Comparison of dietary agents’ garlic and bitter melon on in vitro glycation and advanced glycation end products formation

Background: Protein glycation is a spontaneous post translational modification of proteins by excess sugars causing formation of advanced glycation end products (AGEs) in diabetic individuals and responsible for diabetes complications. Momordica charantia L (bitter melon) and garlic have been used historically for medicinal purposes particularly for treatment of diabetes and cancers and contain potent antioxidant activity hence we planned to compare the antiglycating activities.Methods: Human serum albumin (HSA) was used for in vitro glycation. Various concentrations of extracts of M. charantia L and aged garlic were analyzed.Results: Co-incubation of the M. charantia L and aged garlic extracts with HSA-fructose mixture gives contradictory results in tryptophan fluorescence, AGE specific fluorescence and protein bound carbonyl studies.Conclusions: M. charantia L seems to aggravate sugar mediated glycation of the protein and need further studies to pinpoint specific bioactive compounds responsible for the observed activities whereas aged garlic seems to have strong ant glycation properties

Validation of the use of POSSUM score in enteric perforation peritonitis - results of a prospective study

Introduction: The objective of the study was to present our last 5-years experience of peritonitis and validate POSSUM score in predicting mortality and morbidity in patients of enteric perforation (EP) peritonitis. Methods: Data was collected prospectively for all peritonitis cases admitted in single surgical unit from January 2005 to December 2009. Parameters for calculating POSSUM were also retrieved; in these patients, O:E (Observed vs. Expected) ratio of mortality and morbidity were estimated after calculating predicted mortality and morbidity by exponential regression equations. Results: 887 patients with peritonitis were admitted and treated in this unit during the 5 years of study period. Duodenal (n=431; 48%) followed by ileal (n=380; 42.8%) perforations were the commonest. Mean age of the patients was 34 years and 86% were males. Mean delay in presentation was 78.5 hrs. Mean duration of hospital and ICU stay was 13 and 7.2 days. Postoperative complications were seen in 481 (54%) patients, and 90 (10%) patients died. POSSUM scores and predicted mortality/morbidity were calculated in 380 patients of ileal perforation peritonitis; O:E ratio of mortality and morbidity were 0.47 and 0.85 in these patients. Conclusion: POSSUM and P-POSSUM are accurate tools for predicting morbidity and mortality respectively in EP patients. Though they may sometime over or under predict morbidity as well as mortality.Key words: Enteric perforation, Peritonitis, POSSUM , P-POSSU

Goiter: Overview of Aetiopathogenesis and Therapy

The goiter was described in history for long time. Many luminaries suffered from it. The enlargement of thyroid is known as goiter, it can arise from various causes and each has separate aetiopathogenesis and treatment. As an overview for the book, this chapter delves into each aspect, whereas the details are in separate chapter

Efficacy and safety of various drugs used for the treatment of nonneurogenic lower urinary tract symptoms in tertiary care hospital

Background: Lower urinary tract symptoms (LUTS) due to benign prostatic hyperplasia (BPH) are common in elder men. Previously surgical treatment was mainstay of treatment of BPH. But now number of drugs alone or combined are clinically used for this disorder. Primary aim was to study the prescribing pattern of different drug therapies and their role in treating LUTS/BPH by evaluating their efficacy and safety in tertiary health care centre.Methods: An observational study including 78 male patients ≥45 years, newly diagnosed with LUTS from April 2014 to May 2015. Patients were followed up every 4 weeks for 3 months after the drug has been prescribed. Efficacy assessment was done on basis of change in IPSS score over 12 weeks. Data was expressed in percentage and Mean ±SD.Results: Mean age of Patients was 64.94 years. Alpha blockers are mainstay prescribed drug either as monotherapy (48.7%) or with 5 alpha reductase inhibitor-dutasteride (38.4%) and with antimuscarinic –Tolterodene (12.8%). Among alpha blockers Tamsulosin (58.97%) was most commonly prescribed, followed by Silodosin (20.5%) and Alfuzosin (20.5%). All drug treatment results in significant improvement with dizziness being the most common adverse event. A subgroup analysis in symptoms was done comparing alpha blockers. All alpha blockers have near about similar efficacy with no significant difference.Conclusions: Alpha blockers are main drugs prescribed in management of LUTS/BPH with near about similar efficacy of all alpha blockers

