MAJOR BIOACTIVE TRITERPENOIDS FROM GANODERMA SPECIES AND THEIR THERAPEUTIC ACTIVITY: A REVIEW

Ganoderma a traditional Chinese medicine popularly used for complementary cancer therapy and longevity for centuries. The vast amount of study has been performed on the medicinal properties of Ganoderma lucidum. G. lucidum contains various compounds with a high grade of biological activity, which increase the immunity. Several of these substances belong to the triterpenoids and polysaccharides. Proteins, sterols, phenols, lipids, etc., are also present. Ganoderma triterpenes are important secondary metabolites of G. lucidum. Ganoderma triterpenes are limestone-tetracyclic terpenes which have been reported to possess antioxidant, antitumor, anti-human immunodeficiency virus, anticancer, anti-inflammation, cytotoxic, hepatoprotective, and neuroprotective activities. This review deals with most important triterpenes isolated from Ganoderma and their therapeutic effects

ETHNOMYCOLOGICAL KNOWLEDGE OF SOME WILD MUSHROOMS OF NORTHERN DISTRICTS OF JAMMU AND KASHMIR, INDIA

  Objective: Mushrooms are known for their nutritional and medicinal importance from ancient times throughout the world. The use of mushrooms as valuable tonic, food, and ethnomedicines has also been reported from India. However, information on the ethnomedicinal use of mushrooms is not available from the surveyed area of Kashmir valley. Therefore, the objective of this work is to study the ethnomedicinal use of wild mushrooms from the Northern districts of Jammu and Kashmir.Materials and Methods: Different remote areas of Northern districts, Baramulla and Kupwara of Kashmir Valley were surveyed to document the indigenous use of various mushrooms growing in the area by local tribal people and local herbalists. Mushroom hunters, local Hakims, herbalists and aged people from tribal communities and nomads were consulted, interviewed and taken as guides to collect various mushroom species.Results: The mushroom samples collected from the study area were used as a source of food and medicines for different ailments. The specimens collected were photographed by Sony cyber shot 12.1 megapixel camera in their natural habitats and were identified on the basis of macro and microscopic characters, expert mushroom taxonomists, field guides and standard related literature. The study revealed that 33 mushroom species belonging to Ascomycetes and Basidiomycetes were used for their nutritional and medicinal values. These mushrooms were used by the local hakims against various ailments ranging from respiratory, blood and heart ailments, arthritis, nervous and urogenital diseases either alone or in combination with some herbs.Conclusions: It was concluded from this study that all the mushrooms used by the local tribal people and local herbalists for different ailments can be further evaluated for medicinal value and for bioactive constituents

MAJOR BIOACTIVE PROPERTIES OF GANODERMA POLYSACCHARIDES: A REVIEW

Ganoderma a white rot fungus has been used as a folk remedy for promoting health and longevity for centuries. The vast amount of study has been performed on the medicinal properties of Ganoderma in general and Ganoderma lucidum in particular. The bioactivities of the metabolites reported from G. lucidum are immense. The main bioactive metabolites of G. lucidum consist of mainly polysaccharides and triterpenoids. The major bioactive polysaccharides isolated from Ganoderma species are β (1→3), β (1→4), and β (1→6)-D glucans. With respect to the pure chemical and structural points of view, G. lucidum polysaccharides are mostly composed of β-glucans, heteropolysaccharides, and glycoptoteins. The major component of this sugar molecule is glucose together with xylose, mannose, galactose, and fructose in different conformations. Many of these bioactive polysaccharides have shown activities against the major diseases of our time and the list of effects shown is huge. Various important bioactivities, namely, antitumor, antioxidant, cytotoxic, immunomodulatory, antibacterial, anti-inflammation, neuroprotective, hepatoprotective, anti-HIV, and so on have been shown by these bioactive polysaccharides. The main purpose of this review is to report the most bioactive polysaccharides from G. lucidum and other species of Ganoderma and to report their potential health benefits

Allelopathic effect of leaf extracts of Punica granatum and Spiraea prunifolia against post-harvest rot of tomato and brinjal

