A prospective, single-arm, open-label study to determine the safety and effectiveness of a fixed-dose combination of camylofin and mefenamic acid in Indian women with primary dysmenorrhea

Background: Treatment of dysmenorrhea is aimed at providing symptomatic relief from associated pain. A prospective, single-arm, open-label, multicenter study was conducted at 5 sites across India to assess the safety, effectiveness and tolerability of a fixed-dose combination (FDC) of camylofin 50 mg and mefenamic acid 250 mg in women with primary dysmenorrhea.Methods: Women were prescribed a 3/5-day course of the FDC orally thrice daily. The primary endpoint was to assess the safety of the FDC as analyzed by incidence of adverse events (AEs), and the main secondary endpoint was to evaluate effectiveness by change in mean intensity of pain as assessed by visual analog scale (VAS) scoring from baseline to day 3/5.Results: Out of 274 enrolled women, pain associated with menses was reported by 271 (98.9%) women at baseline. In all, 28 (10.2%) women reported treatment-emergent AEs. The most common AEs were back pain, headache, vomiting, and upper abdominal pain, which were of mild intensity and resolved at the end of treatment (EoT). None of the women discontinued the study due to AEs. No serious AEs or deaths were reported in the study. The mean (standard deviation [SD]) pain intensity on VAS scale was 72.6 (16.28) at baseline and 3.3 (7.11) at EoT. A statistically significant reduction of 69.9 (18.60) from baseline in mean pain intensity was observed after treatment (p<0.0001).Conclusions: An FDC of camyolfin and mefenamic acid had a good safety and tolerability profile and could effectively relieve pain in Indian women with primary dysmenorrhea

Qualitative Phytochemical analysis & determination of antimicrobial activity of Zingiber officinale

Numerous nations consume Zingiber officinale on a daily basis. Ginger (Zingiber officinale) is a popular tropical &amp; subtropical shrub medicinal plant. The current study sought to assess the phytochemical composition and antimicrobial properties of Z.officinale extract. Qualitative evaluation of phytochemical tests revealed the existence of saponins, alkaloids, flavonoids, and steroids in ginger extracts in methanol and acetone, as well as the absence of carbohydrate, anthraquinones, and tannin in ginger extracts in methanol and acetone. The antimicrobial properties of Z.officinale extracts in solvents (aqueous, methanol) towards bacteria as well as fungus was investigated. When compared to other concentrations, the highest zone of inhibition was seen in 100µl concentrations of aqueous and methanolic extracts of Z.officinale towards Escherichia coli, Pseudomonas aeruginosa, Staphylococcus aureus, Aspergillus flavus, A.niger, and Penicillium sp. This study discovered that the plant possesses excellent metabolites, proving that it has medicinal properties and may be used in daily lif

The Center for Innovations in Business and Management Practice CO-RELATIONAL REVIEW INTERFACE BETWEEN ACADEMIC ACHIEVEMENT AND PROFESSIONAL SUCCESS

Abstract The performance of real life achievers vis-à-vis academic achievers has long been a subject of debate and discussion. It has often been witnessed that real life achievers often do no

Identification of Clinical Immunological Determinants in Asymptomatic VL and Post Kala-azar Dermal Leishmaniasis Patients

Background: Visceral Leishmaniasis (VL) caused by protozoa belonging to the genus Leishmania, usually have anthroponotic mode of transmission and is issue of great public health importance in Indian subcontinent. Asymptomatic cases of VL and PKDL are subject of keen interest to find their role in the transmission of VL in epidemic areas. We evaluated the immunological cytokine determinants expressed in most clinical suspects of asymptomatic VL and PKDL (IL-10, IFN-γ, and TNF-α). Methods: Eighty-four participants were included at RMRIMS, Patna, India in 2016-17 out of which 64 asymptomatic individual positive for rK-39, without sign and symptoms of VL; 15 PKDL patient’s with past history of VL and 5 endemic healthy subjects were recruited from VL endemic areas. DAT and quantitative assessment of plasma cytokines was determined from the blood samples collected in a plain and sodium-EDTA vacutainer respectively from the subjects. Results: The mean level of IL-10 in DATposLOW of asymptomatic VL and PKDL was significantly higher than endemic healthy (P<0.05). The cytokine polarization index (IFN-γ versus IL-10) was significantly low in PKDL cases compared with asymptomatic VL cases in DATposLOW titre (P<0.05). This index was low again but statistically not significant in PKDL than in asymptomatic VL when TNF-α was considered against IL-10. The ratio of IFN-γ: IL-10 and TNF-α: IL-10 was observed decreased both in asymptomatic VL and PKDL cases than in healthy from endemic areas. Conclusion: Collectively we surmise from our data that asymptomatic VL can also play an important role like PKDL in transmission of VL

Assessment of the dual role of Lyonia ovalifolia (Wall.) Drude in inhibiting AGEs and enhancing GLUT4 translocation through LC-ESI-QTOF-MS/MS determination and in silico studies

