Impact of body mass index and low estrogen level on urinary hydroxyl proline and other bone related parameters in postmenopausal women

Background: The study revealed the impact of body mass index and low estrogen level on urinary hydroxyl proline and other bone related parameters in postmenopausal women.Methods: The study comprised 145 obese postmenopausal women and 145 ideal weight postmenopausal women as a study subjects and 145 normal reproductive age group women taken as control. The following biochemical parameters serum calcium, serum phosphorous, serum alkaline phosphatase, urinary calcium, urinary creatinine, urinary hydroxyproline were estimated for assessment of bone loss. Then these results were compared with control group.Results: The significant changes found in biochemical parameters in ideal weight postmenopausal women and highly significant changes in biochemical parameters observed in obese post menopause women.Conclusions: The obese postmenopausal women who have high BMI and low estrogen level have higher bone loss and are more prone to suffer from bone related problems

Comparative antioxidant and bioavailability studies of Vitamin C in Phyllanthus emblica Linn. and its combinations with Piper nigrum Linn. and Zingiber officinale Roscoe

Phyllanthus emblica Linn. (amla) is used in Ayurveda, the ancient Indian system of medicine and its major constituent is vitamin C which has effective free radical scavenging property. The purpose of this study was to evaluate the in vitro antioxidant activity and the bioavailability profile of vitamin C in amla and its combinations with piperine and ginger in comparison to synthetic vitamin C using New Zealand rabbits. In vitro antioxidant activity studies of synthetic vitamin C, amla, amla with piperine and amla with ginger were carried out using different models such as 2,2-Diphenyl-1-picrylhydrazyl, Nitric Oxide, Hydrogen peroxide scavenging methods, Total reductive capability and Oxygen Radical Absorbance Capacity estimation. The study results showed that synthetic vitamin C, amla, amla with piperine and amla with ginger possess significant in vitro antioxidant activity. For bioavailability studies, synthetic vitamin C, amla, amla with piperine and amla with ginger 100 mg/kg, were administered orally and the serum samples were analyzed by HPLC at 0, 1, 2, 3, 4, 6, 8, 10, 12 and 24 hours. Bioavailability studies revealed that amla with piperine combination has higher concentration of vitamin C when compared to synthetic vitamin C. This is probably due to presence of piperine, which is a bioavailability enhancer. The present study supports the fact that amla with piperine combination can be an alternative to synthetic vitamin C.Phyllanthus emblica Linn. (amla) é utilizada na medicina Ayurveda, medicina da Índia antiga e seu principal constituinte é a vitamina C, que possui propriedade sequestrante de radicais livres. O propósito deste estudo foi avaliar a atividade antioxidante in vitro e o perfil de biodisponibilidade da vitamina C na amla e suas combinações com piperina e gengibre em comparação com a vitamina C sintética, utilizando coelhos da Nova Zelândia. Os estudos de atividade antioxidante in vitro de vitamina C sintética, amla, amla com piperina e amla com gengibre foram realizados utilizando-se diferentes modelos para sequestrantes, como 2,2-difenil-1-picrilidrazil, óxido nítrico, peróxido de hidrogênio, capacidade redutiva total e a estimativa da capacidade de absorvância do radical oxigênio. Os resultados do estudo mostraram que vitamina C sintética, amla, amla com piperina e amla com gengibre possuem atividade antioxidante in vitro significativa. Para os estudos de biodisponibilidade, administraram-se oralmente vitamina C sintética, amla, amla com piperina e amla com gengibre 100 mg/kg e as amostras de soro foram analisadas por CLAE em 0, 1, 2, 3, 4, 6, 8, 10, 12 e 24 horas. Os estudos de biodisponibilidade revelaram que a associação de amla com piperina tem maior concentração de vitamina C, quando comparada com a vitamina C sintética. Este efeito é provavelmente devido à presença de piperina, que é intensificador de biodisponibilidade. O presente estudo apoia o fato de que a associação de amla e piperina pode ser uma alternativa para a vitamina C sintética

COMBINATION OF MOMORDICA CHARANTIA AND PHYLLANTHUS AMARUS FOR HEPATOPROTECTIVE ACTIVITY IN ETHANOL AND ANTI-TUBERCULAR DRUGS INDUCED HEPATOTOXICITY IN RATS

