Metabolic effects of Olanzapine versus Iloperidone: A 24 weeks randomized, prospective, interventional study

Atypical antipsychotics have become the mainstay of therapy for psychosis. Though extrapyramidal side effects have been reduced with atypical antipsychotics, yet there are increased concerns over metabolic effects. The present study is aimed to comparatively evaluate the metabolic profile of olanzapine and iloperidone in cases of psychosis. A prospective, randomized, open label, observational study of 6 months duration was conducted in the Department of Pharmacology and Department of Psychiatry, Rohilkhand Medical College and Hospital, Bareilly. A total of 62 patients of both sexes newly diagnosed with psychosis (ICD-10, F20- F29) were included in the study, 31 each in olanzapine and iloperidone groups. Demographic parameters were recorded, following which the patient’s body weight, BMI, fasting blood sugar and lipid profile were estimated at baseline. Follow-up of the patients was done periodically after one month, three months and six months. Olanzapine treated patients showed markedly significant rise in body weight up to 7 kg at the endpoint (p<0.0001) at each follow-up, with a significant increase in BMI. Rise in fasting blood sugar (FBS), total cholesterol (TC), triglycerides (TG) and low-density lipoprotein (LDL) levels werealso statistically significant. At the same time, significant decrease in HDL levels was also observed. Iloperidone treated patients showed statistically significant less rise in body weight (upto 1kg, p<0.05) and BMI. No significant changes in fasting blood sugar, total cholesterol, LDL and HDL levels were noted, while TG levels were significantly reduced. Iloperidone caused numerically less rise in bodyweight and BMI, and fewer metabolic adverse effects as compared to olanzapine, and hence should be preferred.Keywords: Atypical antipsychotics; Weight gain; Blood sugar level; Dyslipidemi

Neuromyelitis optica and liver cirrhosis: an association or co-incidence

Neuromyelitis optica (NMO) is a rare central nervous system demyelination syndrome predominantly targeting optic nerves and the spinal cord. Here we present a middle-aged female presenting with new onset quadriparesis and a history of persistent splenomegaly and pancytopenia, eventually being diagnosed as NMO along with autoimmune cirrhosis. The association of NMO spectrum disorders (NMOSD) with chronic liver disease has not been previously described in the literature. The purpose of this case report is to bring forward an unusual presentation and to ascertain whether it could be part of a heterogenous spectrum of an autoimmune disorder, or merely a co-incidence

Expeditious synthesis of isolated Steroids-Fluorine prodrugs, their single crystal X-ray crystallography, DFT studies and mathematical modeling

In the present research article, we have synthesized novel steroidal-fluorine prodrugs using cholesterol (1), stigmasterol (4) and hydrocortisone acetate (7) isolated from the flowers of Allamanda violacea. These isolated compounds were converted into their fluorinated prodrugs Cholest-5-en-3β-yl-2-fluoro-benzoate (2), Cholest-5-en-3β-yl-4-fluoro-benzoate (3), 24α-ethylcholest-5, 22E-dien-3β-yl-2-fluoro benzoate (5), 24α-ethylcholest-5, 22E-dien-3β-yl-4-fluoro benzoate (6), 11, 17-dihydroxy-21-(2-fluoro benzoyloxy)-pregn-4-en-3, 20-dione (8) and 11, 17-dihydroxy-21-(4-fluoro benzoyloxy)-pregn-4-en-3, 20-dione (9). We also synthesized fluorinated prodrugs 25R-spirost-5-en-3β-yl-2-fluoro-benzoate (11) and 25R-spirost-5-en-3β-yl-4-fluoro-benzoate (12) from diosgenin (10) a steroidal sapogenin. The structure and stereochemistry of 25R-spirost-5-en-3β-yl-4-fluoro-benzoate (12) was confirmed with help of single crystal X-ray crystallography. The characterization of compounds have been carried out with the help of 1H, 13C NMR, FT-IR spectroscopy and mass spectrometry. Density functional theory (DFT) with 6-31G (d, p) basis set and B3LYP functional has been used for the Quantum chemical calculations. Global reactivity descriptors have also been calculated to find the electrophilicity and nucleophilicity of a molecule. Dipole moment, polarizability and first static hyperpolarizability have been calculated to get NLO properties of synthesized prodrugs. Lastly a nonlinear mathematical model has been proposed and analyzed to study the effect of catalysts on these reactions. Local and global stability analysis of the mathematical model along with the persistence of the system was checked using theory of nonlinear ordinary differential equations

Bilateral Parotid Involvement as the Solitary Metastatic Site from Squamous Cell Lung Cancer

The detection of metastatic disease has major therapeutic and prognostic implications on the management of cancer patients. We report an asymptomatic metastasis from the lung cancer to the intra-parotid lymph node which was detected by the FDG PET scan and subsequently confirmed by fine needle aspiration cytology. The case is unique as solitary metastatic involvement of the parotid from non-head and neck tumors are extremely rare and thus, may be missed during staging evaluation

Mobilization of Stem Cells Using G-CSF for Acute Ischemic Stroke: A Randomized Controlled, Pilot Study

