Noninvasive Imaging for the Assessment of Coronary Artery Disease

Noninvasive cardiac imaging is a cornerstone of the diagnostic work-up in patients with suspected coronary artery disease (CAD), cardiomyopathy, heart failure, and congenital heart disease. It is essential for the assessment of CAD from functional and anatomical perspectives, and is considered the gate-keeper to invasive coronary angiography. Cardiac tests include exercise electrocardiography, single photon emission computed tomography myocardial perfusion imaging, positron emission tomography myocardial perfusion imaging, stress echocardiography, coronary computed tomography angiography, and stress cardiac magnetic resonance. The wide range of imaging techniques is advantageous for the detection and management of cardiac diseases, and the implementation of preventive measures that can affect the long-term prognosis of these diseases. However, clinicians face a challenge when deciding which test is most appropriate for a given patient. Basic knowledge of each modality will facilitate the decision-making process in CAD assessment

Formulation and Evaluation of Levofloxacin Oral Dispersible Tablets

INTRODUCTION:Oral disintegrating tablets are solid single unit dosage forms that are placed on tongue, allowed to disperse or dissolve in saliva without the need of water, frequently releasing of the drug for quick onset of action. Oral disintegrating tablets are well accepted by wide range of population especially as pediatric and geriatric patients who have difficulty in swallowing of conventional dosage forms. Some drugs are absorbed from mouth, pharynx and esophagus as saliva passes down to stomach. The bioavailability of such drug will be increase due to first pass metabolism1. Consumer satisfaction is the buzzword of the current millennium, and movement to achieve it has already begun in the pharmaceutical industry. An inability or un willingness to swallow solid oral dosage forms such as tablets and poor taste of medicine are some of the important reasons for consumer dissatisfaction.AIM AND OBJECTIVE:F or the past two decades, there has been enhanced demand for more patient compliance dosage forms. As a result, the demand for their technologies has been increasing three fold annually. Since the development cost of a new chemical entity is very high, the pharmaceutical companies are focusing on the development of new drug delivery systems for existing drug with an improved efficacy and bioavailability together with dosing frequency to minimize side effects. This results in slower dissolution and absorption rates on oral administration and is one of the causes of gastro intestinal side effects Improvement in drug solubility expected to enhance its bioavailability and reduce local side effects Difficulty in swallowing (dysphasia) is a common problem of all age groups, especially the elderly and pediatrics, because of physiological changes associated with these groups. Other categories also several problems in using conventional oral dosage forms include the mentally ill, uncooperative patients suffering from nausea, sudden episodes of allergic attack or coughing. Sometimes it may be difficult to swallow conventional products due to nonavailability of water. These problems led to the development of levofloxacin as mouth dissolving tablets. Which disintegrate and dissolve in saliva without the need of drinking water. The saliva serves to rapidly disperse the dosage form and the dissolved medicament is swallowed along with saliva in normal way. As the dissolved medicaments along with saliva passes down into stomach, they are absorbed from the mouth, pharynx, and oesophagus. Therefore the bioavailability of levofloxacin is significantly greater than those observed from conventional levofloxacin dosage forms.SUMMARY AND CONCLUSION: Oral dispersible Tablets of Levofloxacin were prepared with two different superdisintegrants and evaluation of blend powder, tablets evaluation studies, IR spectral studies, dissolution studies and stability studies were performed .The summary are presented. Preformulation studies such as angle of repose, bulk density, tapped density, compressibility index and hausner ratio were performed and the results showed that all the parameters are within the acceptable limits. Tablets were prepared by direct compression method and evaluated for general appearance, hardness test, uniformity of weight, friability, wetting time, disintegration time, drug content estimation and in vitro release study. All the formulations were found to be good appearance without showing any chipping, capping and sticking defects and all other parameters were passed the test. IR spectroscopic studies indicated that the drug is compatible with all the polymers and there was no drug-polymer interaction. When comparing all the formulations, F7 shows a better drug release of 96.10% at the end of 15 minutes. All the formulations were subjected for stability studies for 45 days at different temperatures such as room temperature, fridge temperature and accelerated temperature (45°C±2°C). At 15 days interval upto 45 days, the drug content and dissolution studies were carried out. There was no significant change in the drug content and invitro drug release. The main objective of the present study was to develop Oral dispersible tablet formulation containing 150mg of Levofloxacin for the treatment of a number of infections including infection of Joints and bones, respiratory tract infections, urinary tract infections, skin structural infections and typhoid fever etc. In the present work it has been observed from all formulations of precompression and post compression studies were given within the limit of values. The in vitro dissolution data, FLOT- 7(combination of different superdisintegrants) formulation was found that the drug release is best and the cumulative % of drug release was 96.10 % respectively, when compared to other formulation

