A Prospective, Randomized, Open Label, Comparative Study of Cholecalciferol as an Add on Therapy to Standard Treatment in Adult Patients with Bronchial Asthma

BACKGROUND: Bronchial asthma one of the most common chronic diseases globally is a chronic inflammatory disease of the airways. Chronic inflammation leads to airway remodeling resulting in irreversible airway obstruction. Treatment of bronchial asthma includes bronchodilators – beta-2 agonists, anticholinergics, methylxanthines; leukotriene antagonists and corticosteroids. Cholecalciferol (Vitamin D) has been found to play key beneficial role in asthma. Cholecalciferol reduces airway inflammation by increasing the levels of anti-inflammatory cytokines. Vitamin D also reduces airway hyper responsiveness and improves the response to inhaled and oral corticosteroids. Hence, the present study was planned to evaluate the efficacy of Cholecalciferol as an add on therapy in patients with bronchial asthma. OBJECTIVES: To evaluate the efficacy and tolerability of Cholecalciferol as an add on therapy to standard treatment in modifying disease severity in adult patients with bronchial asthma. METHODS: A prospective, randomized, open labelled, comparative study was conducted in asthmatic patients of mild to moderate severity attending Thoracic Medicine OPD of Rajiv Gandhi Government General Hospital. After screening, the study subjects (n=60) were allocated into 2 groups by simple randomization. Control group (n=30) patients received Formoterol (6 mcg) and Budesonide (200 mcg) metered dose inhale r(MDI) bid and study group (n=30) patients received Formoterol (6 mcg) and Budesonide (200 mcg) metered dose inhaler (MDI) bid with Tablet cholecalciferol 1000IU/D for 12 weeks and followed-up after 4 weeks. RESULTS: The primary outcome of the study was to measure the change in Forced Expiratory Volume in one second (FEV1), Forced Vital Capacity (FVC) & Peak Expiratory Flow Rate (PEFR). Improvement in FEV1, FVC & PEFR values in study group was significant at the end of 12 weeks (p < 0.05). In addition, the frequency of exacerbations in study group was less compared to control group. No serious adverse events were reported in both groups. CONCLUSION: We conclude that Cholecalciferol supplementation improves the long-term control over bronchial asthma and is well tolerated

Ayurvedic management of pituitary macroadenoma-a case report

Pituitary macroadenoma is an infrequently encountered clinical condition, characterized by a non-metastasizing neoplasm situated within the pituitary gland. This case report endeavours to elucidate the efficacy of ayurvedic interventions in achieving symptomatic resolution. A 44-year-old female patient, residing in Thrissur, diagnosed with features suggestive of pituitary macroadenoma, sought admission to Vaidyaratnam ayurveda college hospital for complaints of generalized pain, heaviness of head, impaired peripheral vision in the left eye, and amenorrhea persisting for approximately 7 months. The case was conclusively diagnosed as Pituitary Macroadenoma and meticulously addressed through therapeutic modalities including takradhara, nasyam, and thalapothichil.  patient was already prescribed with Caberlin tablets at a dosage of 0.25 mg twice weekly, administered nocturnally. Following 21 days of treatment, notable improvement in the LBNQ-Pituitary score was observed from 60 to 21 accompanied by significant symptomatic alleviation. A specific treatment protocol for the management of pituitary macroadenoma is currently unavailable

Mental health and sleep: in COVID positive health care workers in India

Background: Starting from Wuhan as a local transmission, COVID-19 turned out to be a pandemic affecting the entire global population either as a patient or at least being exposed to the novel corona virus. The present study has been done to see how much working to treat Covid patients has put stress, anxiety, depression and sleep disturbance on health care professional after becoming covid positive themselves, essentially their own life at risk. Methods: This was a prospective observational cross-sectional study done in Sri Manakula Vinayagar Medical College and Hospital, Puducherry, with ethics approval. Sample size was 145 health care workers who had covid infection. The study comprised of questions from Dass 21 questionnaire and Likert sleep scale. Results: Mild levels of stress was seen in 16 members (11.03%), moderate stress was seen in 3 members (2.06%). The chi square value was calculated as significant p value of 0.045. Mild anxiety was seen among 13 (8.96%), moderate anxiety seen in 23 (15.86%), severe anxiety was seen in 2 (1.37%), Extremely severe anxiety was seen in 1 individual (0.68%). Mild depression was seen in 12 (8.27%), moderate depression was seen in 14 (9.65%). The quality of sleep was rated on a 10-point scale, 5.5% had reported poor sleep, 53.8% reported moderate sleep disturbance. Conclusions: This study reveals that mental health issues are possible for medical professionals too and that anxiety needs to be addressed in health professionals too. More so when isolated from their families and friends

Inorganic nitrogen availability alters Eucalyptus grandis receptivity to the ectomycorrhizal fungus Pisolithus albus but not symbiotic nitrogen transfer.

