COMPARISON OF PHENOLIC ACIDS AND ANTIOXIDANT ACTIVITIES OF YOUNG AND MATURE LEAVES OF TECTONA GRANDIS L F

Objective: The present study aims in comparison of phenolic acids and its antioxidant potentialities of young and mature leaf extract of Tectona grandis L f.Methods: Various phenolic acids present in methanolic leaf extract of young and mature leaves of T. grandis were analyzed by reversed-phase high-performance liquid chromatography analysis. The antioxidant potentiality of the extracts was determined by various analytical methods such as 2,2-diphenyl-1-picrylhydrazyl, ferric reducing/antioxidant power, and metal chelating activity.Results: Methanolic leaf extracts of young and mature leaf of T. grandis showed a pool of phenolic compounds such as gallic, vanillic, p-hydroxybenzoic, ferulic, chlorogenic, sinapic, p-coumarate, and cinnamic acids. Irrespective of the methods used for analyzing antioxidant capacity, young leaf extract showed potent antioxidant potentiality when compared with the mature leaf extract.Conclusion: The methanolic extract of teak leaves is rich source of many phenolic compounds, and these compounds attribute to the antioxidant capacity of the leaves. Meanwhile, by comparing the young and mature leaves, the young leaves showed much more potential than the other. It is, therefore, concluded that the young teak leaves can be used as a good source of natural antioxidant

A prospective analytical study on the effect of posterior femoral condylar offset on range of knee flexion in patients undergoing cruciate retaining total knee arthroplasty

Background: Osteoarthritis (OA) of knee joint is a common problem in our society causing pain, deformity, oedema, malalignment and limitation of activity. Total knee arthroplasty (TKA) is the surgery done for treatment of this problem. The range of movement obtained after TKA is an important factor influencing success of surgery. Posterior femoral condylar offset (PCO) is one of the parameters influencing range of movement after surgery. The dearth of studies in Indian population and contradicting results in already conducted studies has been observed in assessing the effect of PCO on range of knee flexion in patients undergoing TKA. Hence this study is done to explore this correlation.Methods: A prospective analytical study on 36 patients (50 knees) who underwent cruciate retaining TKA at Department of Orthopaedics, Rajagiri Hospital, Aluva. PCO and posterior femoral condylar offset ratio (PCOR) were calculated radiologically before and after TKA. Range of flexion (ROF) and knee society scores (for functional outcome assessment) were recorded preoperatively and postoperatively (at 6 weeks and 3 months).Results: The study found a strong positive correlation between PCO difference and ROF difference (r=0.735). Strong positive correlation was also found between PCOR difference and ROF difference (r=0.777). Both these correlations were statistically significant (p<0.05).Conclusions: The study enlightened us about the point that PCO is an important factor in attaining a good ROF after cruciate retaining TKA

Osteonecrosis of bilateral femoral head in a post COVID-19 patient: case report

Osteonecrosis of the femoral head, can be secondary to various causes, which can be traumatic or atraumatic. The corticosteroid used is a common cause of non-traumatic osteonecrosis. Various viral infections have been documented to cause osteonecrosis, none of the studies report COVID-19. 23-year-old gentleman diagnosed with COVID-19. He received steroid injections as a part of treatment. Nearly after two months, he was diagnosed to have stage II osteonecrosis of both femoral heads. The cumulative dose of steroid given to the patient was not enough to consider diagnosis of steroid associated osteonecrosis of femoral heads. The combination hypercoagulability, inflammation of blood vessels, and leukocyte/platelet aggregation associated with COVID-19 might have contributed to the development of osteonecrosis in this case. So, it is also important to consider osteonecrosis as an important differential if a patient with past history of COVID-19 come with hip pain

Prospective Randomized Comparison of Three Different Doses of Hyperbaric Bupivacaine Combined with Fentanyl in Randomly Selected Elderly Patients Posted for TURP Surgeries