Impaired Protein Tolerance Test as a Marker of Early Renal Dysfunction in Type 2 Diabetes Mellitus

INTRODUCTION: India is frequently referred to as the diabetic capital of the world. Diabetes mellitus is widely prevalent in our country and its incidence is rising in alarming proportions. The worldwide prevalence1 of diabetes has risen dramatically over the past two decades, from an estimated 30 million cases in 1985 to 177 million in 2000. Based on current trends, >360 million individuals worldwide will have diabetes by the year 2030. Although the prevalence of both type 1 and type 2 diabetes is increasing worldwide, the prevalence of type 2 diabetes is rising much more rapidly because of increasing obesity and reduced activity levels as countries become more industrialized. Worldwide estimates project that in 2030 the greatest number of individuals with diabetes will be 45–64 years of age. According to the Diabetes Atlas published by the International Diabetes Federation (IDF), there are an estimated 40 million persons with diabetes in India in 2007, now it has risen to 60 million in 2009 and this number is predicted to rise to almost 120 million people in 2025 by which time every fifth diabetic subject in the world would be an Indian. Diabetes is a major cause of mortality, but several studies indicate that diabetes is likely under reported as a cause of death. A recent estimate suggested that diabetes was the fifth leading cause of death worldwide and was responsible for almost 3 million deaths annually (1.7–5.2% of deaths worldwide). AIMS AND OBJECTIVES: The aims of the study were ; 1. To identify individuals with impaired protein tolerance test as a marker of early renal dysfunction in type 2 diabetes mellitus. 2. To compare individuals with impaired protein tolerance with normal population. MATERIALS AND METHODS: The study was conducted on patients attending the out patient department of Government Rajaji Hospital, Madurai. Approval from the hospital ethical committee was obtained. Study Design: The study was a case control study conducted for a period of one year between October 2008 - September 2009. Inclusion Criteria: • Patients with type 2 diabetes mellitus were included in the study. • Fifty healthy, age and sex matched controls without diabetes or its complications were also included in the study for comparison. Exclusion Criteria: • Patients with type 2 diabetes mellitus with proteinuria. • Systemic hypertension. • Renal Failure. Diagnosis of Type 2 diabetes mellitus was made by clinical details and routine blood investigations including fasting and postprandial blood sugar values. The WHO criteria were employed for the diagnosis of diabetes mellitus. The presence of absence of renal dysfunction was made on the basis of the following: 1. Clinical details, 2. Routine Blood investigations, 3. Measurment of baseline creatinine clearance and. creatinine clearance after a protein meal (100 gm of protein as cottage cheese). 4. Spot urinary protein estimation at baseline and after a protein meal. METHODS: After the diagnosis of Type 2 diabetes mellitus, All the selected patients were subjected to a high protein meal. To detect renal dysfunction in type 2 diabetes mellitus, blood samples were collected after 8 hours of fasting for fasting blood sugar and after two hours of postprandial state. Blood samples were collected at 0, 30, 60 and 120 minutes for serum creatinine after giving high protein meal. Serum was separated and stored in the refrigerator. Serum creatinine was measured from this serum. RESULTS: Majority of the patients were from in and around Madurai city. The total number of patients