Forest trees are able to thrive in nutrient-poor soils in part because they obtain growth-limiting nutrients, especially nitrogen (N), through mutualistic symbiosis with ectomycorrhizal (ECM) fungi. Addition of inorganic N into these soils is known to disrupt this mutualism and reduce the diversity of ECM fungi. Despite its ecological impact, the mechanisms governing the observed effects of elevated inorganic N on mycorrhizal communities remain unknown. We address this by using a compartmentalized in vitro system to independently alter nutrients to each symbiont. Using stable isotopes, we traced the nutrient flux under different nutrient regimes between Eucalyptus grandis and its ectomycorrhizal symbiont, Pisolithus albus. We demonstrate that giving E.&nbsp;grandis independent access to N causes a significant reduction in root colonization by P.&nbsp;albus. Transcriptional analysis suggests that the observed reduction in colonization may be caused, in part, by altered transcription of microbe perception genes and defence genes. We show that delivery of N to host leaves is not increased by host nutrient deficiency but by fungal nutrient availability instead. Overall, this advances our understanding of the effects of N fertilization on ECM fungi and the factors governing nutrient transfer in the E.&nbsp;grandis-P.&nbsp;microcarpus interaction

Production of Diamino propionic acid ammonia lyase by a new strain of Salmonella typhimurium PU011

BACKGROUND: Seeds of the legume plant Lathyrus sativus, which is grown in arid and semi arid tropical regions, contain Diamino Propionic acid (DAP). DAP is a neurotoxin, which, when consumed, causes a disease called Lathyrism. Lathryrism may manifest as Neurolathyrism or Osteolathyrism, in which the nervous system, and bone formation respectively, are affected. DAP ammonia lyase is produced by a few microorganisms such as Salmonella typhi, Salmonella typhimurium and Pseudomonas, and is capable of detoxifying DAP. RESULTS: S. typhimurium PU011, a non-virulent bacterial strain isolated in our lab, was found to produce DAP ammonia lyase enzyme when grown in minimal medium containing DAP. There was a direct correlation between biomass yield and enzyme activity, until 16 h post inoculation in minimal medium containing DAP. Following ammonium sulphate precipitation and passing through Sephadex G100, CM-Sephadex and DEAE-Sephacel for crude enzyme extract preparation, about 68-fold enzyme purity was obtained. The purified enzyme gave maximum activity at pH 8.0 and was stable up to 45 degrees C. The Km value for the substrate was found to be 0.685mM, calculated from a Line Weaver Burk plot. CONCLUSION: A new bacterial strain, S.typhimurium PU 011, which is capable of producing DAP ammonia lyase, was isolated

Resveratrol, cancer and cancer stem cells: A review on past to future

Cancer remains to be an unresolved medical challenge despite of tremendous advancement in basic science research and clinical medicine. One of the major limitations is due to the side effects of chemotherapy which remains to be palliative without offering any permanent cure for cancer. Cancer stem cells (CSCs) are the subpopulation of cells in tumors that remain viable even after surgery, chemo- and radio-therapy that eventually responsible for tumor relapse. Hence, by eliminating non-stem cancer cells and cancer stem cells from the patient, permanent cure is expected. Phytochemicals have been under the intensive study to target these CSCs effectively and permanently as they do not cause any side effects. Resveratrol (RSV) is one such compound attaining lot of interest in recent days to target CSCs either alone or in combination. RSV has been used by several researchers to target cancer cells in a variety of disease models, however its CSC targeting abilities are under intensive study at present. This review is to summarize the effects of RSV under in vitro and in vivo conditions along with advantages and disadvantages of its uses against cancer cells and cancer stem cells. From the first reports on phytochemical applications against cancer and cancer stem cells in 1997 and 2002 respectively followed by later reports, up to date observations and developments are enlisted from PubMed in this comprehensive review. RSV is shown to be a potential compound having impact on altering the signal transduction pathways in cancer cells. However, the effects are variable under in vitro and in vivo conditions, and also with its use alone or in combination with other small molecules. Past research on RSV is emphasizing the importance of in vivo experimental models and clinical trials with different prospective combinations, is a hope for future promising treatment regimen