A STUDY ON PATTERN OF PRESCRIBING MEDICATIONS USED IN SECONDARY PREVENTION OF STROKE

ABSTRACTObjectives: The main objectives of this study were to estimate the demographic details of patients with the first incidence of stroke and to study thevarious risk factors for ischemic stroke.Methods: It was a retrospective, observational study carried out for 1 year at the Department of Stroke Medicine of a tertiary care teaching hospitalin Kerala, India. A total of 636 patients were admitted under stroke medicine during the period from July 1, 2014, to July 1, 2015, and who satisfiedthe inclusion and exclusion criteria were included in the study. A standardized data collection form was prepared and necessary data were collectedfrom patient's medical records.Results: The maximum number of patients was in the age group of 60-69 years. 65.1% patients were residing in the rural area. 60.7% patients weremale. Most of them had hypertension as common comorbidity (21.35%) and the highest number of patients had diabetes mellitus and hypertension(21.7%). Majority of the patients were prescribed with antiplatelets (94.91%), followed by statins (93.8%).Conclusion: A strict control on the comorbid conditions and sticking on to the medications can prevent the occurrence of future stroke.Keywords: Stroke, Secondary prevention, Drugs, Prescribing pattern

A Rapid Protocol for Somatic Embryogenesis Mediated Regeneration in Banana (Musa Spp.) Cv. Nendran

A simple and rapid protocol for somatic embryogenesis in banana cv. Nendran (AAB) using immature male flowers (IMF) has been developed. The IMF produced palewhite to yellow, globular embryogenic callus on MS medium supplemented with BA (0.05 - 0.50mgL-1) and picloram (0.50 - 2.00mgL-1) with explant response of to 30 per cent. Addition of ascorbic acid (20mgL-1) and Gelrite© (0.45 per cent) to callus induction medium reduced interference from phenolic exudation. Embryogenesis was induced (33.3 to 60 per cent) on semisolid (0.30 per cent Gelrite©) MS medium supplemented with BA 2mgL-1 + IAA 0.5mgL-1. The somatic embryos showed 60-80 per cent germination on half- strength semisolid MS medium with BA 2mgL-1 + IAA 0.5mgL-1. Transfer of germinated embryos to semisolid MS medium supplemented with BA 2mgL-1 + NAA 1mgL-1under 14 h light /8h dark photoperiod resulted in hundred percent conversion to plantlets. This protocol takes merely 6 months for producing plantlets from immature flower buds through somatic embryogenesis, without any intermediate liquid cultures

Human BBB-on-a-chip reveals barrier disruption, endothelial inflammation, and T cell migration under neuroinflammatory conditions

The blood-brain barrier (BBB) is a highly selective barrier that ensures a homeostatic environment for the central nervous system (CNS). BBB dysfunction, inflammation, and immune cell infiltration are hallmarks of many CNS disorders, including multiple sclerosis and stroke. Physiologically relevant human in vitro models of the BBB are essential to improve our understanding of its function in health and disease, identify novel drug targets, and assess potential new therapies. We present a BBB-on-a-chip model comprising human brain microvascular endothelial cells (HBMECs) cultured in a microfluidic platform that allows parallel culture of 40 chips. In each chip, a perfused HBMEC vessel was grown against an extracellular matrix gel in a membrane-free manner. BBBs-on-chips were exposed to varying concentrations of pro-inflammatory cytokines tumor necrosis factor alpha (TNFα) and interleukin-1 beta (IL-1β) to mimic inflammation. The effect of the inflammatory conditions was studied by assessing the BBBs-on-chips’ barrier function, cell morphology, and expression of cell adhesion molecules. Primary human T cells were perfused through the lumen of the BBBs-on-chips to study T cell adhesion, extravasation, and migration. Under inflammatory conditions, the BBBs-on-chips showed decreased trans-endothelial electrical resistance (TEER), increased permeability to sodium fluorescein, and aberrant cell morphology in a concentration-dependent manner. Moreover, we observed increased expression of cell adhesion molecules and concomitant monocyte adhesion. T cells extravasated from the inflamed blood vessels and migrated towards a C-X-C Motif Chemokine Ligand 12 (CXCL12) gradient. T cell adhesion was significantly reduced and a trend towards decreased migration was observed in presence of Natalizumab, an antibody drug that blocks very late antigen-4 (VLA-4) and is used in the treatment of multiple sclerosis. In conclusion, we demonstrate a high-throughput microfluidic model of the human BBB that can be used to model neuroinflammation and assess anti-inflammatory and barrier-restoring interventions to fight neurological disorders