Introduction: Diabetes mellitus (DM) is a metabolic disorder that results in glucose accumulation in the blood, accompanied by the production of advanced glycation end products (AGEs) through glycation of cellular proteins. These AGEs interfere with insulin signaling and prevent GLUT4 membrane translocation, thereby promoting the accumulation of more glucose in the blood and causing post-diabetic complications.Methods: In this study, we examine the anti-diabetic potential of Lyonia ovalifolia (Wall.) Drude, a well-known ethnomedicinal plant of the Indian Himalayas. Considering its various medicinal properties, we analyzed its ethanolic extract and various solvent fractions for in vitro antiglycation activity and antidiabetic potential, i.e., stimulation of GLUT4 translocation.Result and Discussions: The results showed that the extract and fractions exhibited increased antiglycation activity and an increased level of GLUT4 translocation. Analysis of a further 12 bioactive compounds of ethanolic extract, identified through LC-ESI-QTOF-MS/MS, revealed the presence of three new compounds: leucothol B, rhodoterpenoids A, and leucothol A. Moreover, we performed molecular docking of identified compounds against key proteins of diabetes mellitus: the sirtuin family of NAD (+)-dependent protein deacetylases 6 (SIRT6), aldose reductase (AR), and tyrosine kinase (TK). The results showed that flavonoid luteolin showed the best binding affinity ((−12.3 kcal/mol), followed by eriodictyol, astilbin, and syringaresinol. An ADMET study showed that luteolin, eriodictyol, astilbin, and syringaresinol may be promising drug candidates belonging to the flavonoid class of compounds, with no harmful effects and complying with all the drug-likeness guidelines. Furthermore, molecular dynamics (MD) simulations on a 50 ns timescale revealed that AR protein was most stable with luteolin throughout the simulation period. Therefore, this study reveals for the first time that L. ovalifolia plays an important role in insulin homeostasis, as shown in in vitro and in silico studies

Prevalence of visual impairment, cataract surgery and awareness of cataract and glaucoma in Bhaktapur district of Nepal: The Bhaktapur Glaucoma Study

<p>Abstract</p> <p>Background</p> <p>Cataract and glaucoma are the major causes of blindness in Nepal. Bhaktapur is one of the three districts of Kathmandu valley which represents a metropolitan city with a predominantly agrarian rural periphery. This study was undertaken to determine the prevalence of visual impairment, cataract surgery and awareness of cataract and glaucoma among subjects residing in this district of Nepal.</p> <p>Methods</p> <p>Subjects aged 40 years and above was selected using a cluster sampling methodology and a door to door enumeration was conducted for a population based cross sectional study. During the community field work, 11499 subjects underwent a structured interview regarding awareness (heard of) and knowledge (understanding of the disease) of cataract and glaucoma. At the base hospital 4003 out of 4800 (83.39%) subjects underwent a detailed ocular examination including log MAR visual acuity, refraction, applanation tonometry, cataract grading (LOCSΙΙ), retinal examination and SITA standard perimetry when indicated.</p> <p>Results</p> <p>The age-sex adjusted prevalence of blindness (best corrected <3/60) and low vision (best corrected <6/18 ≥3/60) was 0.43% (95%C.I. 0.25 - 0.68) and 3.97% (95% C.I. 3.40 - 4.60) respectively. Cataract (53.3%) was the principal cause of blindness. The leading causes of low vision were cataract (60.8%) followed by refractive error (12%). The cataract surgical coverage was 90.36% and was higher in the younger age group, females and illiterate subjects. Pseudophakia was seen in 94%. Awareness of cataract (6.7%) and glaucoma (2.4%) was very low. Among subjects who were aware, 70.4% had knowledge of cataract and 45.5% of glaucoma. Cataract was commonly known to be a 'pearl like dot' white opacity in the eye while glaucoma was known to cause blindness. Awareness remained unchanged in different age groups for cataract while for glaucoma there was an increase in awareness with age. Women were significantly less aware (odds ratio (OR): 0.63; 95%, confidence interval (CI): 0.54 - 0.74) for cataract and (OR: 0.64; 95% CI: 0.50 - 0.81) for glaucoma. Literacy was also correlated with awareness.</p> <p>Conclusion</p> <p>The low prevalence of visual impairment and the high cataract surgical coverage suggests that cataract intervention programs have been successful in Bhaktapur. Awareness and knowledge of cataract and glaucoma was very poor among this population. Eye care programs needs to be directed towards preventing visual impairment from refractive errors, screening for incurable chronic eye diseases and promoting health education in order to raise awareness on cataract and glaucoma among this population.</p