Antimycotic activities of different solvent extracts of Punica granatum L. and Spiraea prunifolia Siebold and Zucc. were carried out through agar well diffusion assay at three concentrations (25µl, 50µl and 75µl) against seven fungi causing rot diseases of tomato and brinjal. All the concentration of plant extracts showed antifungal activity against tested pathogenic fungi. Antimycotic activity increased with the increased concentrations of plant extracts. However, higher concentrations proved more effective than lower concentrations. It was revealed from the present study that the ethanolic extract of Punica granatum L. showed maximum antifungal activity against Rhizoctonia solani and Penicillium expansum and least inhibitory activity against Aspergillus niger. However, the aqueous extract of Punica granatum L. showed maximum antimycotic activity against Rhizoctonia solani and Alternaria alternata and least inhibitory effect against Penicillium expansum. It was further observed from the present study that the ethanolic extract of Spiraea prunifolia Siebold and Zucc. showed maximum antimycotic activity against Rhizoctonia solani and least inhibitory effect against Alternaria alternata. Whereas the aqueous extract of Spiraea prunifolia Siebold and Zucc showed maximum antifungal activity against Aspergillus niger and least inhibitory activity against Alternaria alternata. Keywords: Plant extracts, Concentration, Antimycotic effectiveness, tomato and brinjal, fungal rot pathogens, Inhibition zone

Surgical Outcome of Renal Cell Carcinoma with Tumor Thrombus Extension into Inferior Vena Cava and Right Atrium (Beating Heart Removal of Level 4 Thrombus): A Challenging Scenario

Aim: “To evaluate oncological and surgical outcomes of different levels of tumor thrombus and tumor characteristics secondary to renal cell carcinoma (RCC)”. Materials and Methods: Retrospective review from 2013 to 2020 of 34 patients who underwent radical nephrectomy with thrombectomy for RCC with tumor thrombus extending into the inferior vena cava (IVC) and right atrium (RA) at our center. Level I and most level II tumors were removed using straight forward occluding maneuvers with control of the contralateral renal vein. None of the patients had level III tumor extensions in our study group. For level IV thrombus, a beating heart surgery using a simplified cardiopulmonary bypass (CPB) technique was used for retrieval of thrombus from the right atrium. Results: “Of the 34 patients with thrombus”, 19 patients had level I, 12 patients had level II, none had level III, and three patients had level IV thrombus. Two patients required simplified CPB. Another patient with level IV thrombus CPB, was not attempted in view of refractory hypotension intraoperatively. Pathological evaluation showed clear-cell carcinoma in 67.64%, papillary carcinoma in 17.64%, chromophobe in 5.8%, and squamous cell carcinoma in 8.8% of cases. Left side thrombectomy was difficult surgically, whereas right side thrombectomy did not have any survival advantage. Mean blood loss during the procedure was 325 mL, ranging from 200 to 1000 mL, and mean operative time was 185 min, ranging from 215 to 345 min. The immediate postoperative mortality was 2.9%. Level I thrombus had better survival compared to level II thrombus. Conclusion: Radical nephrectomy with tumor thrombectomy remains the mainstay of treatment in RCC with inferior venacaval extension. The surgical approach and outcome depends on primary tumor size, location, level of thrombus, local invasion of IVC, any hepato-renal dysfunction or any associated comorbidities. The higher the level of thrombus, the greater is the need for prior optimization and the adoption of a multidisciplinary approach for a successful surgical outcome

Evaluation of antifungal activity of Magnesium oxide (MgO) and Iron oxide (FeO) nanoparticles on rot causing fungi

The antifungal activity of Magnesium oxide (MgO) and iron oxide (FeO) nanoparticles prepared by bio safe method was evaluated for Penicillium expansum, Aspergillus niger, Alternaria alternata, Mucor plumbeus, Penicillium chrysogenum, Trichothecium roseum and Rhizoctonia solani. It was observed from the study that all the concentrations of nanoparticles brought about significant inhibition in the spore germination and mycelial growth of all the rot causing fungi. However, the highest inhibition in the germination of all the test fungi was observed at higher concentrations followed by lower concentrations of nanoparticles. It was observed from the present study that MgO and FeO nanoparticles showed significant antimycotic activity against all the tested fungal pathogens. However, highest reduction in spore germination was observed against Mucor plumbeus whereas least reduction of spore germination was observed against Aspergillus niger at different concentration of nanoparticles of MgO respectively. Likewise, the maximum inhibition in the fungal growth was observed against Alternaria alternate and least inhibition in zone of fungal growth due to MgO nanoparticle was found against Mucor plumbeus respectively. Similarly, highest inhibition in spore germination was found against Penicillium expansum and least inhibition in spore germination was found against Aspergillus niger at different concentrations of nano FeO. Likewise, the maximum inhibition in the fungal growth was found against Rhizoctonia solani and Trichothecium roseum and least inhibition in zone of fungal growth was found against Penicillium expansum and Mucor plumbeus at 0.1mg/ml, 0.25mg/ml and 0.5 mg/ml concentrations of FeO nanoparticles respectively. Activity index was recorded highest against P. chrysogenum (0.97) in case of MgO and against T. roseum (0.97) in case of FeO nanoparticles respectively. Keywords: Spore germination, mycelial growth, rot causing fungi, tomato, brinjal, MgO and FeO nanoparticl

