Cardio-Oncology - A new subspecialty with collaboration at its heart

Cardio-Oncology is the care of cancer patients with cardiovascular disease, overt or occult, already established or acquired during treatment. Cancer patients can present with a variety of cardiovascular problems not all of which are directly related to cancer therapy (medications or radiotherapy). The cardiovascular problems of oncology patients can range from ischaemia to arrhythmias and can also include valve problems and heart failure. As such, within cardiology, teamwork is required with members of different cardiology subspecialties. The way forward will be to adopt a multidisciplinary approach to produce optimal individual care. Close collaboration between cardiology and oncology specialists in a Cardio-Oncology setting can make this happe

Standardization of a traditional polyherbo-mineral formulation Brahmi vati

The present study deals with standardization of an in-house standard preparation and three marketed samples of Brahmi vati, which is a traditional medicine known to be effective in mental disorders, convulsions, weak memory, high fever and hysteria. Preparation and standardization have been done by following modern scientific quality control proceduresfor raw material and the finished products. The scanning electron microscopic (SEM) analysis showed the reduction of metals and minerals (particle size range 2-5 ìm) which indicates the proper preparation of bhasmas, the important ingredient of Brahmi vati. Findings of EDX analysis of all samples of Brahmi vati suggested the absence of Gold, an importantconstituent of Brahmi vati in two marketed samples. All the samples of Brahmi vati were subjected to quantitative estimation of Bacoside A (marker compound) by HPTLC technique. Extraction of the samples was done in methanol and the chromatograms were developed in Butanol: Glacial acetic acid: water (4.5:0.5:5 v/v) and detected at 225nm. The regression analysis of calibration plots of Bacoside A exhibited linear relationship in the concentration range of 50-300 ng, while the %recovery was found to be 96.06% w/w, thus proving the accuracy and precision of the analysis. The Bacoside A content in the in-house preparation was found to be higher than that of the commercial samples. The proposed HPTLC method was found to be rapid, simple and accurate for quantitative estimation of Bacoside A in different formulations. The results of this study could be used as a model data in the standardization of Brahmi vati.Keywords: Brahmi vati( BV); Standardization; EDX; HPTLC; Bacoside-

Adoption behaviour of dairy farmers in relation to green fodder cultivation in a cooperative farming system

This study was carried out at purposively selected Gaighata and Bagdah blocks of the North-24-Parganas District, West Bengal, India. From each of the purposively selected two blocks, 25 per cent of the villagelevel- milk cooperative societies were selected randomly. Thus, 10 village-level milk cooperative societies (25%) from Gaighata Block and 20 (25.64%) from Bagdah Block were randomly selected. From each of the selected milk cooperative societies, four dairy farmers were randomly selected, out of which both Member Cooperative Society (MCS) and Non-member Cooperative Society (NMCS) were two. Thus, 60 MCS and 60 NMCS (total of 120 respondents) were selected, which constituted the sample of this study. The direct face-to-face interview method with structured schedulewas followed for data collection. The study showed that adoption of green fodder cultivation was highly correlated with all the socio-psychological variables in MCS and NMCS. It also showed that all the communication variables had significant correlation with adoption of green fodder cultivation in MCS and NMCS, excepting personal cosmopolite and personal localite in MCS. Among socio-economic variables, age had significant negative correlation with adoption of green fodder cultivation in MCS. On Path analysis, knowledge about green fodder feeding in MCS, concentrate feeding, and deworming in NMCS came out to be the key variables that directly and indirectly influenced the adoption of green fodder cultivation

Hair Growth Promotant Activity of Petroleum Ether Root Extract of Glycyrrhiza Glabra L (Fabaceae) in Female Rats

