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Bedaquiline: First FDA-approved tuberculosis drug in 40 years
Rajiv Mahajan
January-June 2013, 3(1):1-2
DOI:10.4103/2229-516X.112228  PMID:23776831
  92 5,411 949
A review of drug isomerism and its significance
Naveen Chhabra, Madan L Aseri, Deepak Padmanabhan
January-June 2013, 3(1):16-18
DOI:10.4103/2229-516X.112233  PMID:23776834
Isomerism finds its importance in the field of clinical pharmacology and pharmacotherapeutics, as isomers differ in their pharmacokinetic and pharmacodyanmic properties. Drug isomerism has opened a new era of drug development. Currently, knowledge of isomerism has helped us in introducing safer and more effective drug alternatives of the newer as well as existing drugs. Many existing drugs have gone chiral switch i.e., switching from racemic mixture to one of its isomers. Cetrizine to levocetrizine is one of such examples, where effective and safer drug has been made available. In this article, we have attempted to review the basic concepts of stereochemistry and chirality and their significance in pharmacotherapeutics. Various pharmacological aspects such as pharmacokinetic and pharmacodynamic variations resulting out of chirality has been discussed in detail in this article.
  54 11,789 1,489
A comparative study of visual and auditory reaction times on the basis of gender and physical activity levels of medical first year students
Aditya Jain, Ramta Bansal, Avnish Kumar, KD Singh
May-August 2015, 5(2):124-127
DOI:10.4103/2229-516X.157168  PMID:26097821
Background: Reaction time (RT) is a measure of the response to a stimulus. RT plays a very important role in our lives as its practical implications may be of great consequences. Factors that can affect the average human RT include age, sex, left or right hand, central versus peripheral vision, practice, fatigue, fasting, breathing cycle, personality types, exercise, and intelligence of the subject. Aim: The aim was to compare visual RTs (VRTs) and auditory RTs (ARTs) on the basis of gender and physical activity levels of medical 1 st year students. Materials and Methods: The present cross-sectional study was conducted on 120 healthy medical students in age group of 18-20 years. RT for target stimulus that is, for the beep tone for measuring ART, and red circle for measuring VRT was determined using Inquisit 4.0 (Computer Software) in the laptop. The task was to press the spacebar as soon as the stimulus is presented. Five readings of each stimulus were taken, and their respective fastest RT's for each stimuli were recorded. Statistical analysis was done. Results: In both the sexes' RT to the auditory stimulus was significantly less (P < 0.001) as compared to the visual stimulus. Significant difference was found between RT of male and female medical students (P < 0.001) as well as between sedentary and regularly exercising healthy medical 1 st year students. Conclusion: The ART is faster than the VRT in medical students. Furthermore, male medical students have faster RTs as compared to female medical students for both auditory as well as visual stimuli. Regularly exercising medical students have faster RTs when compared with medical students with sedentary lifestyles.
  42 9,645 1,236
Real world data: Additional source for making clinical decisions
Rajiv Mahajan
May-August 2015, 5(2):82-82
DOI:10.4103/2229-516X.157148  PMID:26097811
  31 2,303 522
An increase of granulosa cell apoptosis mediates aqueous neem (Azadirachta indica) leaf extract-induced oocyte apoptosis in rat
Anima Tripathi, Tulsidas G Shrivastav, Shail K Chaube
January-June 2013, 3(1):27-36
DOI:10.4103/2229-516X.112238  PMID:23776837
Objective: Neem plant (Azadirachta indica) has been extensively used in Ayurvedic system of medicine for female fertility regulation for a long time, but its mechanism of action remains poorly understood. Hence, the present study was aimed to determine whether an increase of granulosa cell apoptosis is associated with aqueous neem leaf extract (NLE)-induced oocyte apoptosis. Materials and Methods: Sexually immature female rats of 20 days old were fed NLE (50 mg/day) for 10 days and then subjected to superovulation induction protocol. The morphological changes in cumulus oocyte complexes (COCs), rate of oocyte apoptosis, hydrogen peroxide (H 2 O 2 ), total nitrite, and cytochrome c concentrations, inducible nitric oxide synthase (iNOS), cytochrome c, p53, Bcl2 and Bax expressions, deoxyribonucleic acid (DNA) fragmentation, and estradiol 17β level in granulosa cells collected from preovulatory COCs were analyzed. Results: Aqueous NLE increased H 2 O 2 concentration and decreased catalase activity, increased iNOS expression and total nitrite concentration, increased p53, Bax, and p53 expressions but decreased Bcl2 expression, increased cytochrome c concentration and induced DNA fragmentation in granulosa cells. An increased granulosa cell apoptosis resulted in reduced estradiol 17β concentration and induced apoptosis in ovulated oocytes. Conclusion: We conclude that aqueous NLE-induced granulosa cell apoptosis through the mitochondria-mediated pathway, reduced estradiol 17β concentration and induced apoptosis in ovulated oocytes. Thus, granulosa cell apoptosis mediates NLE-induced oocyte apoptosis during female fertility regulation in rat.