Rémy Ollier And Imperial Citizenship

This essay discusses Rémy Ollier’s (1816–45) journalism. As an early claimant of citizenship through (rather than against) the British Empire during the 1840s, Ollier attempted to redress a gap that he perceived between the institutionalization of rights in Britain and Mauritius. Established accounts of Ollier’s political intervention provide a rich narrative of how his efforts are implicated in the development of rights in Mauritius and broader postcolonial nationalisms. However, I argue that facets of his expression of imperial citizenship reside apart from this genealogy. To explore how Ollier uniquely created imperial citizenship, an “acts”-influenced approach to citizenship is adopted. By analyzing his writings in La Sentinelle de Maurice, I reveal how imperial citizenship is generated through a subversive loyalism to Britain and an orientalist portrayal of indentured labourers. I conclude by mobilizing Ollier’s struggle as a challenge to the notion that citizenship realizes itself in teleological fashion

Global, regional, and national burden of disorders affecting the nervous system, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021

BackgroundDisorders affecting the nervous system are diverse and include neurodevelopmental disorders, late-life neurodegeneration, and newly emergent conditions, such as cognitive impairment following COVID-19. Previous publications from the Global Burden of Disease, Injuries, and Risk Factor Study estimated the burden of 15 neurological conditions in 2015 and 2016, but these analyses did not include neurodevelopmental disorders, as defined by the International Classification of Diseases (ICD)-11, or a subset of cases of congenital, neonatal, and infectious conditions that cause neurological damage. Here, we estimate nervous system health loss caused by 37 unique conditions and their associated risk factors globally, regionally, and nationally from 1990 to 2021.MethodsWe estimated mortality, prevalence, years lived with disability (YLDs), years of life lost (YLLs), and disability-adjusted life-years (DALYs), with corresponding 95% uncertainty intervals (UIs), by age and sex in 204 countries and territories, from 1990 to 2021. We included morbidity and deaths due to neurological conditions, for which health loss is directly due to damage to the CNS or peripheral nervous system. We also isolated neurological health loss from conditions for which nervous system morbidity is a consequence, but not the primary feature, including a subset of congenital conditions (ie, chromosomal anomalies and congenital birth defects), neonatal conditions (ie, jaundice, preterm birth, and sepsis), infectious diseases (ie, COVID-19, cystic echinococcosis, malaria, syphilis, and Zika virus disease), and diabetic neuropathy. By conducting a sequela-level analysis of the health outcomes for these conditions, only cases where nervous system damage occurred were included, and YLDs were recalculated to isolate the non-fatal burden directly attributable to nervous system health loss. A comorbidity correction was used to calculate total prevalence of all conditions that affect the nervous system combined.FindingsGlobally, the 37 conditions affecting the nervous system were collectively ranked as the leading group cause of DALYs in 2021 (443 million, 95% UI 378–521), affecting 3·40 billion (3·20–3·62) individuals (43·1%, 40·5–45·9 of the global population); global DALY counts attributed to these conditions increased by 18·2% (8·7–26·7) between 1990 and 2021. Age-standardised rates of deaths per 100 000 people attributed to these conditions decreased from 1990 to 2021 by 33·6% (27·6–38·8), and age-standardised rates of DALYs attributed to these conditions decreased by 27·0% (21·5–32·4). Age-standardised prevalence was almost stable, with a change of 1·5% (0·7–2·4). The ten conditions with the highest age-standardised DALYs in 2021 were stroke, neonatal encephalopathy, migraine, Alzheimer's disease and other dementias, diabetic neuropathy, meningitis, epilepsy, neurological complications due to preterm birth, autism spectrum disorder, and nervous system cancer.InterpretationAs the leading cause of overall disease burden in the world, with increasing global DALY counts, effective prevention, treatment, and rehabilitation strategies for disorders affecting the nervous system are needed

Calotropis procera induced ocular toxicity, manifestations and management – an observational study

Introduction: Calotropis procera produces copious amounts of latex, which possesses several pharmacological properties. It produces severe inflammatory response on local application and its accidental instillation in the eye is associated with significant ocular morbidity. This is an observational study to assess the ocular toxicity of the latex of Calotropis procera and its management. Methods: 34 patients presenting to the ophthalmology department of a tertiary care centre of central India with exposure to the latex of Calotropis procera, were included in the study. Results: The main symptoms reported were burning, watering and discomfort. Corneal edema with striate keratopathy was found to be a universal manifestation with or without epithelial lesions and intraocular inflammation.The keratopathy showed good response to topical corticosteroids. Conclusion: Exposure to the latex of Calotropis procera is associated with significant ocular morbidity. The typical manifestation of striate keratopathy resolves with topical steroids. Simple health education in the form of hand washing, and avoiding eye contact and eye rubbing while plucking the flowers and leaves of Calotropis can prevent this injury

Base-Catalyzed 1,6-Conjugate Addition of Nitroalkanes to p‑Quinone Methides under Continuous Flow

A mild base-catalyzed protocol for the synthesis of substituted nitroalkane derivatives has been developed under continuous flow using a microreaction technique. This transformation basically involves the 1,6-conjugate addition of nitroalkanes to p-quinone methides, leading to the substituted nitroalkanes in good to excellent yields