Purpose: To investigate the effect of Glycyrrhiza glabra root extract on hair growth in female Wistar rats.Methods: Female Wistar rats were used for the hair growth promotion studies. They were divided into three groups(n = 6) and their dorsal skin was completely denuded to completely remove hair. Paraffin oil (control), 2 % minoxidil solution (reference) or petroleum ether (60 – 80 0C) root extract of G. glabra (2 %), was applied to the denuded skin once daily for 30 days. During this period, they were observed visually for hair growth and thereafter skin biopsy was taken for evaluation of follicular density and cyclic phases of hair growth.Results: Animals treated with petroleum ether extract of G. glabra roots showed longer hair than those treated with either minoxidil or control. Furthermore, the time (5 – 13 days) for commencement of hair growth and to reach complete hair growth was least in extract-treated animals, followed by those treated with minoxidil (6 - 19 days). A maximum of 76 % of hair follicles were in anagenic stage (active growth phase of hair) in extract-treated animals, compared to 66 and 45 % in minoxidil-treated and control groups, respectively.Conclusion: This study indicates that the petroleum ether extract of G. glabra roots has potentials as a hair growth promoting agent for females.Keywords: Hair growth promotant, G. glabra, Minoxidi

ELICITATION OF TRIGONELLINE, A HYPOGLYCEMIC AGENT IN FENUGREEK SPROUTS BY CALCIUM AND NITRIC OXIDE PRIMING

Objective: This work was performed to evaluate the effect of priming with exogenous sources of calcium ion and nitric oxide on the antidiabeticactivity and the alkaloid contents of fenugreek sprouts along with isolation and identification of trigonelline, a bioactive alkaloid responsible for hypoglycemic property of fenugreek.Methods: The fenugreek seeds were pre-treated with calcium chloride (CC), lanthanum chloride (LC) a calcium channel blocker; ethylene glycol-bis (2-aminoethylether) -N, N, N´, N tetra acetic acid (EG) a calcium chelator; sodium nitroprusside (SNP) and 2-(4-carboxyphenyl) -4,4,5,5-tetramethylimidazoline-1-oxyl-3-oxide (CP) a nitric oxide scavenger and germinated for 72 hrs. The sprout extracts were evaluated for their in vitro antidiabetic potential by α-amylase and α-glucosidase inhibition along with their trigonelline content. Trigonelline was isolated from fenugreek sprouts and identified by Infrared analysis and nuclear magnetic resonance (NMR) spectroscopy.Results: The results revealed that sprouts pre-treated with CC and SNP exhibited enhanced antidiabetic potential as well as alkaloid content overcontrol; on the other hand, their action was reversed by their antagonists, EG, LC, and CP. The sprouts pre-treated with 2mM CC showed the best elicitation of alkaloid content and antidiabetic activity followed by SNP-20 mM.Conclusions: The study suggests probable involvement of the signaling molecules, calcium ion, and nitric oxide in pathways associated withbiosynthesis of bioactive compounds responsible for hypoglycemic activity of fenugreek sprouts one of which being trigonelline. Â

Entrectinib-related myocarditis in a young female patient with metastatic non-small cell lung cancer

A 51-year-old woman presented with a 2-week history of off balance, left lower limb weakness and neglect and neck pain radiating down the right arm. Investigations revealed a metastatic, ROS1 fusion-positive, non-small cell lung cancer, and treatment with entrectinib, a recently approved multikinase inhibitor, was started. Two weeks after, she was admitted to the emergency department with new-onset pressure-like chest pain and dyspnoea. Laboratory evaluation showed elevated troponin and mild left ventricular systolic dysfunction with reduced global longitudinal strain on transthoracic echocardiogram. Cardiac magnetic resonance revealed mild oedema and non-ischaemic fibrosis. A diagnosis of drug-induced myocarditis was made. Cardioprotective medication with an angiotensin-converting enzyme inhibitor and a beta-blocker was started. Entrectinib was temporarily discontinued and restarted at a reduced dose after a multidisciplinary team meeting involving both the oncology and cardio-oncology teams. This is the second described case of entrectinib-induced myocarditis and the first one without eosinophilia