Real time endobronchial ultrasound guided transbronchial needle aspiration of intrathoracic lymphadenopathy: an initial experience

Background: Conventional TBNA has been used in the evaluation of intrathoracic lymphadenopathy with varied success rates depending upon size, site and aetiology of the node. Although mediastinoscopy has higher successes but it comes at the cost of general anaesthesia, more complications and limited access to the inferior and posterior mediastinum. Endobronchial ultrasound guided transbronchial needle aspiration has the advantage of real time nodal sampling with good success rates and minimal complications. The aim of our study was to assess the diagnostic yield and safety of EBUS TBNA in the evaluation of intrathoracic lymphadenopathy.Methods: This prospective observational study was conducted at government chest diseases hospital Srinagar over a period of two years from January 2016-December 2018 on 100 consecutive patients who underwent EBUS TBNA procedure for evaluation mediastinal and hilar lymphadenopathy. The data was collected and analysed for diagnostic yield and safety profile.Results: Out of the 100 subjects included in the study 52% were males and 48% were females. Mean age of the study population was 48.5±16.65 years. Most of the nodes sampled were subcarinal in location followed by paratracheal and hilar group. Granulomatous pathology (tuberculosis and sarcoidosis) was present in 41 patients followed by malignancy in 39 patients. Anthracosis was the cause of lymphadenopathy in 4 of the patients. There were no major complications in our study.Conclusions: EBUS TBNA is an effective and safe procedure for evaluation of mediastinal and hilar lymphadenopathy

Global Retinoblastoma Presentation and Analysis by National Income Level.

Importance: Early diagnosis of retinoblastoma, the most common intraocular cancer, can save both a child's life and vision. However, anecdotal evidence suggests that many children across the world are diagnosed late. To our knowledge, the clinical presentation of retinoblastoma has never been assessed on a global scale. Objectives: To report the retinoblastoma stage at diagnosis in patients across the world during a single year, to investigate associations between clinical variables and national income level, and to investigate risk factors for advanced disease at diagnosis. Design, Setting, and Participants: A total of 278 retinoblastoma treatment centers were recruited from June 2017 through December 2018 to participate in a cross-sectional analysis of treatment-naive patients with retinoblastoma who were diagnosed in 2017. Main Outcomes and Measures: Age at presentation, proportion of familial history of retinoblastoma, and tumor stage and metastasis. Results: The cohort included 4351 new patients from 153 countries; the median age at diagnosis was 30.5 (interquartile range, 18.3-45.9) months, and 1976 patients (45.4%) were female. Most patients (n = 3685 [84.7%]) were from low- and middle-income countries (LMICs). Globally, the most common indication for referral was leukocoria (n = 2638 [62.8%]), followed by strabismus (n = 429 [10.2%]) and proptosis (n = 309 [7.4%]). Patients from high-income countries (HICs) were diagnosed at a median age of 14.1 months, with 656 of 666 (98.5%) patients having intraocular retinoblastoma and 2 (0.3%) having metastasis. Patients from low-income countries were diagnosed at a median age of 30.5 months, with 256 of 521 (49.1%) having extraocular retinoblastoma and 94 of 498 (18.9%) having metastasis. Lower national income level was associated with older presentation age, higher proportion of locally advanced disease and distant metastasis, and smaller proportion of familial history of retinoblastoma. Advanced disease at diagnosis was more common in LMICs even after adjusting for age (odds ratio for low-income countries vs upper-middle-income countries and HICs, 17.92 [95% CI, 12.94-24.80], and for lower-middle-income countries vs upper-middle-income countries and HICs, 5.74 [95% CI, 4.30-7.68]). Conclusions and Relevance: This study is estimated to have included more than half of all new retinoblastoma cases worldwide in 2017. Children from LMICs, where the main global retinoblastoma burden lies, presented at an older age with more advanced disease and demonstrated a smaller proportion of familial history of retinoblastoma, likely because many do not reach a childbearing age. Given that retinoblastoma is curable, these data are concerning and mandate intervention at national and international levels. Further studies are needed to investigate factors, other than age at presentation, that may be associated with advanced disease in LMICs