included in the study was 52. Fifty controls were also included in the study for comparative analysis. Among the total of 52 Type 2 diabetes mellitus patients [Female (F)-24; Male (M)-28], 32 diabetic patients [Female (F)-16; Male (M)-16] had no evidence of Renal Dysfunction (Group-I), whereas 9 diabetic patients (F-4; M-5) had evidence of Renal injury(Group-II) and 11 diabetic patients (F-4; M-7) had evidence of incipient Renal Failure (Group-III) Out of the 50 controls, 24 were female and 26 were male, 2 diabetic patients (F-1; M-1) had evidence of renal injury (Group-II) The age of the controls ranged from 32 to 67 years with a mean age of 52.1 years. The age of the patients in the study group ranged from 32-67 years with a mean of 54.11 years. In the study group, 9 patients were in the age group of upto 40 years (18%) , 15 patients in 41-50 age group (30%), 22 patients in 51-60 age group (44%), 4 patients (8%) were in the age group of >60years. The age groups of the cases and controls were comparable and there was no statistical difference (p=0.3594). SUMMARY: The study “impaired protein tolerance test as a marker of early renal dysfunction in type 2 diabetes mellitus” was undertaken to find out the usefulness of protein tolerance test in detecting patients with type 2 diabetes mellitus who were at risk of developing renal dysfunction. The present study was a case control study done at Govt. Rajaji Hospital Madurai. After institutional Ethical Committee clearance, 52 patients with type 2 diabetes mellitus and 50 healthy controls were selected according to the inclusion criteria. There were almost equal males and females in the study. A baseline fasting and post prandial blood sugar, serum creatine and baseline GFR was calculated. This was followed by a protein challenge with 100 grams of protein food. Serum creatinine and GFR were measured at 30, 60 and 120 minutes after protein challenge. Using statistical data, correlation was analyzed between pre/post protein challenge serum creatinine in cases and controls in relation to GFR and renal function. It was found that patients with renal failure had more persistent elevation of serum creatinine and sustained decrease in GFR as compared to patients with normal renal function or those with mild renal dysfunction. There was also an age related decline in renal function. Proteinuria was found to be an independent risk factor for renal failure. It was also found that patients with long duration of diabetes and poor glycemic control have more chance of early renal injury and dysfunction than those with short duration of diabetes and good glycemic control. CONCLUSIONS: 1. Kidney damage starts in Diabetic patients even before microalbuminuria and clinical nephropathy starts. 2. It was found that longer the Duration of diabetes ,more the chance of early renal injury and dysfunction. 3. Renal injury and dysfunction directly correlates with poor metabolic control. 4. Protein tolerance test can be a very useful test to detect such incipient renal failure in patients with normal GFR and normal serum creatinine values. 5. Identifying those patients with subnormal renal function may enable us to initiate an early aggressive intervention. 6. This Protein Tolerance Test may be very much useful in high risk patients like Diabetics, Hypertensive patients. 7. Patients with diseases like solitary kidney, polycystic kidney disease, post renal transplants can also be subjected to this test to identify incipient renal failure. 8. Protein Tolerance Test can also be used to check the borderline renal donor in order to give accurate prognostication in a progressive renal disease

