Effect of Azadirachta indica and Tamarindus indica leaf extract and evaporative cooling on the quality characteristics and shelf life of sapota (Manilkara zapota)

Tropical fruits such as Sapota (Manilkara zapota) are highly perishable. The main reasons for the quality deterioration of these fruits are field heat and microbial attack, which can be reduced by proper cooling techniques and by using antimicrobial agents. The present study was undertaken to extend the shelf life of Sapota using evaporative cooling and antimicrobial coating, namely, neem leaves (Azadirachta indica) and tamarind leaves (Tamarindus indica), at different concentrations (20, 50 and 100%). Coated Sapota fruits were stored for 24 days, whereas uncoated fruits were stored for only 7 days. Both the selected antimicrobial extracts showed antimicrobial activity, and the cooling efficiency of the evaporative cooling chamber was 81-85%. Fruits were cooled to 15-18°C (core temperature), which could enable retention of physio-chemical properties. The results indicated that fruits coated with the highest level (100%) of antimicrobial extract coating (neem leaves and tamarind leaves) and stored under evaporative cooling conditions had the lowest percentage loss in weight (5-7% after 24 days of storage) and good retention of total soluble solids (1-2%), pH (2-3%) and total sugars (3-5%). Thus, coating Sapota fruits with neem leaves and tamarind leaf extracts and storing them under evaporative cooling conditions can be a better way to enhance the shelf life of sapota

A study of the diagnostic effectiveness of repeated fine needle aspiration in thyroid and breast lesions

Background: Fine needle aspiration cytology (FNAC) is a relatively safe diagnostic tool with high sensitivity and specificity. Due to lesion inherent properties and lack of proper technique, adequate cellularity is not yielded in some instances, resulting in an inconclusive report. In such instances we have to go for repeat FNA to make a proper diagnosis. Repeat aspirations impose unnecessary workload on the lab and are distressful to the patients. The issue of repeat aspiration is largely unaddressed. Objectives were to identify the proportion of repeated fine needle aspirations in breast and thyroid lesions turning out to be diagnostic and to identify and describe the common factors leading to repeat fine needle aspiration.Methods: 190 cases of repeated FNA including both thyroid and breast lesions are included in the study. FNA done after an initial aspiration with inconclusive smear is considered as repeated FNA. History, clinical examination findings, findings in imaging studies, nature of aspirate obtained for each patient advised repeat FNA, are recorded. Proportion of repeat FNAs turning out to be diagnostic and the documented reasons for repeat were taken as the outcome measure.Results: 78% of repeat FNA in thyroid lesions and 50% of the repeat FNA in breast lesions were diagnostic. Inadequate cellularity, haemorrhagic aspirate and cystic change are the most common factors leading to repeat FNA.Conclusions: Since thyroid and breast are the most common sites where FNA is done and 64% of the total lesions are diagnostic, repeat FNA in all other sites are likely to yield a similar diagnostic outcome. Hence, repeat FNA is advisable in lesions which had initial non diagnostic result

Pathological features in perinatal autopsy and its relation with clinical and antenatal sonography findings

Background: Perinatal mortality is considered as a yardstick of obstetric and maternal care before and around the time of death. Perinatal autopsy is an inevitable procedure which helps to ascertain the cause of death, identify rare diseases, supplements clinical diagnosis and provide risk estimates for future pregnancies. The aim of the study was to describe the pathological features in perinatal autopsy specimens and to compare the pathological features with clinical and antenatal sonography findings.Methods: A descriptive study was conducted among 43 perinatal autopsy cases. A thorough perinatal autopsy was done. Detailed maternal medical and obstetric history including the laboratory and USG findings were collected. Collected data analysed using Statistical package for social sciences (SPSS) software. Results: The results were grouped into fetal, maternal and placental findings. Congenital anomalies were detected in 20% cases. That included gastrochisis, ebstein anomaly, isolated dextrocardia, hypoplastic left heart syndrome, cleft lip and palate, prune belly syndrome, club foot. Placenta findings observed were chorioamnionitis, placental thrombotic vasculopathy and placental findings in COVID-19 positive cases. The most common maternal comorbidity was hypertension (20.9%). Perinatal mortality was high in those cases with past history of abortions and history of infertility treatment. Full agreement between perinatal autopsy and antenatal USG findings was detected in 36.36% cases. Additional anomalies detected on autopsy was 54.54%.Conclusions: A thorough clinical history, prenatal ultrasonography and perinatal autopsy features could be described in detail in all the cases. Comparison of finding at autopsy with antenatal ultrasonography finding indicate that ultrasonography finding have only a reasonable value in assessing fetal status. Advanced radiology techniques could be maximum helpful.