Background. There is emerging evidence to support the use of granulocyte colony-stimulating factor (G-CSF) therapy in patients with acute ischemic stroke. Aims. To explore feasibility, safety, and preliminary efficacy of G-CSF therapy in patients with acute ischemic stroke. Patients and Method. In randomized study, 10 patients with acute ischemic stroke were recruited in 1 : 1 ratio to receive 10 μg/kg G-CSF treatment subcutaneously daily for five days with conventional care or conventional treatment alone. Efficacy outcome measures were assessed at baseline, one month, and after six months of treatment included Barthel Index (BI), National Institute of Health Stroke Scale, and modified Rankin Scale. Results. One patient in G-CSF therapy arm died due to raised intracranial pressure. No severe adverse effects were seen in rest of patients receiving G-CSF therapy arm or control arm. No statistically significant difference between intervention and control was observed in any of the scores though a trend of higher improvement of BI score is seen in the intervention group. Conclusion. Although this study did not have power to examine efficacy, it provides preliminary evidence of potential safety, feasibility, and tolerability of G-CSF therapy. Further studies need to be done on a large sample to confirm the results

Heavy Metal Contamination of Food Crops: Transportation via Food Chain, Human Consumption, Toxicity and Management Strategies

Food security is a major concern that requires sustained advancement both statistically and on the basis of Qualitative assessment. In recent years, antagonistic impacts of unforeseen toxins have impacted the quality of crops and have created a burden on human lives. Heavy metals (e.g., Hg, As, Pb, Cd, and Cr) can affect humans, adding to dreariness and in severe cases even death. It additionally investigates the conceivable geological routes of heavy metals in the surrounding subsystems. The top-to-the-bottom conversation is additionally offered on physiological/atomic movement systems engaged with the take-up of metallic foreign substances inside food crops. At long last, the board procedures are proposed to recapture maintainability in soil–food subsystems. This paper reflects the contamination of the food crops with heavy metals, the way of transport of heavy metal to food crops, degree of toxicity after consumption and the strategies to maintain the problem

The International Natural Product Sciences Taskforce (INPST) and the power of Twitter networking exemplified through #INPST hashtag analysis

Background: The development of digital technologies and the evolution of open innovation approaches have enabled the creation of diverse virtual organizations and enterprises coordinating their activities primarily online. The open innovation platform titled "International Natural Product Sciences Taskforce" (INPST) was established in 2018, to bring together in collaborative environment individuals and organizations interested in natural product scientific research, and to empower their interactions by using digital communication tools. Methods: In this work, we present a general overview of INPST activities and showcase the specific use of Twitter as a powerful networking tool that was used to host a one-week "2021 INPST Twitter Networking Event" (spanning from 31st May 2021 to 6th June 2021) based on the application of the Twitter hashtag #INPST. Results and Conclusion: The use of this hashtag during the networking event period was analyzed with Symplur Signals (https://www.symplur.com/), revealing a total of 6,036 tweets, shared by 686 users, which generated a total of 65,004,773 impressions (views of the respective tweets). This networking event's achieved high visibility and participation rate showcases a convincing example of how this social media platform can be used as a highly effective tool to host virtual Twitter-based international biomedical research events

Factors Deciding Outcome of Chronic Subdural Hematoma

Background: C.S.D.H is a common condition in neurosurgical practise found widely in elderly people. Recurrence following surgical decompression is not uncommon and depends on mode of surgery. Objective: To identify the best mode of treatment in view of recurrence prevention. Methods: Cases of C.S.D.H operated at our hospital between 2018 - 2020 were reviewed prospectively. Data included preoperative and postoperative symptoms, type of surgical treatment, use of surgical drain and clinical outcome. Results: A total of 240 cases were analysed. And overall recurrence was 9.5 %. The risk of recurrence was higher in patients who undergone surgery without drain application, twist drill aspiration of hematoma and septate CSDH operated with burr hole craniotomy. Conclusion: Burr hole craniostomy with drain had lower recurrence rate in comparison to twist drill aspiration. Septate SDH may need craniotomy to prevent recurrence

Extradural Hematoma: A Case Series of Patients Presenting To A Tertiary Care Center of Bihar

Introduction: India is undergoing major economic and demographic transition coupled with increasing urbanization and motorization. Among the top ten causes of mortality in the country, head injury was the tenth cause two decades back. The aim of this study was to analyze various causes, clinical presentations, factors influencing presentations and to evaluate the postoperative outcome in patients with head injury with an extradural hematoma before surgery and to formulate recommendations for improvement of therapy and suggestions for the future. Methodology: This is a prospective observational Study which included 50 patients admitted at Patna Medical College & Hospital, Patna, Bihar over the past one year that was January 2022 to December 2022 with head injury, diagnosed to have traumatic extradural hemorrhage. Prior ethical approval was obtained from the institutional Ethics Committee. The study included all patients between age groups of 5 to 70 years. The study evaluated initial outcome, excluding long term outcome. Collected data were entered into and analyzed using Statistical Package for Social Sciences (SPSS) Version 21.0 (IBM, Chicago). Results: A total of 50 cases were included in the study. Maximum patients suffering from EDH were in the age group of 21-30 years. The mean age was 29.3 years with a standard deviation of 8.2 years. There was a male preponderance with a male to female ratio of 5.25:1. The most common mode of injury among the patients was road traffic accident (78%) and 64% of cases of RTA occurred under the influence of alcohol. Conclusion: The present study concludes that, road traffic accident was the commonest mode of causative agent for EDH. Alcohol influence had a significant contribution in the causation, revealed by present study series and proved a social evil. So, early presentation to hospital with mild to moderate GCS has good clinical outcome with minimal disability