Knockdown of MBP-1 in Human Foreskin Fibroblasts Induces p53-p21 Dependent Senescence

MBP-1 acts as a general transcriptional repressor. Overexpression of MBP-1 induces cell death in a number of cancer cells and regresses tumor growth. However, the function of endogenous MBP-1 in normal cell growth regulation remains unknown. To unravel the role of endogenous MBP-1, we knocked down MBP-1 expression in primary human foreskin fibroblasts (HFF) by RNA interference. Knockdown of MBP-1 in HFF (HFF-MBPsi-4) resulted in an induction of premature senescence, displayed flattened cell morphology, and increased senescence-associated beta-galactosidase activity. FACS analysis of HFF-MBPsi-4 revealed accumulation of a high number of cells in the G1-phase. A significant upregulation of cyclin D1 and reduction of cyclin A was detected in HFF-MBPsi-4 as compared to control HFF. Senescent fibroblasts exhibited enhanced expression of phosphorylated and acetylated p53, and cyclin-dependent kinase inhibitor, p21. Further analysis suggested that promyolocytic leukemia protein (PML) bodies are dramatically increased in HFF-MBPsi-4. Together, these results demonstrated that knockdown of endogenous MBP-1 is involved in cellular senescence of HFF through p53-p21 pathway

Birthweight, childhood growth and left ventricular structure at age 60-64 years in a British birth cohort study

Background: High left ventricular mass (LVM) is an independent predictor of cardiovascular disease and mortality, but information relating LVM in older age to growth in early life is limited. We assessed the relationship of birthweight, height and body mass index (BMI) and overweight across childhood and adolescence with later life left ventricular (LV) structure. Methods: We used data from the MRC National Survey of Health and Development (NSHD) on men and women born in 1946 in Britain and followed up ever since. We use regression models to relate prospective measures of birthweight and height and BMI from ages 2–20 years to LV structure at 60–64 years. Results: Positive associations of birthweight with LVM and LV end diastolic volume (LVEDV) at 60–64 years were largely explained by adult height. Higher BMI, greater changes in BMI and greater accumulation of overweight across childhood and adolescence were associated with higher LVM and LVEDV and odds of concentric hypertrophy. Those who were overweight at two ages in early life had a mean LVM 11.5 g (95% confidence interval: -2.19,24.87) greater, and a mean LVEDV 10.0 ml (3.7,16.2) greater, than those who were not overweight. Associations were at least partially mediated through adult body mass index. Body size was less consistently associated with relative wall thickness (RWT), with the strongest association being observed with pubertal BMI change [0.007 (0.001,0.013) per standard deviation change in BMI 7–15 years]. The relationships between taller childhood height and LVM and LVEDV were explained by adult height. Conclusions: Given the increasing levels of overweight in contemporary cohorts of children, these findings further emphasize the need for effective interventions to prevent childhood overweight

Cardio-oncology for the general physician: 'old' and 'new' cardiovascular toxicities and how to manage them

Cardio-oncology is the care of cancer patients with cardiovascular disease. The need for a dedicated subspecialty emerged to address heart failure caused by drugs such as anthracyclines and anti-human epidermal growth factor receptor 2 (HER2) therapies, but over time has expanded into an exciting subspecialty with widening horizons. While still dealing with a lot of commonly recognised toxicities, such as heart failure, hypertension and coronary disease, new and revolutionary cancer therapies have been associated with challenging cardiovascular complications, requiring specialist input to manage effectively. Echocardiography is a key investigation, with advanced techniques such as three-dimensional and strain assessment allowing more accurate diagnosis and earlier detection of subtle changes. Cardiac magnetic resonance and biomarkers are useful adjuncts to aid diagnosis and management. With increasing cancer incidence and improved cancer survival rates, it is important that general cardiologists and physicians are aware of cardiac complications associated with cancer and how to manage them