Anti-dyslipidemic activity of acacia tortilis seed extract in alloxan-induced diabetic rats

Background: The present study was carried out to evaluate the anti-dyslipidemic activities of seed extract of acacia tortilis (ATE) in alloxan inducd diabetic rats.Methods: The Rats were divided into five groups of six animals each. Groups I and II received normal saline, group III received ATE in dose of 100 mg/kg body weight, group IV received ATE in dose of 200 mg/kg b.w.; and group V received standard drug pioglitazone dose 3 mg/kg b.w. Drugs were administered orally once a day for 30 days. At the end of 0th, 10th, 20th  and 30th day, blood was collected to analyse serum glucose, serum insulin, total cholesterol (TC), serum phospholipid (PL), serum triglyceride (TG), Free fatty acids (FFA) and High density lipoprotein (HDL).Results: The results has been showed that ATE in above doses significantly increase the serum insulin and HDL level but significantly decreased the elevated level of TC, PL, TG , FFA, LDL and VLDL. It also decreased the atherogenic index and coronary risk index level significantly which was comparable with the pioglitazone.Conclusions: It is concluded that the seed extract of acacia tortilis at the dose of 100 and 200 mg/kg body weight produced significant anti-dyslipidemic activity in alloxan-induced diabetic rats

Biogenic Preparation, Characterization, and Biomedical Applications of Chitosan Functionalized Iron Oxide Nanocomposite

Chitosan (CS) functionalization over nanomaterials has gained more attention in the biomedical field due to their biocompatibility, biodegradability, and enhanced properties. In the present study, CS functionalized iron (II) oxide nanocomposite (CS/FeO NC) was prepared using Sida acuta leaf extract by a facile and eco-friendly green chemistry route. Phyto-compounds of S. acuta leaf were used as a reductant to prepare CS/FeO NC. The existence of CS and FeO crystalline peaks in CS/FeO NC was confirmed by XRD. FE-SEM analysis revealed that the prepared CS/FeO NC were spherical with a 10–100 nm average size. FTIR analyzed the existence of CS and metal-oxygen bands in the prepared NC. The CS/FeO NC showed the potential bactericidal activity against E. coli, B. subtilis, and S. aureus pathogens. Further, CS/FeO NC also exhibited the dose-dependent anti-proliferative property against human lung cancer cells (A549). Thus, the obtained outcomes revealed that the prepared CS/FeO NC could be a promising candidate in the biomedical sector to inhibit the growth of bacterial pathogens and lung cancer cells

Feasibility of polymer-drug conjugates for non-cancer applications

Polymer-drug conjugates have been intensely studied in the context of improving cancer chemotherapy and yet the only polymer-drug conjugate on the market (MovantikÒ) has a different therapeutic application (relieving opioid-induced constipation). In parallel, a number of studies have recently been published proposing the use of this approach for treating diseases other than cancer. In this commentary, we analyse the many and very diverse applications that have been proposed for polymer-drug conjugates (ranging from inflammation, to cardiovascular diseases) and the rationales underpinning them. We also highlight key design features to be considered when applying polymer-drug conjugates to these new therapeutic areas

Measuring performance on the Healthcare Access and Quality Index for 195 countries and territories and selected subnational locations: A systematic analysis from the Global Burden of Disease Study 2016

