A randomized comparative study of efficacy and safety of saroglitazar with fenofibrate in diabetic dyslipidemic patients on metformin and glimeperide

Background: This study was conducted to compare the efficacy and safety of saroglitazar with fenofibrate in Indian diabetic dyslipidemic patients who were on Metformin and Glimepiride.Methods: Adults patients with diabetic dyslipidaemia fulfilling the inclusion criteria were randomized in two groups. Group A patients received metformin (1000 mg/ day) + Glimepiride (4 mg/day) with fenofibrate (160 mg/day), while group B patients received metformin (1000 mg/day) + Glimepiride (4 mg/day) with saroglitazar (4 mg/day). Glycosylated haemoglobin (HbA1C), triglyceride (TG), LDL- cholesterol (LDL-C), HDL-cholesterol (HDL-C) levels were measured at baseline and at 12 weeks. Fasting plasma glucose (FPG) and post prandial plasma glucose (PPPG) were measured at baseline and at 4, 8 and 12 weeks.Results: There was a significant reduction in TG and HbA1C levels at 12 weeks from the baseline value (p=0.001) in both groups. However, there was no significant reduction in TG between the groups at 12 weeks but HbA1C levels in group B decreased significantly compared to group A at 12 weeks. Also, there was a significant reduction in FPG and PPPG levels at 4, 8 and 12 weeks in both groups from their baseline values (p=0.001). The reduction in FPG and PPPG levels in group B was statistically significantly compared to group A at every interval. There was statistically significant change in LDL-C and HDL-C at 12 weeks from baseline in both the groups. Also, there was significant rise in HDL-C in group B when compared to group A.Conclusions: Group B patients on saroglitazar with metformin and Glimepiride showed a significant reduction in HbA1C, FPG and PPG levels compared to group A patients on fenofibrate with metformin and Glimepiride

A prospective study of antimicrobial drug utilization in infective diseases in pediatrics at Navodaya Medical College Hospital of Raichur, Karnataka, India

Background: There is increased concern regarding the inappropriate use of antimicrobials resulting in emergence of resistant strains, unnecessary adverse effects and poor therapeutic outcome. This present study has been taken up with a view to analyze the use of various antimicrobial agents alone and/or in combination to combat diseases of infective origin in a proposed manner.Methods: This was a prospective study carried out for a period of 1 year from January 2011 to December 2011. The prescriptions of all eligible patients were reviewed on daily basis and all the relevant data were retrieved to assess the utilization pattern of antimicrobials and also their safety and potential interactions.Results: A total of 500 patients were selected randomly who satisfied the inclusion criteria. Of the total selected patients with infectious diseases, 493 patients (98.6%) received one or more antimicrobials. Use of antimicrobials was high in the age group of ‘6 months to 3 years’, ‘rural patients’ constituted 62% and were mostly from ‘Lower Socio-economic status’ (46%). Respiratory diseases constituted 38% of the patients. Fever was the notable symptom in 68.4%. Cephalosporins (48.6%) were the most frequently prescribed class of antimicrobials. Combination of ‘Parenteral therapy followed by oral therapy’ was the preferred route in 92%, and a combination of two antimicrobials was seen in 34.4%. Majority of the patients (81%) were discharged on advice and most of the patients (37.6%) had duration of stay of 7-9 days. 25.8% reported ‘Adverse Drug Reactions’ including predictable and unpredictable reactions.Conclusions: Antimicrobial prescribing is common in pediatric infectious diseases. As inappropriate usage of systemic antimicrobials was observed, it is essential that appropriate guidelines on the use of systemic antimicrobials are implanted to ensure rational prescribing of antimicrobials

HEPATOPROTECTIVE EFFECTS OF PUNICA GRANATUM FRUIT AGAINST D-GALACTOSAMINE INDUCED HEPATOTOXICITY IN RATS: IN VITRO AND IN VIVO STUDIES

