The effect of docosahexaenoic acid (DHA) supplementation on experimental depression in mice

Background: Depressive disorder is a prevalent psychiatric disorder, which affects 21% of the world population. Many drugs which are available as effective antidepressants produce various side effects like sedation weight gain postural hypotension etc., so there is need to develop novel compounds with minimized side effects. Hence this study was aimed to investigate the antidepressant activity of DHA, an omega-3 polyunsaturated fatty acid in albino mice.Methods: Animals were divided into four groups, consisting six mice in each group. Out of these, group I served as control (2% gum acacia), group II and III received test drug in two different doses 200mg/kg and 300mg/kg respectively and group IV received fluoxetine (20mg/kg) as standard drug. To determine the antidepressant-like activity, we used forced swim test and tail suspension test in mice. These methods are based on the observation that a mouse show alternating agitation and immobility; the immobility is indicative of a state of depression.Results: DHA produced significant antidepressant effect at all the doses, as indicated by reduction in immobility times as compared to control in both FST and TST. (P˂0.05) The efficacy of DHA at dose of 300 mg/kg was comparable with that of fluoxetine. DHA at 200mg/kg dose showed significantly less antidepressant activity compared to fluoxetine. (P˂0.05).Conclusions: The result specifies that compared to two doses of DHA (200mg/kg and 300mg/kg), higher dose of DHA found as an effective dose for treating depression produced due to stress

Evaluation of anti-inflammatory activity of docosahexaenoic acid on carrageenan induced paw oedema in rats

Background: Inflammation is a tissue reaction to infection, irritation of foreign substance. It is a part of the host defence mechanism but if in excess it becomes harmful. Docosahexaenoic acid (DHA) is omega-3-derivative of alpha-linolenic acid. This study was conducted to determine the anti-inflammatory activity of DHA and its comparison with standard drug diclofenac.Methods: The study was carried out by using inflammatory models in male albino rats. Rats were divided into 4 groups of 6 animals of each. The anti-inflammatory activity was studied with carrageenan induced rat paw edema.  The anti-inflammatory activity of DHA was compared with standard drug diclofenac. The study parameters for acute inflammation was assessment of reduction in inflammation and the percentage inhibition of the paw edema.Results: DHA 200 mg/kg, DHA 300 mg/kg, and diclofenac 10 mg/kg showed 58%, 64%, and 67% reduction in paw volume, respectively. The DHA showed significant (p<0.05) anti-inflammatory activity in both dosages as compared to control and was dose dependent.Conclusions: DHA produced dose dependent anti-inflammatory activity which suggest its probable use in the treatment of inflammation

COLOUR AND HEALING

Colour has always been associated with healing, because man related the power of the sun and rainbow to divine forces. For the ancients, the colours that make up sunlight were each considered to show a different aspect of the divine and to influence different qualities of life. Colour is therefore an important feature in the symbolism of ancient cultures throughout the world, and the origins of healing with colour in Western civilization can be traced back to the mythology of Ancient Egypt and Greece. According to Ancient Egyptian mythology, the art of healing with colour was founded by the god Thoth. He was known to the Ancient Greeks as Hermes Trismegistus, literally “Hermes thrice-greatest” because he was also credited with various works on mysticism and magic. Teachings attributedto him include the use of colour in healing in the Hermetic tradition; the Ancient Egyptians and Greeks used coloured minerals, stones, crystals, salves, and dyes as remedies, and painted treatment sanctuaries in various shades of colour.Interest in the physical nature of colour developed in Ancient Greece alongside the concept of the elements-air, fire, water, and earth. These fundamental constituents of the universe were associated with the qualities of coldness, heat, wetness and dryness, and also with four humors of bodily fluids-choler or yellow bile, blood (red), phlegm (white), and melancholy or black bile. These were thought to arise in four organs the spleen, heart, liver, and brain and to determine emotional and physical disposition. Health involved the proper balance of these humors, and diseases would result if their mixture was in an unbalanced proportion. Colour was intrinsic to healing, which involved restoring the balance. Coloured garments, oils, plasters, ointments, and salves were used to treat disease. (Graham, 1998

EFFICACY, SAFETY, AND COST-EFFECTIVE ANALYSIS OF LOW-DOSE ETORICOXIB AND ADD-ON PARACETAMOL VERSUS THERAPEUTIC DOSE ETORICOXIB FOR PAIN IN PATIENTS AFTER TOOTH EXTRACTION: A RANDOMIZED INTERVENTIONAL DOUBLE-BLIND STUDY