A Clinical Approach to Hirsutism

Hirsutism is a condition of hyper androgenism, which is defined as androgen- dependent excessive male- pattern hair growth, affects approximately 10% of women with or without complex underlying pathology. It is a physiological phenomenon if it occurs with a familial history and is considered as a serious condition if it is due to various metabolic and genetic causes along with androgen secreting tumors. Hence an apt treatment is only possible after a proper diagnosis. In our classics, there is no direct term for hirsutism is mentioned. But we can decipher relative aspects from multiple references regarding hair and hair growth. Even though, based on the Dushya involvement it can be considered as a condition of Kapha Pradhana Tridosha Kopa. Hence based on a proper diagnosis through an apt diagnostic technique Abhyantara (internal) as well as Bahya (external) Chikitsa (treatment) like depilation techniques, use of Lepa (topical medicaments), oil etc

Insights into an Immunotherapeutic Approach to Combat Multidrug Resistance in Hepatocellular Carcinoma

Hepatocellular carcinoma (HCC) has emerged as one of the most lethal cancers worldwide because of its high refractoriness and multi-drug resistance to existing chemotherapies, which leads to poor patient survival. Novel pharmacological strategies to tackle HCC are based on oral multi-kinase inhibitors like sorafenib; however, the clinical use of the drug is restricted due to the limited survival rate and significant side effects, suggesting the existence of a primary or/and acquired drug-resistance mechanism. Because of this hurdle, HCC patients are forced through incomplete therapy. Although multiple approaches have been employed in parallel to overcome multidrug resistance (MDR), the results are varying with insignificant outcomes. In the past decade, cancer immunotherapy has emerged as a breakthrough approach and has played a critical role in HCC treatment. The liver is the main immune organ of the lymphatic system. Researchers utilize immunotherapy because immune evasion is considered a major reason for rapid HCC progression. Moreover, the immune response can be augmented and sustained, thus preventing cancer relapse over the post-treatment period. In this review, we provide detailed insights into the immunotherapeutic approaches to combat MDR by focusing on HCC, together with challenges in clinical translation

Modeling ischemic stroke in a triculture neurovascular unit on-a-chip

BACKGROUND: In ischemic stroke, the function of the cerebral vasculature is impaired. This vascular structure is formed by the so-called neurovascular unit (NVU). A better understanding of the mechanisms involved in NVU dysfunction and recovery may lead to new insights for the development of highly sought therapeutic approaches. To date, there remains an unmet need for complex human in vitro models of the NVU to study ischemic events seen in the human brain. METHODS: We here describe the development of a human NVU on-a-chip model using a platform that allows culture of 40 chips in parallel. The model comprises a perfused vessel of primary human brain endothelial cells in co-culture with induced pluripotent stem cell derived astrocytes and neurons. Ischemic stroke was mimicked using a threefold approach that combines chemical hypoxia, hypoglycemia, and halted perfusion. RESULTS: Immunofluorescent staining confirmed expression of endothelial adherens and tight junction proteins, as well as astrocytic and neuronal markers. In addition, the model expresses relevant brain endothelial transporters and shows spontaneous neuronal firing. The NVU on-a-chip model demonstrates tight barrier function, evidenced by retention of small molecule sodium fluorescein in its lumen. Exposure to the toxic compound staurosporine disrupted the endothelial barrier, causing reduced transepithelial electrical resistance and increased permeability to sodium fluorescein. Under stroke mimicking conditions, brain endothelial cells showed strongly reduced barrier function (35-fold higher apparent permeability) and 7.3-fold decreased mitochondrial potential. Furthermore, levels of adenosine triphosphate were significantly reduced on both the blood- and the brain side of the model (4.8-fold and 11.7-fold reduction, respectively). CONCLUSIONS: The NVU on-a-chip model presented here can be used for fundamental studies of NVU function in stroke and other neurological diseases and for investigation of potential restorative therapies to fight neurological disorders. Due to the platform's relatively high throughput and compatibility with automation, the model holds potential for drug compound screening