press and back squat (measures of lower and upper body force and power output) is not explained by time-of-day oscillations in Trec

Unusual tumours of the heart: diagnostic and prognostic implications

Metastases to the heart are extremely uncommon. We describe three unusual cases along with their management. A review of the current literature concerning cardiac secondaries is included