  31 4,515 513
Human papillomavirus-associated cancers: A growing global problem
Anshuma Bansal, Mini P Singh, Bhavana Rai
April-June 2016, 6(2):84-89
DOI:10.4103/2229-516X.179027  PMID:27127735
Human papillomavirus (HPV) infection is linked with several cancers such as cancer cervix, vagina, vulva, head and neck, anal, and penile carcinomas. Although there is a proven association of HPV with these cancers, questions regarding HPV testing, vaccination, and treatment of HPV-related cancers continue to remain unanswered. The present article provides an overview of the HPV-associated cancers.
  29 4,153 902
Bioenhancers from mother nature and their applicability in modern medicine
Gurpreet Kaur Randhawa, Jagdev Singh Kullar, Rajkumar
January-June 2011, 1(1):5-10
DOI:10.4103/2229-516X.81972  PMID:23776764
Concept of bioenhancers or biopotentiators was first time reported in 1929 by Bose. A bioenhancer is an agent capable of enhancing bioavailability and efficacy of a drug with which it is co-administered, without any pharmacological activity of its own at therapeutic dose used. Development and consequent isolation of these molecules, such as piperine and quercetin, is considered as scientific breakthrough. A fixed drug combination (Risorine) of rifampicin, isoniazid, and piperine is the result of this research. It contains almost 60% less dose of rifampicin because of its increased bioavailability and it also prevents resistance. This concept is mentioned as yogvahi in ayurveda and was used to increase the effect of medicines by increasing oral bioavailability, decreasing adverse effects and to circumvent parenteral routes of drug administration. More such useful and economically viable drug combinations can be developed by integrating knowledge of time tested ayurveda with modern methods of research. This review is an account of these bioenhancers, available from the natural resources.
  25 11,839 1,637
Carbapenemase-producing Enterobacteriaceae: Risk factors for infection and impact of resistance on outcomes
Shanthi Mariappan, Uma Sekar, Arunagiri Kamalanathan
January-March 2017, 7(1):32-39
DOI:10.4103/2229-516X.198520  PMID:28251105
Background: Carbapenemase-producing Enterobacteriaceae (CPE) have increased in recent years leading to limitations of treatment options. The present study was undertaken to detect CPE, risk factors for acquiring them and their impact on clinical outcomes. Methods: This retrospective observational study included 111 clinically significant Enterobacteriaceae resistant to cephalosporins subclass III and exhibiting a positive modified Hodge test. Screening for carbapenemase production was done by phenotypic methods, and polymerase chain reaction was performed to detect genes encoding them. Retrospectively, the medical records of the patients were perused to assess risk factors for infections with CPE and their impact. The data collected were duration of hospital stay, Intensive Care Unit (ICU) stay, use of invasive devices, mechanical ventilation, the presence of comorbidities, and antimicrobial therapy. The outcome was followed up. Univariate and multivariate analysis of the data were performed using SPSS software. Results: Carbapenemase-encoding genes were detected in 67 isolates. The genes detected were New Delhi metallo-β-lactamase, Verona integron-encoded metallo-β-lactamase, and oxacillinase-181.Although univariate analysis identified risk factors associated with acquiring CPE infections as ICU stay (P = 0.021), mechanical ventilation (P = 0.013), indwelling device (P = 0.011), diabetes mellitus (P = 0.036), usage of multiple antimicrobial agents (P = 0.007), administration of carbapenems (P = 0.042), presence of focal infection or sepsis (P = 0.013), and surgical interventions (P = 0.016), multivariate analysis revealed that all these factors were insignificant. Mortality rate was 56.7% in patients with CPE infections. By both univariate and multivariate analysis of impact of the variables on mortality in these patients, the significant factors were mechanical ventilation (odds ratio [OR]: 0.141, 95% confidence interval [CI]: 0.024-0.812) and presence of indwelling invasive device (OR: 8.034; 95% CI: 2.060-31.335). Conclusion: In this study, no specific factor was identified as an independent risk for acquisition of CPE infection. However, as it is evident by multivariate analysis, there is an increased risk of mortality in patients with CPE infections when they are ventilated and are supported by indwelling devices.