Objective: To evaluate the synergistic protective effect of Momordica charantia and Phyllanthus amarus combination (MC+PA) of doses 200 and 400 mg/kg on the liver in different experimental models of hepatotoxicity. Methods: The hepatoprotective activity was evaluated in ethanol and anti-tubercular drugs (isoniazid-INH, rifampicin-RIF) induced hepatotoxicity models. Hepatotoxicity in both models was induced to all groups except the normal control. Intoxicated rats were treated with silymarin and various doses of MC+PA for 8 d in ethanol-induced and 21 d in INH+RIF induced hepatotoxicity models. At the completion of study, the biochemical markers and the anti-oxidant status (SOD and MDA) were measured and also the histopathological evaluation of the liver tissue was carried out. Results: Combination therapy remarkably reduced the elevated profile of the biochemical markers and thereby improved the anti-oxidant status, thus exhibiting the synergistic hepatoprotective effect when compared with the positive control group (p<0.001). Histopathological evaluation demonstrated that MC+PA decreased the liver damage significantly in comparison with the positive group. Conclusion: The current work suggests that the combined extract showed synergistic effects on ethanol and anti-tubercular drugs induced hepatotoxicity models by significantly decreasing the liver damage

Assessment of Self-Care Practices among Type 2 Diabetic Patients in a Secondary Care Teaching Hospital

Background: Diabetes is one of the major health problems worldwide that can be effectively managed by good self-care activities like medication adherence, exercise, monitoring of blood glucose, foot care and diet. Objectives: The study assessed the self-care activities of diabetic patients using summary of diabetes self-care activities scale (SDSCA) and the variables (Age, gender, educational level, socioeconomic status (SES)) associated with it. Methods: A cross-sectional descriptive study was undertaken in 400 Type 2 diabetic patients. Self-care practices of the patients were evaluated by using SDSCA and correlation with variables were determined statistically. Results: Among 400 diabetic patients about 215 (53.75%) had an average score of self-care. Self-care was poor in 184 (46%) subjects, and only 1 subject (0.25%) scored good. Blood sugar monitoring was the highest (100%) followed by medication adherence (92.75%) whereas inadequate levels of self-care were reported in foot care (1.5%), and physical activity (31.5%) domains. A significant positive correlation was found between self-care practices and socio-demographic variables such as age (r=0.298, p=0.000), income (r=0.490, p=0.000) occupation (r=0.433, p=0.000), education (r=0.582, p=0.000), and Socio-Economic status (r=0.599, p=0.000). Conclusion: The study revealed higher level of adherence to self-care activities in terms of blood sugar monitoring and medication taking behaviour in the current setting, but self-care in other domains such as foot care is critically low. Age, education and Socio-Economic status seems to affect the self-care practice by the patients. Keywords:  Diabetes, Diabetes self- care, Diabetic foot care, Summary of diabetes self-care activities (SDSCA) score

Drug Utilization Evaluation of Lorazepam in Alcohol Withdrawal Syndrome Patients: A Secondary Care Teaching Hospital Based Study

Background: Drug utilization evaluation is an important parameter for the safe, effective and rational use of medications in medical care. Alcoholism results in abundant cases of alcohol withdrawal which can prove to be life-threatening if untreated, lorazepam is a drug of choice for Alcohol Withdrawal Syndrome and requires close monitoring as its over-dosing or under-dosing is common in case of withdrawal. Objective:  ensures the safe and rational use of Lorazepam in the management of Alcohol Withdrawal Syndrome. Materials and Method: This prospective, observational study was conducted among alcoholic patients admitted in the KC General Hospital, Karnataka, India. Baseline data for Clinical Institute Withdrawal Assessment for Alcohol revised scale (CIWA-Ar) was collected on the day of admission and the response to lorazepam treatment was recorded using the same with respect to the baseline data every 12th hourly after the initial administration until withdrawn. Results: Statistical analysis for 72 patients was done using ANOVA to calculate the overall progression of the syndrome with treatment. Among 72 patients 94.44% were male and 5.55% were female. The mean age of patients reported with AWS was found to be 44.90 years. A significant CIWA-Ar score reduction was observed with a p-value of <0.0001. Conclusion: Our study revealed a strong predominance of male patients with alcohol withdrawal syndrome, where maximum patients started consuming alcohol before the age of 20 years. After the administration of lorazepam, a significant CIWA-Ar score reduction was observed. Keywords: Alcohol Withdrawal Syndrome, CIWA-Ar scale, Drug utilization evaluation, Lorazepam

Prescription Pattern Analysis of Type II Diabetes Mellitus Inpatients and Associated Co-Morbidities