Objectives: The objectives of the study were to study the efficacy, safety, and cost-effective analysis of low-dose etoricoxib and add-on paracetamol versus therapeutic dose etoricoxib in patients who experienced pain after tooth extraction. Methods: Patients were recruited and randomized to two study groups E1P and E2 on etoricoxib 30 mg and add-on paracetamol 500 mg 8 hourly and etoricoxib 60 mg once respectively for 3 days. The efficacy was assessed by visual analog scale, pain relief score, and global evaluation score. Patients were assessed at 0, 6, 24, 48, and 72 h. Safety was assessed by adverse drug reactions reported by the patients after 72 h. Cost-effective analysis was done by calculating the cost of treatment and the cost-effective ratio in both groups. Results: Eighty patients completed the study having 40 patients in each group. Mean pain intensity reduction, mean pain relief score, and global evaluation score all showed significantly better results (p&lt;0.05) in Group E1P as compared to Group E2 at 6, 24, 48, and 72 h, respectively. No patient had reported any serious adverse drug reaction in both the groups; however, incidence of headache and fatigue was twice in the etoricoxib only treated group (n=4) than low-dose etoricoxib-treated group (n=2). The treatment cost of Group E1P was lesser than Group E2 and was also cost effective. Conclusion: Low-dose etoricoxib with add-on paracetamol is a better analgesic than therapeutic dose etoricoxib and is also found to be safer and cost effective

Incidence and sensitivity pattern of Klebsiella pneumoniae, Escherichia coli and Pseudomonas aeruginosa in a tertiary care hospital

Background: Antimicrobial resistance is a serious problem worldwide and differs from region to region. This study was planned to determine the incidence and sensitivity pattern of Klebsiella pneumoniae (K. pneumoniae), Escherichia coli (E. coli) and Pseudomonas aeruginosa (P. aeruginosa) in our region and discuss the general issues related to antimicrobial resistance.Methods: Prospective study was carried out between March to October 2015. Samples of urine, blood, pus, CSF and miscellaneous samples (fluids, swabs, sputum and stool) were collected from indoor and outdoor patients for isolation and antimicrobial susceptibility of K. pneumoniae, E. coli and P. aeruginosa in the Department of Microbiology G.R. Medical College, Gwalior (MP).Results: Out of the 5000 samples analyzed 1684 showed growth. K. pneumoniae (38.50%), E. coli (33.29%) and P. aeruginosa (28.19%) constituited a total of 805 isolates. Both E.coli and K. pneumoniae showed highest sensitivity for doxycycline (75%; 67% resp.) and second highest for levofloxacin (70%; 64% resp.), whereas, P. aeruginosa showed highest 57% sensitivity for amikacin followed by 48% for levofloxacin. β-lactam antibiotics and aminoglycosides showed high mean resistance (K.pneumoniae-83%, E.coli-79%, P. aeruginosa-86.4%) and (K. pneumoniae-75%, E. coli-61%, P. aeruginosa-70%) resp.Conclusions: The data indicates high resistance among the gram-negative bacteria for β-lactam and aminoglycoside antibiotics. Increasing resistance to doxycycline and flouroquinolones for K. pneumoniae and E. coli and multidrug resistance to P. aeruginosa is a cause of concern in this region. Thus, there is a need to stop misuse of antibiotics with immediate effect and to implement a strong antimicrobial stewardship program

Fixed drug eruption due to paracetamol

Fixed drug eruption is a common type of drug eruption seen in dermatology OPD’s. Usually it is seen with sulphonamides, salicylates, tetracyclines, oxyphenbutazones, dapsone, barbiturates, phenolphthalein, morphine, codeine, quinine, phenacetin, erythromycin, griseofulvin, mebendazole etc. We hereby report a case of fixed drug eruption due to single dose of oral paracetamol in an otherwise healthy male after one hour of consuming it. A provisional diagnosis of Paracetamol induced fixed drug eruption was made. Paracetamol was stopped and patient advised never to take Paracetamol in future. Patient was managed with prednisolone 10mg /day, cetirizine 10 mg/day, and amoxicillin 500 mg twice a day and mometasone + fusidic acid cream to be applied over the lesions

Comparison of efficacy and safety of cilnidipine and losartan in patients of hypertension with or without diabetes from Gwalior, India

Background: Hypertension (HTN) is the most common cardiovascular disease. The objectives of present study are to investigate the comparison between cilnidipine and losartan with respect to changes in blood pressure (BP) and heart rate (HR) in hypertensive patients with or without type 2 diabetes mellitus (DM).Methods: We conducted a longitudinal, prospective, open labelled, comparative clinical study of hypertensive patients with or without type 2 DM. Of 161 enrolled hypertensives, 130 completed the study with follow up over a period of one year. Group I (n=34); and Group III (n = 32) patients with type 2 DM received cilnidipine 10-20mg orally OD. Group II (n =33); and Group IV (n = 31) patients with type 2 DM received losartan 50-100mg orally OD. The dosages were adjusted if the magnitude of reduction was insufficient. The parameters were monitored during follow – up at 4, 8 and 12 weeks.Results: Levels of systolic and diastolic BP and HR significantly decreased with both drugs. However, magnitude of HR reduction was greater with cilnidipine groups as compared to losartan groups with statistically significant difference (group I 70.79±9.21 versus group II 79.42±8.25, p = 0.000 and group III 76.25±7.08 versus group IV 81±7.15, p = 0.010). Of 161 patients, only 1 patient experienced hot flushes from group I.Conclusions: The present study demonstrated that therapy with cilnidipine can be used safely and effectively in hypertensive patients with or without diabetes. Cilnidipine was equally efficacious in lowering BP, while it more effectively reduced HR as compared to losartan. Cilnidipine can, therefore, be recommended as an alternative especially when there is associated tachycardia