Objective: Hepatoprotective activity of Punica granatum Linn. (Family: Punicaceae) was evaluated by in vitro and in vivo model. HepG2 cell lines were used for in vitro study and D-Galactosamine (D-GalN) induced hepatic damage model for in vivo evaluation.Methods: Hepatoprotective potential was assessed by measuring serum level of glutamate oxaloacetate transaminase, glutamate pyruvate transaminase, alkaline phosphatase, total bilirubin, and albumin. Enzymatic antioxidant parameters like TBARs (thiobarbituric acid reactive substances), GSH (glutathione), SOD (superoxide dismutase) and CAT (catalase) also evaluated in this study. Results: Rats treated with D-GalN showed a significant increase in serum levels of SGOT (serum glutamate oxaloacetate transaminase), SGPT (serum glutamate pyruvate transaminase), ALP (alkaline phosphatase), bilirubin and TBARs, reflecting liver damage. The in vitro study indicates a beneficial effect of aqueous extract of P. granatum in comparison with methanolic extract, on D-GalN induced toxicity to HepG2 cells. On the basis of in vitro study, aqueous extract was selected for in vivo evaluation. The aqueous extract of P. granatum significantly reduced the elevated serum biomarkers, indicating the recovery of hepatocellular injury. It was also observed that D-GalN induced a significant decrease in GSH, SOD, CAT, protein, and albumin level were increased on the treatment of the rats with aqueous extract of P. granatum. The findings were also confirmed by histopathological studies. Periportal area and extensive hepatocyte damage and haemorrhage are seen in D-GalN treated group. The portal triad with less degree of inflammatory cell infiltration around the bile duct is seen in P. granatum (500 mg/kg)+(D-GalN) treated group.Conclusion: Results of this study revealed that P. granatum fruit could afford a significant protection for the alleviation of hepatic toxicity. Possible mechanism may involve its action against oxidative stress.Â

DETERMINATION OF 10-GINGEROL IN INDIAN GINGER BY VALIDATED HPTLC METHOD OF SAMPLES COLLECTED ACROSS SUBCONTINENT OF INDIA

Objective: A simple, sensitive, precise, and accurate stability indicating HPTLC (high-performance thin-layer chromatography) method for analysis of 10-gingerol in ginger has been developed and validated as perICH guidelines.Methods: The separation was achieved on TLC (thin layer chromatography) aluminum plates pre-coated with silica gel 60F254 using n-hexane: ethyl acetate 55:45 (%, v/v) as a mobile phase. Densitometric analysis was performed at 569 nm.Results: This system was found to have a compact spot of 10-gingerol at RF value of 0.57±0.03. For the proposed procedure, linearity (r2 = 0.998±0.02), limit of detection (18ng/spot), limit of quantification (42 ng/spot), recovery (ranging from 98.35%–100.68%), were found to be satisfactory.Conclusion: Statistical analysis reveals that the content of 10-gingerol in different geographical region varied significantly. The highest and lowest concentration of 10-gingerol in ginger was found to be present in a sample of Patna, Lucknow and Surat respectively which inferred that the variety of ginger found in Patna, Lucknow are much superior to other regions of India

GENETIC DIVERSITY IN ACCESSIONS OF INDIAN TURMERIC (CURCUMA LONGA L.) USING RAPD MARKERS

Objective: The present investigation was undertaken for identification and assessment of eight accessions of Curcuma longa collected from all ecological zones in India by random amplification of polymorphic DNA (RAPD) markers.Methods: DNA was isolated using modified cetyl trimethyl ammonium bromide (CTAB) method. Polymerase chain reaction (PCR) was performed according to the method based on Williams et al. and data analysis was done using Alpha Imager EC software.Results: Eleven out of twenty primers screened were informative and produced 150 amplification products among which 132 products (88%) were found to be polymorphic. The percentage polymorphism of all 08 accessions ranged from 44.44% to 100%. A total of 150 amplification products were scored with an average frequency of 13.63 bands per primer. Most of the RAPD markers studied showed a different level of genetic polymorphism. The data of 150 RAPD bands were used to generate Jaccard's similarity coefficients and to construct a dendrogram by means of UPGMA.Conclusion: Results shows that C. longa undergoes genetic variation due to a wide range of ecological conditions within distribution area of its population in India. This investigation as an understanding of the level and partitioning of genetic variation within the accessions and would provide an important input into determining efficient management strategies and will help to breeders for turmeric improvement program

Microwave-assisted green synthesis and antimicrobial activity of silver nanoparticles derived from a supercritical carbon dioxide extract of the fresh aerial parts of Phyllanthus niruri L