A study of efficacy of tranexemic acid in reducing cesarean section blood loss

AIMS OF THE STUDY: 1. To find whether tranexamic acid is effective in reducing peroperative and postoperative blood loss in lower segment caesaerean section. 2. To find whether tranexamic acid is associated with any adverse reactions or complications. MATERIALS AND METHODS: The study was done by Dr.D. Punitha Meenakshi at Government Chengalpattu Medical College Hospital between November 2013 to August 2014.The source of data for this study are patients who were admitted in the Antenatal ward and Labour ward who were planned for elective and emergency caesarean section at Chengalpattu Medical College Hospital, Chengalpattu. Inclusion Criteria: 1. Primi and second gravida with term gestation, 2. Singleton pregnancy, 3. Emergency and elective cases for caesarean section. Exclusion Criteria: 1. Allergic to tranexamic acid 2. Severe medical illness like cardiac, Renal and Liver diseases 3. Patients with past history of thromboembolic disorders. 4. Complicated pregnancies at risk of PPH. • PIH, Preeclampsia, • HELLP, • Anaemia with Hb < 9gms%, • Abnormal placenta –Abruptio placenta,Placenta previa, • Polyhydromnios, • Multiple pregnancy, • Estimated fetal weight > 4kgs (Macrosomia), • Myoma uterus with pregnancy, • Prolonged labour, • Anesthesia-Halogenated /General anesthesia. METHODS: The subjects of this Randomized Controlled trial were 200 patients who were admitted for elective and emergency caesarean section in labour ward and antenatal ward. • Detailed obstetric and Medical History was taken in all patients. Their weight and Height were recorded. Vital parameters were checked. General, systemic and obstetric examination was done. USG was done to confirm gestational age, fetal wellbeing, liquor status. Complete blood count at the time of admission and on 3 rd postoperative period was done. Bleeding Time, Clotting Time at the time of admission. Renal and Liver function test at the time of admission and on 3 rd postoperative period. Urine was examined for Albumin, Sugar and Deposits during admission • Subjects were randomized by BLOCK RANDOMIZATION. • 100 Antenatal women were placed in STUDY GROUP (Group A ) and 100 antenatal women were placed in CONTROL GROUP(GROUP B) with the same inclusion and exclusion criteria. • All patients were informed about the study and the effects of drug Tranexamic acid and consent was obtained after counseling the patients. STUDY GROUP: • Patient in this group received injection Tranexamic acid 15mg /kg dose infusion in 100 ml Ringer lactate solution over 10 - 15 minutes prior to the skin incision. • After Delivery of Baby during Cesarean Section, they received Injection oxytocin 10 units indramuscularly. CONTROL GROUP: • Patient in this group did not receive injection Tranexamic acid. Just they received plain Ringer lactate. Lower segment caesarean section was done under spinal anesthesia. • After the delivery of the baby, they received Injection oxytocin 10 units intramuscularly. • Both groups received parentral Antibiotics just prior to surgery. CONCLUSION: There is no significant difference in Age, BMI, Parity, Indication and Duration of Cesarean Section and Birth weight of Baby between the study group and control group. Both Groups are comparable. Intravenous infusion of Tranexemic Acid at the dose of 15 mg/Kg Body Weight, initiated 15 minutes prior to Skin Incision. • does not alter the (1) Heart rate, (2) Systolic BP, (3) Diastolic BP and (4) Respiratory Rate. • leads to significant reduction (p <0.05) in Per Operative (average 114.40 ml) and Post Operative Blood Loss (average 32.77 ml) during Cesarean Section. Total Blood Loss is reduced by an average of 147 ml. • leads to significant (p <0.05) difference in fall of Hb level in control group who have not received inj.Tranexamic acid. The mean difference was 0.28gms%(P=0.01) • leads to Reduction in (1) the incidence of PPH, (2) need for maternal blood Transfusion, (3) Use of additional Uterotonics, (4) Duration of stay in an insignificant manner • does not alter the APGAR Score and Rate of admission into NICU, in a significant manner. • does not produce other adverse reactions like nausea, vomiting, diarrhea in a significant manner. It was not associated with thrombotic complications. Intravenous infusion of Tranexemic Acid at the dose of 15 mg/Kg Body Weight, initiated 15 minutes prior to Skin Incision is effective and safe in women undergoing caesarean section in reducing preoperative and postoperative cesarean section blood los

An efficient protocol devised for rapid callus induction from leaf explants of Stephania wightii (Arn.) Dunn. - an endemic medicinal plant

Callus culture of Stephania wightii (Arn.) Dunn. was established from leaf explants.Different growth regulators greatly influenced the growth of callus cultures. Leaf derivedcallus grown on Murashige and Skooge (MS) medium fortified with different concentrations(0.1-2.5 mg/L) of Thiodiazuran (TDZ), 6-Benzyladenine (BA), 2, 4- DichlorophenoxyaceticAcid (2, 4-D) and α-Naphthalene Acetic Acid (NAA). Maximum callus growth was achievedin medium supplemented with TDZ + NAA (1.5+0.02 mg/L) was found to be more suitablethan other growth regulators used

In vitro cytotoxic activity of methanolic extract of Cardiospermum canescens Wall. (Sapindaceae)