INTRODUCTION: The aim of anaesthesiology as a science is the removal of pain temporarily have been started initially with pain relief for surgeries, extending now to post operative pain relief and relief from chronic pain and cancer pain. Spinal anaesthesia plays an important role in alleviating pain intraoperatively and also in the post operative period also. The entry of Corning‘s needle in 1885 into subarachnoid space paved the way for the greatest leap into spinal anaesthesia. As a neurologist, Corning‘s objective was to relieve chronic pain in his patients, not to produce operative anaesthesia. Cocaine was the drug first used experimentally in dogs. In men the first spinal anaesthesia was conducted by August Bier on 16.08.1898 with cocaine 3cc as 0.5% solution followed by Rudolph Matas in America and Theodore Tuffier in France. TURP and other cystoscopic urologic procedures are usually done under spinal anesthesia because it provides an adequate anaesthesia for the patient and good relaxation of the pelvic floor and perineum for the surgeon. The complication of cystoscopic procedures can be easily recognized because the patient is awake. Change in the mental status in a conscious patient can be detected early. Sympathetic blockade produced by regional anaesthesia will increase the venous capacitance thereby decreasing the effect of fluid absorption. Bladder perforation is recognized earlier. Decreased requirement of analgesics in the immediate postoperative period. The advantages of neuraxial opioids over neuraxial local anaesthetics are that it produces prolonged, intense and selective segmental analgesia without motor blockade and sympathetic dysfunction. Opioids and local anaesthetics administered together have a potent synergistic analgesic effect. Intrathecal opioids enhance analgesia from subtherapeutic dose of local anaesthetic and make it possible to achieve successful spinal anaesthesia using otherwise inadequate doses of local anesthetic. Hence the present study has been under taken to combine ―Fentanyl‖ a potent synthetic opioid and ―Bupivacaine‖ a long acting local anesthetic for intrathecal administration to provide anaesthesia for endoscopic urological procedures in elderly patients. AIM OF THE STUDY: Regional anaesthesia is the most frequently employed anaesthetic technique for TURP and other endoscopic urologic procedures. These patients are mostly elderly with low cardiac reserve. The conventional dose of Bupivacaine (12.5-15mg) may produce haemodynamic instability. The aim of my study is to find out the minimum effective dose of hyperbaric Bupivacaine with Fentanyl for spinal anaesthesia in elderly patients undergoing TURP surgery. MATERIALS AND METHODS: After getting the approval from the institutional ethical committee study was conducted in 75 patients aged above 60 years undergoing TURP surgery. After getting consent and explaining the procedure details the anaesthetic technique was performed. Inclusion Criteria: 1. Elective elderly male surgical patients posted for TURP surgery. 2. ASA physical status 2. 3. Age 60 yrs and older who have given valid informed consent. Exclusion Criteria: 1. Patient refusal, 2. Post spinal surgeries, 3. Coagulation abnormalities, 4. Cardiac or Renal failure, 5. Neurological illness, Mental illness, 6. Deformity of spinal column, 7. Allergy to local anesthetics, 8. Not fitting into inclusion criteria. RESULTS: In this randomized single blinded study conducted in 75 patients, the subjects were allocated in to three groups . Group A - Received Inj. 0.5% Bupivacaine 1.0 cc, Group B - Received Inj. 0.5% Bupivacaine 1.5 cc, Group C - Received Inj.0.5% Bupivacaine 2.0 cc. All the three groups received 25 mcg of Inj Fentanyl. SUMMARY: From this randomised comparison of three different doses of Bupivacaine with Fentanyl it was found that • All three groups were comparable with respect to age, sex, height, weight, comorbid illness and nature of surgery. • Adequate sensory level was achieved in all the three groups. • Difference in the time to achieve sensory level of T 10 was statistically significant among the three groups, • Adequate motor block to the level of putting the patient in lithotomy was achieved in all the three groups. • Hypotension was observed invariably in the group receiving high dose of Bupivacaine whereas it was less evident in groups using lower dose Bradycardia was observed in patients who had high sensory level. • Adequate analgesia was present throughout the procedure in all the three groups. Postoperative analgesia was significantly prolonged in groups receiving higher dose of Bupivacaine. • Motor block was prolonged significantly in groups receiving higher dose of Bupivacaine. • Nausea and vomiting was not found in any of the groups. Pruritus was found in all the groups but was not statistically significant. CONCLUSION: This study is conducted in patients aged above 60 years. Spinal Bupivacaine was used in variable doses with Fentanyl 25mcg to find out the minimum effective dose of Bupivacaine with Fentanyl 25mcg in elderly patients undergoing endoscopic urological procedures. From this study it can be concluded that addition of Fentanyl 25μg to 5 mg of 0.5% Bupivacaine provides reliable and satisfactory surgical anaesthesia with an ideal peak sensory block height, stable haemodynamic status and without any significant adverse effects when compared to the combination of 10 mg Bupivacaine and 25 μg Fentanyl, in elderly patients undergoing endoscopic urologic procedures

