Systematic review: combination therapies for treatment-naïve chronic hepatitis B

Background: There is a renewed interest in use of combination therapies in treatment-naïve chronic hepatitis B (CHB) because of limitations of monotherapies. Aim: To discuss the current status of combination therapies in treatment-naive CHB. Methods PubMed search was done using 'combination', 'sequential' and 'chronic hepatitis B' as the search terms. Results: The two most popular combination therapies include 'combination of nucleos(t)ide analogues' and 'combination of interferons and nucleos(t)ide analogues'. Combination therapies using two nucleos(t)ide analogues do not lead to higher long-term efficacy. However, addition of a nucleos(t)ide analogue with a good resistance profile to a nucleos(t)ide analogue with a lower genetic barrier to resistance decreases the risk of emergent resistance to the latter. Greater sustained virological, biochemical and seroconversion rates are observed with addition of lamivudine to conventional interferon, but pegylated-interferon monotherapy is equally effective as combination with lamivudine. Again, resistance to lamivudine is lower with its combination with interferons. Conclusions: The answer to the question whether hepatitis B can be treated better with combination or monotherapy remains largely unknown. Additional trials are warranted of combination therapies of peginterferon and potent nucleos(t)ide analogues or therapies with the combined use of nucleos(t)ide analogues or immunomodulators

In vivo and In vitro Estimation of Colchicine in Gloriosa superba L. by High Pressure Liquid Chromatography

The presence of Colchicine in Gloriosa superba was confirmed by Thin Layer Chromatography (TLC) and High Pressure Liquid Chromatography (HPLC) in which a spot coinciding with the authentic sample of Cochicine in Rf value (Colchicine 0.70) appeared. The maximum amount of Colchicine was found in flower (20.7 mg/gdw) and minimum amount was found in stem (7.4 mg/gdw).The In vitro studies showed the maximum amount of Colchicine in 6 week old cultures (22.6 mg/gdw)) and minimum amount in 2 weeks old cultures (15.3 mg/gdw). Key words: Colchicine, Gloriosa superba, HPLC Laboratory of Bioactive Natural Products, Department of Botany, University of Rajasthan, Jaipur -302004 * Corresponding Author, Email: [email protected]; Tel: +91-141-2701875, +91-9828070584 Please Cite This Article As:Renu Sarin, Anirudha Rishi and Ajit Kumar. 2010. In vivo and In vitro Estimation of Colchicine in Gloriosa superba L. by High Pressure Liquid Chromatography. J. Exp. Sci. 1(4):1-2.Â

Small-intestinal bacterial overgrowth in cirrhosis is related to the severity of liver disease

Background: Small-intestinal bacterial overgrowth (SIBO) is known to be present in patients with cirrhosis, predisposing to various complications. Aim To determine the frequency of SIBO in cirrhotics and correlate with severity of cirrhosis. Methods: Small-intestinal bacterial overgrowth was determined by glucose-hydrogen breath test (GHBT). A basal breath-hydrogen >20 ppm or a rise by ≥12 ppm above baseline following glucose administration was taken as positive test. Prevalence of SIBO in cirrhotics was compared with healthy controls and correlated with severity of cirrhosis. Results: Of the 53 cirrhotics, 26 (49%) had SIBO, compared to one (8%) control (P = 0.010). The prevalence of SIBO increased with severity of cirrhosis (Child-Pugh A 20%, B 52% and C 73%; P = 0.013). On multivariate analysis, SIBO was independently associated with serum bilirubin and ascites. The best cut-off of serum bilirubin was ≥2 mg/dL [AUROC 0.77 (95% CI 0.64-0.90)] predicting SIBO with sensitivity 65%, specificity 81%, positive predictive value 77%, negative predictive value 71% and accuracy 74%. Patients having combination of ascites and serum bilirubin ≥2 mg/dL had 82% chance, while patients having neither had only 10% chance of having SIBO. Conclusions: Small-intestinal bacterial overgrowth was prevalent in about half of cirrhotics. Its frequency increased with increase in severity of cirrhosis. Ascites and raised serum bilirubin reliably predicted presence of SIBO

Interactive on-line conferences

Thesis (Ph.D.)--Massachusetts Institute of Technology, Dept. of Electrical Engineering and Computer Science, 1984.MICROFICHE COPY AVAILABLE IN ARCHIVES AND ENGINEERING.Vita.Bibliography: leaves 223-234.by Sunil Kumar Sarin.Ph.D