Background: The present study was planned to assess the prescription pattern analysis of Type II Diabetes Mellitus and associated co-morbidities. As per WHO, the worldwide prevalence of DM will reach 366 million by 2030. Evaluating drug prescription pattern is a major aspect of patient care, which is used as a measure of the quality of care provided. Objectives: Primary objectives of the study were to highlight the current prescription pattern trends in patients having diabetes mellitus with or without other co-morbid conditions, to ensure safety and rational use of prescribed regimen. And the secondary objectives of the study were to analyse the demographic information of the enrolled patients and also to identify and analyse the prescriptions with polypharmacy. Materials and Methods: A prospective observational study was conducted to analyse the prescribing pattern of anti-diabetic drugs. The study incorporated 100 Type II DM inpatients having comorbid conditions. The study has been conducted with the help of WHO prescribing indicator scale. It is used to analyse drug class, generic and branded drugs, fixed dose combination and dosage form. Patient data was collected and medical data records were analysed daily till discharge from hospital. Results: It was found that most of the drugs have been prescribed are purely from Karnataka Essential Medicine list (KEML). And percentages of medicines prescribed on their generic name were 76%. About 51% of patients were treated only with oral hypoglycemic agents. Whereas, 38% were treated with Insulin and 11% were treated with both oral hypoglycemic agents and Insulin. Conclusion: Improved rational use of prescription by using Essential Medicine List (EML).And also ensured the appropriateness of prescription by using WHO scale. Several Adverse Drug Reactions (ADR)have been reported and which leads to improved  prescription pattern. Keywords: Type II Diabetes Mellitus, Prescribing Indicator, Co-Morbidities

Dizaj i statistička optimizacija liposfera s glipizidom pomoću metodologije odgovora površine

A 32 factorial design was employed to produce glipizide lipospheres by the emulsification phase separation technique using paraffin wax and stearic acid as retardants. The effect of critical formulation variables, namely levels of paraffin wax (X1) and proportion of stearic acid in the wax (X2) on geometric mean diameter (dg), percent encapsulation efficiency (% EE), release at the end of 12 h (rel12) and time taken for 50% of drug release (t50), were evaluated using the F-test. Mathematical models containing only the significant terms were generated for each response parameter using the multiple linear regression analysis (MLRA) and analysis of variance (ANOVA). Both formulation variables studied exerted a significant influence (p < 0.05) on the response parameters. Numerical optimization using the desirability approach was employed to develop an optimized formulation by setting constraints on the dependent and independent variables. The experimental values of dg, % EE, rel12 and t50 values for the optimized formulation were found to be 57.54 ± 1.38 µm, 86.28 ± 1.32 %, 77.23 ± 2.78 % and 5.60 ± 0.32 h, respectively, which were in close agreement with those predicted by the mathematical models. The drug release from lipospheres followed first-order kinetics and was characterized by the Higuchi diffusion model. The optimized liposphere formulation developed was found to produce sustained anti-diabetic activity following oral administration in rats.32 faktorijalni dizajn primijenjen je za pripravu liposfera s glipizidom metodom separacije pomoću emulzija koristeći parafinski vosak i starinsku kiselinu kao tvari za usporavanje. Pomoću F-testa praćen je učinak kritičnih varijabli tijekom formuliranja, tj. količina parafinskog voska (X1) i udio stearinske kiseline (X2) na srednji promjer liposfera (dg), postotak inkapsulirane ljekovite tvari (% EE), oslobađanje ljekovite tvari nakon 12 h (rel12) te vrijeme potrebno za oslobađanje 50% ljekovite tvari (t50). Pomoću multiple linearne regresijske analize (MLRA) i analize varijabli (ANOVA) za svaki su parametar načinjeni matematički modeli koji sadrže samo značajne varijable. Proučavanje varijabli na oba načina ukazalo je na njihov značajan utjecaj (p < 0,05) na parametre liposfera. Postavljanjem ograničenja na zavisne i nezavisne varijable provedena je numerička optimizacija na principu poželjnosti. Eksperimentalne vrijednosti dg, % EE, rel12 i t50 optimiziranih formulacija bile su 57,54 ± 1,38 µm, 86,28 ± 1,32%, 77,23 ± 2,78% i 5,60 ± 0,32 h. Dobivene eksperimentalne vrijednosti iznosile su vrlo slične vrijednostima predviđenim matematičkim modelima. Oslobađanje glipizida iz liposfera slijedio je kinetiku prvog reda i okarakterizirano je Higuchijevim difuzijskim modelom. Optimizirane liposfere su nakon peroralne primjene na štakorima pokazale produljeni antidijabetički učinak

Petrology, geochemistry, and mineralogy of pyroxene and pegmatitic carbonatite and the associated fluorspar deposit at Okorusu alkaline igneous carbonatite complex, Namibia