Efficacy, tolerability and cost effectiveness of zotepine versus olanzapine in patients of acute schizophrenia

Background: Schizophrenia is a functional psychosis with severe personality changes and thought disorders without cerebral damage. No reports are available in literature regarding efficacy and tolerability of atypical antipsychotic drug zotepine over olanzapine a preferred drug worldwide for the treatment of schizophrenia. Therefore, present study is undertaken to evaluate efficacy, tolerability and cost effectiveness of zotepine over olanzapine in patients suffering from schizophrenia. Methods: A prospective, randomized, single blind, parallel, 6 weeks clinical study was conducted on a total of 112 patients, of schizophrenia attending psychiatry outpatient department at G. R. Medical College, Gwalior, India randomized into two groups (56 in each). Patients received either olanzapine (10-20mg) or zotepine (75-150mg) per day for a period of 6 week. Efficacy was measured by Positive and Negative Syndrome Scale (PANSS) and Clinical Global Impression (CGI) scale whereas tolerability was measured by dropout rate and frequency of adverse effects. Cost effectiveness was calculated in terms of cost incurred for improvement at the end of treatment period.Results: Both the drugs showed significant (P.0.05). Olanzapine showed significantly better (P0.05) between the two groups. Incidence of akathisia and drop out (16% and 23%) with zotepine were significant (P<0.05) as compared to olanzapine (2% and 11%) respectively.Conclusions: Though the efficacy of both the drugs is comparable, olanzapine appears to have better tolerability and cost effectiveness than zotepine in patients of schizophrenia

Third generation cephalosporin-resistance in Klebsiella pneumoniae isolates: an emerging threat

Background: Newer generation cephalosporin-resistance among Klebsiella pneumoniae organisms has increased recently. Present study is undertaken to find incidence, antimicrobial susceptibility and prevalence of extended spectrum beta-lactamase (ESBL) in K. pneumoniae isolates in a tertiary care hospital.Methods: Prospective study was carried out between June to December 2011. Samples of pus, blood, urine, cerebro-spinal fluid, stool, peritoneal, pleural and synovial fluid were collected from indoor and outdoor patients for isolation and antimicrobial susceptibility pattern of K. pneumoniae in the department of microbiology, G.R. Medical College Gwalior, M.P. Ceftazidime resistant K. pneumoniae were subjected to Phenotypic Confirmatory Disc Diffusion Test (PCDDT) and Double Disc Synergy Test (DDST) for detection of ESBL.Results: Out of 2480 samples collected a total of 530 K. pneumoniae were isolated and subjected to antimicrobial susceptibility. Antibiotic sensitivity to imipenem, cefoperazone, amikacin and ofloxacin were 82, 74, 73 and 72% respectively whereas sensitivity to ceftizoxime, ceftriaxone cefotaxime, ceftazidime ranged between 47-50%. K. pneumoniae were found to be resistant to ampicillin, co-trimoxazole, doxycycline and gentamicin, by 91, 82, 54 and 50% respectively. Among third generation cephalosporins K. pneumoniae were least sensitive (47%) to ceftazidime. About 33 and 32% of the ceftazidime resistant strains were found to be ESBL positive by PCDDT and DDST respectively.Conclusions: This study has shown that prevalence of ESBL producing K. pneumoniae is the most important reason for increased resistance to third generation cephalosporins. There is need to carry out tests for detection of ESBL producing bacteria routinely

Prevalence and epidemiological aspect of dengue fever in western Rajasthan in year 2018

Background: Dengue fever (DF) is a common mosquito borne disease caused by dengue virus and is transmitted by Aedes mosquito. It is one of the major public health problems in India which affects all levels of society, but the burden of disease is a higher in poor people who live together in communities.  Aim of present study is aimed to assess the prevalence and epidemiological characteristics of cases of DF in  Tertiary Care Hospitals in Jodhpur, Rajasthan.Methods: A cross-sectional study was conducted in all cases of DF registered in the associated group of Hospitals of Dr. S.N. Medical College, Jodhpur from 1st January 2018 to 31st December 2018. Rapid immune-chromatographic card test and MAC ELISA test method was used to detect dengue non-structural protein 1 (NS1) antigen and dengue immunoglobulin M (IgM) antibodies in the Viral Research Diagnostic Laboratory (VRDL) of Department of Microbiology, Dr. S.N. Medical College to confirm the diagnosis. Results: Out of 2701 patients, 541 patients were tested serologically positive for DF (NS1, IgM). The highest number of suspected cases (1061) was reported in the month of October, 2018 out of whom 228 were positive. Maximum number of dengue cases reported were males belonging to 31-40 years age group from urban area. Fever was the main complaint in all the cases followed by vomiting, headache, and abdominal pain.Conclusion: Dengue is one of the major public health problems in India. A large number of cases are reported in the monsoon and post-monsoon period in the months from  September to December. Measures can be taken both at personal and government level to reduce morbidity and mortality from dengue