PHARMACOGNASTIC STUDY AND DEVELOPMENT OF QUALITY CONTROL PARAMETERS FOR FLOWERS OF AVARTAKI (CASSIA AURICULATA LINN)

Context: Avartaki (Cassia auriculata linn) flowers are used for various conditions of ailments in traditional systems of medicine since ancient times. Aims: This study is designed to lay down the various pharmacognostic and phytochemical standards which will be helpful to ensure the purity, safety, and efficacy of this medicinal plant. Materials and Methods: Various methods including macroscopic, microscopic, physicochemical and phytochemical methods were applied to determine the diagnostic features for the identification and standardization of intact and powdered drug of Avartaki (Cassia auriculata Linn) flowers. Results: The shape, color, odour and surface characteristics were determined for the intact drug and powdered materials of Avartaki (Cassia auriculata Linn) flowers. Light and electron microscope images of cross-section of stamen and powdered microscopy revealed useful diagnostic features. Phytochemical, physicochemical analysis of powdered drug proved useful to differentiate the powdered drug material. High performance thin layer chromatography analysis showed the presence of important phytoconstituents. Conclusion: Morphology as well as various pharmacognostic aspects of different parts of the plant were studied and have been described here along with phytochemical and physicochemical studies, which will help in authentication and quality control

Water Extract from the Leaves of Withania somnifera Protect RA Differentiated C6 and IMR-32 Cells against Glutamate-Induced Excitotoxicity

Glutamate neurotoxicity has been implicated in stroke, head trauma, multiple sclerosis and neurodegenerative disorders. Search for herbal remedies that may possibly act as therapeutic agents is an active area of research to combat these diseases. The present study was designed to investigate the neuroprotective role of Withania somnifera (Ashwagandha), also known as Indian ginseng, against glutamate induced toxicity in the retinoic acid differentiated rat glioma (C6) and human neuroblastoma (IMR-32) cells. The neuroprotective activity of the Ashwagandha leaves derived water extract (ASH-WEX) was evaluated. Cell viability and the expression of glial and neuronal cell differentiation markers was examined in glutamate challenged differentiated cells with and without the presence of ASH-WEX. We demonstrate that RA-differentiated C6 and IMR-32 cells, when exposed to glutamate, undergo loss of neural network and cell death that was accompanied by increase in the stress protein HSP70. ASH-WEX pre-treatment inhibited glutamate-induced cell death and was able to revert glutamate-induced changes in HSP70 to a large extent. Furthermore, the analysis on the neuronal plasticity marker NCAM (Neural cell adhesion molecule) and its polysialylated form, PSA-NCAM revealed that ASH-WEX has therapeutic potential for prevention of neurodegeneration associated with glutamate-induced excitotoxicty

Randomized Clinical Trial of High-Dose Rifampicin With or Without Levofloxacin Versus Standard of Care for Pediatric Tuberculous Meningitis: The TBM-KIDS Trial

Background. Pediatric tuberculous meningitis (TBM) commonly causes death or disability. In adults, high-dose rifampicin may reduce mortality. The role of fluoroquinolones remains unclear. There have been no antimicrobial treatment trials for pediatric TBM. Methods. TBM-KIDS was a phase 2 open-label randomized trial among children with TBM in India and Malawi. Participants received isoniazid and pyrazinamide plus: (i) high-dose rifampicin (30 mg/kg) and ethambutol (R30HZE, arm 1); (ii) high-dose rifampicin and levofloxacin (R30HZL, arm 2); or (iii) standard-dose rifampicin and ethambutol (R15HZE, arm 3) for 8 weeks, followed by 10 months of standard treatment. Functional and neurocognitive outcomes were measured longitudinally using Modified Rankin Scale (MRS) and Mullen Scales of Early Learning (MSEL). Results. Of 2487 children prescreened, 79 were screened and 37 enrolled. Median age was 72 months; 49%, 43%, and 8% had stage I, II, and III disease, respectively. Grade 3 or higher adverse events occurred in 58%, 55%, and 36% of children in arms 1, 2, and 3, with 1 death (arm 1) and 6 early treatment discontinuations (4 in arm 1, 1 each in arms 2 and 3). By week 8, all children recovered to MRS score of 0 or 1. Average MSEL scores were significantly better in arm 1 than arm 3 in fine motor, receptive language, and expressive language domains (P < .01). Conclusions. In a pediatric TBM trial, functional outcomes were excellent overall. The trend toward higher frequency of adverse events but better neurocognitive outcomes in children receiving high-dose rifampicin requires confirmation in a larger trial. Clinical Trials Registration. NCT02958709

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Early iron supplementation in very low birth weight infants–a randomized controlled trial

Aim: To evaluate if supplementing iron at 2 weeks of age improves serum ferritin and/or haematological parameters at 2 months of life in very low birth weight (VLBW) infants. Methods: Preterm VLBW infants who received at least 100 mL/kg/day of oral feeds by day 14 of life were randomized to either ‘early iron’ (3–4 mg/kg/day orally from 2 weeks) or ‘control’ (no iron until 60 days) groups. Infants were followed up fortnightly and all morbidities were prospectively recorded. Serum ferritin was measured at 60 days by enzyme immunoassay method. Results: Forty-six infants were included in the study; primary outcome was available for 42 infants. There was no difference in either serum ferritin (mean: 50.8 vs. 45.3 μg/L; adjusted difference in means: 5.8, 95% CI: −3.0, 14.6; p = 0.19) or haematocrit (32.5 ± 5.3 vs. 30.8 ± 6.3%; p = 0.35) at 60 days between the early iron and control groups. The magnitude of fall in serum ferritin from baseline to the end of study period was also not different between the groups (4.9 vs. 13.8 μg/L; difference in means: 8.8; 95% CI: −0.3, 17.9; p = 0.06). The requirement of blood transfusions (9.5 vs. 13%; p = 0.63) and a composite outcome of common neonatal morbidities (19% vs. 21.7%; p = 0.55) were also not different between the two groups. Conclusion: Supplementing iron at 2 weeks of age in preterm VLBW infants did not improve either serum ferritin or the haematological parameters at 2 months when compared to the standard practice of starting iron from 8 weeks of age