Chemical characteristics of aerosols in MABL of bay of Bengal and Arabian sea during spring inter-monsoon: a comparative study

The chemical composition of aerosols in the Marine Atmospheric Boundary Layer (MABL) of Bay of Bengal (BoB) and Arabian Sea (AS) has been studied during the spring and inter-monsoon (March-May 2006) based on the analysis of water soluble constituents (Na+, NH4+, K+, Mg2+, Ca2+, Cl-, NO3- and SO42-), crustal elements (Al, Fe, and Ca) and carbonaceous species (EC, OC). The total suspended particulates (TSP) ranged from 5.2 to 46.6 μg m-3 and 8.2 to 46.9 μg m-3 during the sampling transects in the BoB and AS respectively. The water-soluble species, on average, accounted for 44% and 33% of TSP over BoB and AS respectively, with dominant contribution of SO42- over both the oceanic regions. However, distinct differences with respect to elevated abundances of NH4+ in the MABL of BoB and that of Na+ and Ca2+ in AS are clearly evident. The non-sea-salt component of SO42- ranging from 82 to 98% over BoB and 35 to 98% over AS; together with nss-Ca2+/nss-SO42- equivalent ratios 0.12 to 0.5 and 0.2 to 1.16, respectively, provide evidence for the predominance of anthropogenic constituents and chemical transformation processes occurring within MABL. The concentrations of OC and EC average around 1.9 and 0.4 μg m-3 in BoB and exhibit a decreasing trend from north to south; however, abundance of these carbonaceous species are not significantly pronounced over AS. The abundance of Al, used as a proxy for mineral aerosols, varied from 0.2 to 1.9 μg m-3 over BoB and AS, with a distinctly different spatial pattern - decreasing north to south in BoB in contrast to an increasing pattern in the Arabian Sea

Influence of Humidity on the NO₂ Sensing Properties of SrCo₀.₁Ti₀.₉O₃

Strontium Cobalt Titanate (SCT) was synthesized via solid state route. Phase formation was analyzed using X-ray diffraction (XRD) technique. Resistive sensors were made using screen printing technique and corresponding sensing properties were investigated in dry as well as humid environment (RH 50%). Experimental results demonstrated that sensors displayed least humidity interference at 400 °C. The operating temperature of the sensor was optimized for best responsiveness. These type of sensors can be effectively used in environmental monitoring of NO2 gas at low ppm

Maternal and fetal outcomes in pregnant women with acute hepatitis E virus infection

Background: Hepatitis E virus (HEV) infection is known to cause severe liver disease in pregnant women. It is unclear whether obstetric and fetal outcomes are worse in pregnant women with HEV infection than in women with other forms of viral hepatitis. Objective: To compare maternal, obstetric, and fetal outcomes in pregnant women with acute viral hepatitis caused by HEV and other hepatitis viruses. Design: Observational cohort. Setting: Tertiary care hospital, New Delhi, India. Patients: 220 consecutive pregnant women presenting with jaundice caused by acute viral hepatitis. Measurements: Maternal mortality and medical complications, obstetric complications, deliveries, and fetal outcomes. Results: Infection with HEV caused acute viral hepatitis in 60% of included women. Fulminant hepatic failure was more common (relative risk, 2.7 [95% CI, 1.7 to 4.2]; P = 0.001) and maternal mortality was greater (relative risk, 6.0 [CI, 2.7 to 13.3]; P < 0.001) in HEV-infected women than in non-HEV-infected women. Women with HEV infection were more likely than those with other forms of viral hepatitis to have obstetric complications (relative risk, 4.1 [CI, 1.7 to 10.2] for antepartum hemorrhage and 1.9 [CI, 1.3 to 2.7] for intrauterine fetal death; P < 0.001 for both) and poor fetal outcomes (relative risk, 1.2 [CI, 1.0 to 1.4] for preterm delivery [P = 0.005] and 1.8 [CI, 1.2 to 2.5] for stillbirth [P = 0.026]). Limitations: The findings may not apply to community settings, to women who are asymptomatic or have only minor symptoms, or in the setting of an HEV epidemic. Conclusions: Pregnant women with jaundice and acute viral hepatitis caused by HEV infection had a higher maternal mortality rate and worse obstetric and fetal outcomes than did pregnant women with jaundice and acute viral hepatitis caused by other types of viral hepatitis

Beta-blocker plus nitrates for secondary prevention of variceal bleeding

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