The role of lateral and medial posterior tibial slope in anterior cruciate ligament injuries: a case-control study

Background: The anterior cruciate ligament (ACL) is one of the major stabilisers of the knee   and is the most frequently involved ligament in knee injuries and related functional instability. The objective of the study was to compare the lateral posterior tibial slope (LPTS) and medial posterior tibial slope (MPTS) among those with ACL injury and those with the intact ligament.Methods: MRI of 65 (male-43, female-22) ACL injured and 65 (male-58, female-7) ACL intact knees were studied. Using RadiAnt DICOM viewer software, the slopes of both medial and LPTS s were measured. The statistical analysis was performed by IBM SPSS 25. Associations between various factors were assessed using the Chi square test for categorical variables and independent t test were done for quantitative variables. P<0.05 had been considered statistically significant.Results: Among cases the mean LPTS was 10.230±3.930 and mean MPTS was 6.610±3.490. Among controls, mean LPTS was 8.460±3.630, mean MPTS was 5.510±2.910. Case had a statistically significant (p=0.009) steeper LPTS than control population. MPTS of cases were steeper than the control population with no statistical significance (p=0.055).Conclusions: In this study, the LPTS was significantly increased among patients with ACL injury as compared with ligament-intact controls. LPTS measurements should be considered as a significant independent modifiable risk factor for ACL injury

Purified Quercetin From in vitro Cell Suspension Cultures of Caesalpinia pulcherrima Sw. and Its Antimicrobial Potentials

Tribal people use the flower extract of Caesalpinia pulcherrima to cure liver, stomach and skin disorders in Indian traditional medicine. This study aimed to evaluate the protective roles of purified quercetin extracted from suspension culture of C. pulcherrima against selected bacterial and fungal pathogens. A simple protocol was developed for callus production using leaf explants. 2, 4-D (2.5 mg/l), BAP (2.5 mg/l) + kin (1 mg/ml) was effective for optimal callus induction. Subsequently, cell suspension culture was established.  Role of effect of elicitors in cell suspension culture was carried. Sucrose, ABA and salicylic acid (SA) at different concentrations influenced cell biomass and quercetin accumulation. Cells cultured in the medium fortified with 45 g/L sucrose without ABA/SA showed the highest quercetin content (16.5 mg/g). Flavonoids was purified, fractionated by HPLC-DAD followed by NMR revealed the presence of quercetin, isoquercetin, quercetrin, rutin, quercetin 3-O-β-D-xyloside, quercetin 3-Oarabinopyranoside, quercetin 3-O- α-arabinopyranosyl (1→2) β-galactopyranoside,  isorhamnetin 3-O-rutinoside and an unknown compound. Subsequently, anthocyanin was evaluated for antimicrobial activity against selected Gram-positive bacteria (S. aureus, Bacillus subtilis, and Enterococcus faecalis), Gram-negative bacteria (E. coli, and Pseudomonas aeruginosa) and fungi such as Aspergillus flavus, Candida albicans and Trichophyton rubrum. Quercetin was found to be active against four bacteria and the fungi- Candida albicans. The highest inhibitory effects were found on S. aureus and Enterococcus faecalis. Gram negative bacteria showed more resistance i.e., with insignificant MIC and MBC values. Among the fungi, Aspergillus flavus and Trichophyton rubrum displayed remarkable MIC and MKC values. These results suggest that quercetin may be used as a natural antimicrobial agent. Future works are designed to trace the molecular mechanism of antimicrobial potentiality of quercetin against these tested pathogen