Field observations, petrography, electron microprobe analysis (EPMA), geothermometry, and geochemical analyses (ICP-MS and XRF) of the fluorspar deposit associated with the Late Cretaceous alkaline igneous-carbonatite complex at Okorusu (Namibia) have identified two previously unrecognized types of carbonatites, namely pyroxene and pegmatitic carbonatites. These carbonatites exhibit interesting textural characteristics, with the pyroxene carbonatite exhibiting occasional bands of diopside alternating with coarse-grained calcite-rich bands, and pegmatitic carbonatite having the same mineralogy but much coarser texture. Both types of carbonatites are closely spatially associated. Ülvospinel exsolution lamellae were recognized in magnetite crystals within the pyroxene and pegmatitic carbonatite. Stable isotope determinations for calcite crystals separated from pegmatitic carbonatites, pyroxene carbonatites, and marbles indicate that the carbonatites are primary in origin. Cathodoluminescence microscopy (CL) and emission spectrography of the carbonatites indicated that the carbonate mineral is almost entirely calcite rather than dolomite, and there are at least two generations of calcite. CL study of fenites, which are metasomatised Precambrian metasedimentary rocks, intruded by carbonatites reveal that fenitization is mostly incipient, marked by the introduction of Fe3+ activated feldspars. Geothermometric determination from EPMA of apatite and biotite in pyroxene carbonatite provided a range of 537-409⁰C except in one sample which clearly indicated later hydrothermal alteration. The temperature range is similar to a previous titaniferous magnetite-ilmenite temperature determination and is interpreted to represent magmatic crystallization. Trace element patterns of carbonatites are largely consistent with the results of previous studies, although phosphorus values are anomalously high because of apatite. As one of only two producing carbonatite-related fluorspar deposits in the world, the host rock-ore relationships of the Okorusu fluorspar deposit were identified and characterized. The recognition of certain fluorite ore textures, together with replacement remnants of carbonatite in fluorite ores, has shown that the fluorite ore bodies have formed largely by the replacement of the pyroxene and pegmatitic carbonatite. Fluid inclusion geothermometry of purple and green vug-filling shows that fluorite crystallized over a temperature range of 168-144 ⁰C (uncorrected for pressure) and from fluids with a salinity of 1.57-4.96 wt % NaCl eq. Beneficiation problems, such as the presence of phosphate, rare earth elements and silica in the final fluorspar concentrate, have resulted from those replacements --Abstract, pages iii-iv

In vitro antioxidant and antihyperlipidemic activities of Bauhinia variegata Linn

Objectives : To evaluate the ethanolic and aqueous extracts of Bauhinia variegata Linn. for in vitro antioxidant and antihyperlipidemic activity. Materials and Methods : Ethanolic and aqueous extracts of the stem bark and root of B. variegata Linn. were prepared and assessed for in vitro antioxidant activity by various methods namely total reducing power, scavenging of various free radicals such as 1,2-diphenyl-2-picrylhydrazyl (DPPH), super oxide, nitric oxide, and hydrogen peroxide. The percentage scavenging of various free radicals were compared with standard antioxidants such as ascorbic acid and butylated hydroxyl anisole (BHA). The extracts were also evaluated for antihyperlipidemic activity in Triton WR-1339 (iso-octyl polyoxyethylene phenol)-induced hyperlipidemic albino rats by estimating serum triglyceride, very low density lipids (VLDL), cholesterol, low-density lipids (LDL), and high-density lipid (HDL) levels. Result : Significant antioxidant activity was observed in all the methods, (P < 0.01) for reducing power and (P < 0.001) for scavenging DPPH, super oxide, nitric oxide, and hydrogen peroxide radicals. The extracts showed significant reduction (P < 0.01) in cholesterol at 6 and 24 h and (P < 0.05) at 48 h. There was significant reduction (P < 0.01) in triglyceride level at 6, 24, and 48 h. The VLDL level was also significantly (P < 0.05) reduced from 24 h and maximum reduction (P < 0.01) was seen at 48 h. There was significant increase (P < 0.01) in HDL at 6, 24, and 48 h. Conclusion : From the results, it is evident that alcoholic and aqueous extracts of B. variegata Linn. can effectively decrease plasma cholesterol, triglyceride, LDL, and VLDL and increase plasma HDL levels. In addition, the alcoholic and aqueous extracts have shown significant antioxidant activity. By the virtue of its antioxidant activity, B. variegata Linn. may show antihyperlipidemic activity