Purpose: To synthesize and evaluate the antimicrobial activity of silver nanoparticles (AgNPs) derived from a supercritical carbon dioxide extract of the fresh aerial parts of Phyllanthus niruri. Methods: The synthesis of AgNPs of a P. niruri extract was carried out in a microwave oven. The extraction was carried out using a supercritical fluid extractor. The AgNPs were characterized by the Ultraviolet-visible (UV-vis) spectral analysis, Dynamic Light Scattering (DLS) zetasizer analysis, Transmission electron microscopy (TEM), X-ray diffraction (XRD) analysis and Fourier transform infrared (FT-IR) spectroscopy. The antimicrobial assays of AgNPs were carried out against different bacterial and fungal strains. Results: Results of various analytical techniques confirmed the synthesis of AgNPs of a P. niruri extract. The UV–vis spectroscopy showed an intense silver surface plasmon resonance band at 415 NM. The AgNPs had a mean size of 110 nm in the Zetasizer analysis. TEM images illustrated spherical AgNPs having a mean particle size of 110 nm. The X-ray diffractograms showed peaks at 38.17°, 44.28°, and 64.52°. The average crystallite size of Ag-NPs was found to be 110 nm. FT-IR spectra confirmed the stability of the AgNPs. The AgNPs demonstrated good antimicrobial effects against several tested pathogenic microbes. Conclusion: An efficiently synthesized AgNPs of P. niruri (SC-CO2) extract has been prepared by a simple, eco-friendly, cost-effective, rapid green chemistry methodology. The AgNPs of P. niruri extract possesses significant antimicrobial properties against the tested bacterial and fungal strains. Keywords: Nanoparticles, Phyllanthus niruri, Supercritical fluid extraction, Microwave, Antimicrobial activit

Spontaneous Ventral Spinal Epidural Hematoma in an Infant: An Unusual Presentation

How to Cite This Article: Abbad A, Afzal K, Mujeeb AA, Shahab T, Khalid M. Spontaneous Ventral Spinal Epidural Hematoma in an Infant: An Unusual Presentation. Iran J Child Neurol. 2013  Spring;7(2):47-50.Abstract Spontaneous ventral spinal epidural hematomas are extremely rare in children and clinically recognized by the appearance of acute asymmetric focal motor and sensory involvement. In infants, the initial presenting symptoms are very non-specific and irritability is often the only initial manifestation. Appearance of other neurological signs may be delayed up to hours or even days later. In the absence of significant precipitating factors such as severe trauma or previously known coagulopathies,the diagnosis is usually delayed until the full picture of severe cord compression is developed. The diagnosis is finally made by performing magnetic resonance imaging. We report a 5-month-old infant with spinal epidural hematoma who presented with symmetrical upper limb weakness and diaphragmatic involvement to highlight the importance of recognizing the atypical manifestations for early diagnosis andintervention. References:1. Phillips TW, Kling TF Jr, McGillicuddy JE. Spontaneous ventral spinal epidural hematoma with anterior cordsyndrome: report of a case. Neurosurgery 1981;9:440-3.2. Patel H, Boaz JC, Phillips JP, Garg BP. Spontaneous spinal epidural hematoma in children. Pediatr Neurol1998;19:302-7. Review.3. Penar PL, Fischer DK, Goodrich I, Bloomgarden GM, Robinson F. Spontaneous spinal epidural hematoma. IntSurg 1987;72:218-21.4. Noth I, Hutter JJ, Meltzer PS, Damiano ML, Carter LP. Spinal epidural hematoma in a hemophilic infant. Am JPediatr Hematol Oncol 1993;15:131-4. Review.5. Beatty RM, Winston KR. Spontaneous cervical epidural hematoma. A consideration of etiology. J Neurosurg1984;61:143-8.6. Alva NS. Traumatic spinal epidural hematoma of a 10-month-old male: a clinical note. Pediatr Neurol2000;23:88-9. Review.7. Aminoff MJ: Vascular disorders of the spinal cord, in Davidoff RA (ed): Handbook of the Spinal Cord.Infections and Cancer, Vol 5. New York: Marcel Dekker, 1986, pp 271-273.8. Blount J, Doughty K, Tubbs RS, Wellons JC, Reddy A, Law C, et al. In utero spontaneous cervical thoracicepidural hematoma imitating spinal cord birth injury. Pediatr Neurosurg 2004;40:23-7.9. Iguchi T, Ito Y, Asai M, Ito J, Okada N, Murakami M. [A case of spontaneous spinal epidural hematoma]. No ToHattatsu 1993;25:267-70. Review. Japanese.10. Nagel MA, Taff IP, Cantos EL, Patel MP, Maytal J, Berman D. Spontaneous spinal epidural hematoma in a7-year-old girl. Diagnostic value of magnetic resonance imaging. Clin Neurol Neurosurg 1989;91:157-60.11. Metzger G, Singbartl G. Spinal epidural hematoma following epidural anesthesia versus spontaneous spinalsubdural hematoma. Two case reports. Acta Anaesthesiol Scand 1991;35:105-7.12. Patel H, Garg BP. Increasing irritability with sudden onset of flaccid weakness. Semin Pediatr Neurol 1996;3:192-7.13. Tewari MK, Tripathi LN, Mathuriya SN, Khandelwal N, Kak VK. Spontaneous spinal extradural hematomain children. Report of three cases and a review of the literature. Childs Nerv Syst 1992;8:53-5. Review.14. Pecha MD, Able AC, Barber DB, Willingham AC. Outcome after spontaneous spinal epidural hematoma in children: case report and review of the literature. Arch Phys Med Rehabil 1998;79:460-3. Review