Copyright © 2018 The Author(s). Published by Elsevier Ltd. Background A key component of achieving universal health coverage is ensuring that all populations have access to quality health care. Examining where gains have occurred or progress has faltered across and within countries is crucial to guiding decisions and strategies for future improvement. We used the Global Burden of Diseases, Injuries, and Risk Factors Study 2016 (GBD 2016) to assess personal health-care access and quality with the Healthcare Access and Quality (HAQ) Index for 195 countries and territories, as well as subnational locations in seven countries, from 1990 to 2016. Methods Drawing from established methods and updated estimates from GBD 2016, we used 32 causes from which death should not occur in the presence of effective care to approximate personal health-care access and quality by location and over time. To better isolate potential effects of personal health-care access and quality from underlying risk factor patterns, we risk-standardised cause-specific deaths due to non-cancers by location-year, replacing the local joint exposure of environmental and behavioural risks with the global level of exposure. Supported by the expansion of cancer registry data in GBD 2016, we used mortality-to-incidence ratios for cancers instead of risk-standardised death rates to provide a stronger signal of the effects of personal health care and access on cancer survival. We transformed each cause to a scale of 0-100, with 0 as the first percentile (worst) observed between 1990 and 2016, and 100 as the 99th percentile (best); we set these thresholds at the country level, and then applied them to subnational locations. We applied a principal components analysis to construct the HAQ Index using all scaled cause values, providing an overall score of 0-100 of personal health-care access and quality by location over time. We then compared HAQ Index levels and trends by quintiles on the Socio-demographic Index (SDI), a summary measure of overall development. As derived from the broader GBD study and other data sources, we examined relationships between national HAQ Index scores and potential correlates of performance, such as total health spending per capita. Findings In 2016, HAQ Index performance spanned from a high of 97·1 (95% UI 95·8-98·1) in Iceland, followed by 96·6 (94·9-97·9) in Norway and 96·1 (94·5-97·3) in the Netherlands, to values as low as 18·6 (13·1-24·4) in the Central African Republic, 19·0 (14·3-23·7) in Somalia, and 23·4 (20·2-26·8) in Guinea-Bissau. The pace of progress achieved between 1990 and 2016 varied, with markedly faster improvements occurring between 2000 and 2016 for many countries in sub-Saharan Africa and southeast Asia, whereas several countries in Latin America and elsewhere saw progress stagnate after experiencing considerable advances in the HAQ Index between 1990 and 2000. Striking subnational disparities emerged in personal health-care access and quality, with China and India having particularly large gaps between locations with the highest and lowest scores in 2016. In China, performance ranged from 91·5 (89·1-93·6) in Beijing to 48·0 (43·4-53·2) in Tibet (a 43·5-point difference), while India saw a 30·8-point disparity, from 64·8 (59·6-68·8) in Goa to 34·0 (30·3-38·1) in Assam. Japan recorded the smallest range in subnational HAQ performance in 2016 (a 4·8-point difference), whereas differences between subnational locations with the highest and lowest HAQ Index values were more than two times as high for the USA and three times as high for England. State-level gaps in the HAQ Index in Mexico somewhat narrowed from 1990 to 2016 (from a 20·9-point to 17·0-point difference), whereas in Brazil, disparities slightly increased across states during this time (a 17·2-point to 20·4-point difference). Performance on the HAQ Index showed strong linkages to overall development, with high and high-middle SDI countries generally having higher scores and faster gains for non-communicable diseases. Nonetheless, countries across the development spectrum saw substantial gains in some key health service areas from 2000 to 2016, most notably vaccine-preventable diseases. Overall, national performance on the HAQ Index was positively associated with higher levels of total health spending per capita, as well as health systems inputs, but these relationships were quite heterogeneous, particularly among low-to-middle SDI countries. Interpretation GBD 2016 provides a more detailed understanding of past success and current challenges in improving personal health-care access and quality worldwide. Despite substantial gains since 2000, many low-SDI and middle- SDI countries face considerable challenges unless heightened policy action and investments focus on advancing access to and quality of health care across key health services, especially non-communicable diseases. Stagnating or minimal improvements experienced by several low-middle to high-middle SDI countries could reflect the complexities of re-orienting both primary and secondary health-care services beyond the more limited foci of the Millennium Development Goals. Alongside initiatives to strengthen public health programmes, the pursuit of universal health coverage hinges upon improving both access and quality worldwide, and thus requires adopting a more comprehensive view - and subsequent provision - of quality health care for all populations