Global burden of 369 diseases and injuries in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019

Background: In an era of shifting global agendas and expanded emphasis on non-communicable diseases and injuries along with communicable diseases, sound evidence on trends by cause at the national level is essential. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) provides a systematic scientific assessment of published, publicly available, and contributed data on incidence, prevalence, and mortality for a mutually exclusive and collectively exhaustive list of diseases and injuries. Methods: GBD estimates incidence, prevalence, mortality, years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life-years (DALYs) due to 369 diseases and injuries, for two sexes, and for 204 countries and territories. Input data were extracted from censuses, household surveys, civil registration and vital statistics, disease registries, health service use, air pollution monitors, satellite imaging, disease notifications, and other sources. Cause-specific death rates and cause fractions were calculated using the Cause of Death Ensemble model and spatiotemporal Gaussian process regression. Cause-specific deaths were adjusted to match the total all-cause deaths calculated as part of the GBD population, fertility, and mortality estimates. Deaths were multiplied by standard life expectancy at each age to calculate YLLs. A Bayesian meta-regression modelling tool, DisMod-MR 2.1, was used to ensure consistency between incidence, prevalence, remission, excess mortality, and cause-specific mortality for most causes. Prevalence estimates were multiplied by disability weights for mutually exclusive sequelae of diseases and injuries to calculate YLDs. We considered results in the context of the Socio-demographic Index (SDI), a composite indicator of income per capita, years of schooling, and fertility rate in females younger than 25 years. Uncertainty intervals (UIs) were generated for every metric using the 25th and 975th ordered 1000 draw values of the posterior distribution. Findings: Global health has steadily improved over the past 30 years as measured by age-standardised DALY rates. After taking into account population growth and ageing, the absolute number of DALYs has remained stable. Since 2010, the pace of decline in global age-standardised DALY rates has accelerated in age groups younger than 50 years compared with the 1990–2010 time period, with the greatest annualised rate of decline occurring in the 0–9-year age group. Six infectious diseases were among the top ten causes of DALYs in children younger than 10 years in 2019: lower respiratory infections (ranked second), diarrhoeal diseases (third), malaria (fifth), meningitis (sixth), whooping cough (ninth), and sexually transmitted infections (which, in this age group, is fully accounted for by congenital syphilis; ranked tenth). In adolescents aged 10–24 years, three injury causes were among the top causes of DALYs: road injuries (ranked first), self-harm (third), and interpersonal violence (fifth). Five of the causes that were in the top ten for ages 10–24 years were also in the top ten in the 25–49-year age group: road injuries (ranked first), HIV/AIDS (second), low back pain (fourth), headache disorders (fifth), and depressive disorders (sixth). In 2019, ischaemic heart disease and stroke were the top-ranked causes of DALYs in both the 50–74-year and 75-years-and-older age groups. Since 1990, there has been a marked shift towards a greater proportion of burden due to YLDs from non-communicable diseases and injuries. In 2019, there were 11 countries where non-communicable disease and injury YLDs constituted more than half of all disease burden. Decreases in age-standardised DALY rates have accelerated over the past decade in countries at the lower end of the SDI range, while improvements have started to stagnate or even reverse in countries with higher SDI. Interpretation: As disability becomes an increasingly large component of disease burden and a larger component of health expenditure, greater research and developm nt investment is needed to identify new, more effective intervention strategies. With a rapidly ageing global population, the demands on health services to deal with disabling outcomes, which increase with age, will require policy makers to anticipate these changes. The mix of universal and more geographically specific influences on health reinforces the need for regular reporting on population health in detail and by underlying cause to help decision makers to identify success stories of disease control to emulate, as well as opportunities to improve. Funding: Bill & Melinda Gates Foundation. © 2020 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 licens