Comparative assessment of extraction methods and quantitative estimation of luteolin in the leaves of Vitex negundo Linn. by HPLC

AbstractObjectiveTo find out the ideal organic solvent and extraction technique for the isolation of luteolin from the leaves of Vitex negundo Linn. (V. negundo) by quantitative estimation of luteolin through high performance liquid chromatography (HPLC) method.MethodsThe leaves of V. negundo were identified by a botanist, cleaned, dried under shade and powdered. Maceration, reflux, Soxhlet and ultrasound assisted extraction techniques were used for the extraction of luteolin from the leaves by using four different solvents of varying polarity such as methanol, ethanol, chloroform, and dichloromethane. A simple HPLC method was used to determine the quantity of luteolin in each sample extract.ResultsThe calibration plot of standard luteolin showed a linear relationship in the concentration range of 100-500 μg/mL with a correlation coefficient, r2 of 0.998. The methanolic extract was found to contain highest amount of luteolin and among various techniques employed for extraction and isolation of luteolin, reflux technique was observed to be the most efficient.ConclusionBased on the HPLC results, it can be concluded that reflux technique using methanol is better than the other extraction techniques and should be preferred for the extraction and isolation of luteolin from V. negundo leaves extract in research labs or industries

Production and optimization of mevastatin by Penicillium citrinum MTCC 1256 and effect of citrinin on growth of Actinomadura strains

The aim of the present research was to study the optimisation of mevastatin production by Penicillium citrinum MTCC 1256. Optimization of fermentation medium was carried out by response surface methodology. Simultaneous estimation of mevastatin and citrinin was carried out by high performance thin layer chromatography. Glycerol and peptone were shown to be the best carbon and nitrogen source for mevastatin production by P. citrinum. Under optimized culture medium containing glycerol 10.94 g.l-1 , peptone 8.32 g.l-1 , CaCl2 0.53 g.l-1 , MgSO4 0.52 g.l-1 and KH2PO4 0.049 g.l-1 resulted in a maximal mevastatin production of 522.5 mg.l-1 Growth inhibited effect of citrinin on actinomycetes was . measured in terms of colony forming unit (CFU). There is a decrease in CFU of Actinomadura madura and Actinomadura livida with the increase in citrinin concentration. In terms of citrinin production, an 8-day fermentation would be preferable to a 14-day period, for the eventual bioconversion of mevastatin to pravastatin, since under these conditions spent broth would be free of this inhibitory product.Colegio de Farmacéuticos de la Provincia de Buenos Aire

Quantitative Analysis of Total Phenolic, Flavonoid Contents and HPTLC Fingerprinting for Standardization of Glycyrrhiza glabra Linn. Roots

The Glycyrrhiza glabra Linn is an important medicinal plant and its roots are commonly used in various indigenous system of medicine to cure many acute and chronic diseases. The current study was designed to quantify total phenolic, flavonoid contents in G. glabra Linn roots to evaluate the antioxidant potential and to carry out the pharmacognostical investigations along with HPTLC fingerprinting in order to develop the quality control parameters for the standardization of this important medicinal plant. A variety of pharmacognostical investigations e.g., extractive values, total ash, water soluble ash, and acid insoluble ash, moisture content, loss on drying, pH and phytochemical screening of G. glabra Linn roots were analyzed as per the standard methods. The content of total phenolics, flavonoids, pesticide residues, aflatoxin and heavy metals were also determined as per the reported methods. The HPTLC fingerprinting of methanolic extract of the G. glabra roots was also carried out using CAMAG-HPTLC system. The results of phytochemicals investigations revealed the presence of carbohydrates, phenolic compounds, flavonoids, alkaloids, proteins, saponins, lipids, sterols and tannins in various solvent extracts. Total phenolic and flavonoid contents in methanolic extract were found to be 7.47 mg/gm and 2.25 µg/gm, respectively. Heavy metals concentrations were found to be under the standard limits. Aflatoxins and pesticides residues were not detected in the extract. The standard parameters established through this study may prove important tools for authentication, identification, purification and standardization of G. glabra Linn roots in herbal pharmaceutical industries