The present study was designed to evaluate the in vitro cytotoxicity activity of methanolic extract of Cardiospermum canescens. In this study the extract was tested using human cancer cell lines, Human ductal breast cancer cell line and Colon cancer cell line for their effects on cell viability, growth inhibition and cell morphology. Cell viability and inhibition were determined by MTT [(3,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide)] assay by using DAPI (4- 6-diamidino- 2- phenylindole) staining technique. The significant decrease in cell viability was observed for 100µg/ml in human ductal breast cancer cell line and 150µg/ml in colon cancer cell line. The IC50 value is 31.25µg/ml and 250µg/ml in ductal breast and colon cancer cell lines respectively. The results indicated that methanolic extract of Cardiospermum canescens has a potential cytotoxicity activity on Human ductal breast cancer cell line than the colon cancer cell lines

Anti-inflammatory activity of methanolic extract of Stephania wightii (Arn) Dunn- an endemic medicinal plant

The methanolic extract of aerial parts and tuber of Stephania wightii has been evaluated for their in vitro and in vivo anti-inflammatory activity using human red blood cell membrane stabilization method and carragennan induced paw oedema in mice model. The methanolic extract of S. wightii tuber part showed 75% protection of human red blood cell membrane. The result indicated that the methanolic extract of tuber at the dose of 100mg/kg.body wt., showed a maximum inhibition of paw oedema at 75.3% as compared to the reference drug, indomethacin. The methanolic extract of aerial part with a similar dose produced 63% of inhibition. The methanolic extract of tuber of S. wightii has showed maximum anti-inflammatory activity

Genetic transformation of cry1EC gene into cotton (Gossypium hirsutum L.) for resistance against Spodoptera litura

Cotton is the chief fibre crop of global importance. It plays a significant role in the national economy. Cotton crop is vulnerable to a number of insect species, especially to the larvae of lepidopteron pests. 60% insecticides sprayed on cotton are meant to control the damage caused by bollworm complex. Transgenic technology has become a popular option for the development of bollworm resistant cotton. Spodoptera litura is one of the notorious emerging pests in cotton. Introduction of cry1EC gene into commercial variety have very significant importance. This research work was carried out to transform chimeric δ-endotoxin Cry1EC into cotton. The tobacco cutworm (Spodoptera litura) is a polyphagous foliage insect which is susceptible to the chimeric δ-endotoxin Cry1EC. Six month-old highly friable embryogenic calli derived from cotyledonary explants of Coker 310 were used for transformation using Agrobacterium tumefaciens strain LBA4404 harboring plasmid pBI101.1 carrying the marker gene neomycin phosphotransferase II (npt II) and a synthetic cry 1EC gene under a constitutive 35 S promoter. Agrobacterium treated calli were selected on MS medium containing, 50 mg/L kanamycin, 500 mg/L cefotaxime, 30 g/L maltose and 0.4% phytagel. Embryos developed on kanamycin resistant calli were maintained on the same medium till somatic embryos matured. The cotyledonary stage embryos (3 to 5 mm size) were germinated on MS basal slat with 0.1 mg/L GA3 + 1.0 mg/L IAA, 30 g/L sucrose and solidified with 0.4% phytagel. The regenerated putative transgenic plants were hardened and transferred to the transgenic green house. Transgenic plants were confirmed by polymerase chain reaction (PCR) amplification of 800 bp npt II fragment, and 578 bp amplification of cry1Ec gene. Transgenic plant with single copy insertion of cry1EC was selected in T0 by southern blot hybridization. Insect bioassay using Spodoptera litura larvae of first instar stages on T0 plants showed 70% mortality. Not much data has been published on the toxicity of the endotoxins to S. litura, which is a common pest in warm and humid climates. Efforts are aimed at recovering more efficient transgenic plants through efficient transformation system and developing high resistant transgenic cotton against S. litura and will paved a way for promising future in cotton production.Keywords: Agrobacterium transformation, cry 1EC, molecular analysis, insect bioassayAfrican Journal of Biotechnology Vol. 12(15), pp. 1820-182

NGOs hoping for a better, safer, worry free New Year

EXPECTATIONS: Groups tell of what they're grateful for and what they're looking forward to in the future. THE slew of goodies rolled out by the government, in particular the 1Malaysia Housing Programme (PR1MA), was a resounding success, National House-buyers Association secretary-general Chang Kim Loong says