Survey Among Medical Students During COVID-19 Lockdown: The Online Class Dilemma

Background: In view of COVID-19 lockdown in India, many colleges started online classes. This study aimed to evaluate the attitudes of, and the factors affecting, medical students attending online classes during lockdown. Methods: We designed an online questionnaire with open-ended, close-ended, and Likert scale questions. Links to the questionnaires were shared with the medical students who have attended at least one online class during the COVID-19 lockdown period. Respondents were 1061 participants from 30 medical colleges from the states of Kerala and Tamil Nadu in India. Results: The majority of students – 94% (955/1016) – used smartphones to attend online classes. ZOOM/ Skype – by 57.1% (580/1016) – and Google platforms – by 54.4% (553/1016) – were commonly used. Learning at leisure – 44.5% (452/1016) – was the top reason why students liked online classes, whereas network problems – 85.8% (872/1016) – was the top reason why students disliked them. Lack of sufficient interaction – 61.1% (621/1016) was another reason why students disliked online learning. More than half the participants – 51.7% (526/1016) – did not want to continue online classes after COVID-19 lockdown. More students – 55% (558/1016) – favored regular classes than online classes. Conclusion: Students in our survey did not seem favorably disposed to online classes. Network problems experienced by students should be addressed. Furthermore, teachers should try to make the classes more interactive and educational institutions should address the problems pointed out by the students in order to make online classes more effective in the future

Studies on pollen micro-morphology, pollen storage methods, and cross-compatibility among grape (Vitis spp.) genotypes

The knowledge of pollen morphology, suitable storage condition, and species compatibility is vital for a successful grapevine improvement programme. Ten grape genotypes from three different species, viz., Vitis vinifera L., Vitis parviflora Roxb., and Vitis champini Planc., were studied for their pollen structure and pollen storage with the objective of determining their utilization in grape rootstock improvement programs. Pollen morphology was examined through the use of a scanning electron microscope (SEM). The viability of the pollen was assessed using 2,3,5-triphenyltetrazolium chloride (TTC). In vitro pollen germination was investigated using the semi-solid medium with 10 % sucrose, 100 mg/L boric acid, and 300 mg/L calcium nitrate. The results revealed variations in pollen micro-morphology in 10 genotypes, with distinct pollen dimensions, shapes, and exine ornamentation. However, species-wise, no clear difference was found for these parameters. Pollen of V. parviflora Roxb. and Dogridge was acolporated and did not germinate. The remaining eight genotypes exhibited tricolporated pollen and showed satisfactory in vitro pollen germination. Storage temperature and duration interactions showed that, at room temperature, pollen of most of the grape genotypes can be stored for up to 1 day only with an acceptable pollen germination rate (>30 %). However, storage for up to 7 days was successfully achieved at 4 °C, except for ‘Pearl of Csaba’. The most effective storage conditions were found to be at −20 °C and −196 °C (in liquid N2), enabling pollen storage for a period of up to 30 days, and can be used for pollination to overcome the challenge of asynchronous flowering. Four interspecific combinations were studied for their compatibility, among which V. parviflora Roxb. × V. vinifera L. (Pusa Navrang) and V. parviflora Roxb. × V. champini Planc. (Salt Creek) showed high cross-compatibility, offering their potential use for grape rootstock breeding. However, V. parviflora Roxb. × V. vinifera L. (Male Hybrid) recorded the lowest compatibility index among studied crosses. In the case of self-pollinated flowers from V. parviflora Roxb. and V. parviflora Roxb. × V. champini Planc. (Dogridge), pollen failed to germinate on the stigma due to male sterility caused by acolporated pollen. As a result, the flowers of these genotypes functioned as females, which means they are ideal female parents for grape breeding without the need for the tedious process of emasculation