  24 2,933 520
Prevalence of hypothyroidism in infertile women and evaluation of response of treatment for hypothyroidism on infertility
Indu Verma, Renuka Sood, Sunil Juneja, Satinder Kaur
January-June 2012, 2(1):17-19
DOI:10.4103/2229-516X.96795  PMID:23776802
Context: Prevalence of hypothyroidism is 2-4% in women in the reproductive age group. Hypothyroidism can affect fertility due to anovulatory cycles, luteal phase defects, hyperprolactinemia, and sex hormone imbalance. Aims and Objectives: To study the prevalence of clinical/sub-clinical hypothyroidism in infertile women and the response of treatment for hypothyroidism on infertility. Materials and Methods: A total of 394 infertile women visiting the infertility clinic for the first time were investigated for thyroid stimulating hormone (TSH) and prolactin (PRL). Infertile women with hypothyroidism alone or with associated hyperprolactinemia were given treatment for hypothyroidism with thyroxine 25-150 μg. Results: Of 394 infertile women, 23.9% were hypothyroid (TSH > 4.2 μIU/ml). After treatment for hypothyroidism, 76.6% of infertile women conceived within 6 weeks to 1 year. Infertile women with both hypothyroidism and hyperprolactinemia also responded to treatment and their PRL levels returned to normal. Conclusion: Measurement of TSH and PRL should be done at early stage of infertility check up rather than straight away going for more costly tests or invasive procedures. Simple, oral hypothyroidism treatment for 3 months to 1 year can be of great benefit to conceive in otherwise asymptomatic infertile women.
  21 11,929 1,455
Teaching communications skills to medical students: Introducing the fine art of medical practice
Anjali Choudhary, Vineeta Gupta
August 2015, 5(4):41-44
DOI:10.4103/2229-516X.162273  PMID:26380210
Introduction: Like many other people based professions, communications skills are essential to medical practice also. Traditional medical teaching in India does not address communication skills which are most essential in dealing with patients. Communication skills can be taught to medical students to increase clinical competence. Objective: To teach basic communication and counseling skills to fourth-year undergraduate students to increase their clinical competence. Methodology: A total of 48, fourth-year MBBS students participated in the study. They were given training in basic communication and counseling skills and taught the patient interview technique according to Calgary-Cambridge guide format. Improvement in communication was assessed by change in pre- and post-training multiple choice questions, clinical patient examination, and Standardized Patient Satisfaction Questionnaire (SPSQ) scores. Results and Analysis : About 88% of the students in the sample were convinced of the importance of learning communication skills for effective practice. Almost 90% students were communicating better after training, as tested by improved SPSQ. As judged by Communication Skill Attitude Scale, student's positive attitude toward learning communication skill indicated that there is a necessity of communication skill training during undergraduate years. Conclusion: The ability to communicate effectively is a core competency for medical practitioners. Inculcating habits of good communications skill during formative years will help the medical students and future practitioners. Regular courses on effective communication should be included in the medical school curriculum.
  21 5,380 848
Serum nitric oxide status in patients with type 2 diabetes mellitus in Sikkim
Amrita Ghosh, Mingma L Sherpa, Yazum Bhutia, Ranabir Pal, Sanjay Dahal
January-June 2011, 1(1):31-35
DOI:10.4103/2229-516X.81977  PMID:23776769
Background: Serum nitric oxide (NO) has emerged as a fundamental signal associated with the endothelial dysfunction in type 2 diabetes. Aims: To compare serum nitric oxide level among type 2 diabetic patients along with other biochemical parameters and to compare it with that of normal population in Sikkim. Settings and Design: This prospective study was carried out in the Biochemistry Department in a tertiary care teaching hospital in Sikkim on 50 type 2 diabetics compared to 100 non-diabetics. Materials and Methods: The un-hemolyzed blood sample was collected for estimation of biochemical parameters. Griess reaction was used for indirect assay of stable decomposition products in serum (serum nitrite and nitrate levels) as an index of NO generation. The comparison of different parameters between cases and control was done by using Student's t-test. Results: There was significant difference when age- and sex-matched cases and controls were compared in regard to waist circumference and body mass index. The values of fasting and postprandial serum glucose, and lipid profile between study group and control group differed significantly. The mean serum level of NO in the study and control group was 43.83 ± 11.3 μmoles/L and 58.85 ± 12.8 μmoles/L respectively, and this difference was statistically significant. Conclusion: To sum up, serum NO was observed significantly low in diabetic participants as compared to control, along with difference in other biochemical parameters.
  20 9,278 1,090
Prevalence of metabolic syndrome in type 2 diabetes mellitus patients
Kwabena Nsiah, V Owusua Shang, K Agyenim Boateng, FO Mensah
May-August 2015, 5(2):133-138
DOI:10.4103/2229-516X.157170  PMID:26097823
Background: The diabetic condition is influenced by several factors, some of which can accelerate the disease's progression to various complications that aggravate the morbidity. Aims: This study aimed at determining the prevalence of metabolic syndrome (MetS) and its individual components and the most critical predictive risk factors of MetS in type 2 diabetic patients. Materials and Methods: This cross-sectional study involved 150 type 2 diabetes mellitus patients and was conducted at the Diabetes Centre of the Komfo Anokye Teaching Hospital in Kumasi, the Ashanti Region of Ghana, from February, 2013 to April, 2013. The study involved the use of a questionnaire to obtain some information on the diabetics, undertaking anthropometric measurements, as well as collecting blood samples for the measurement of some biochemical parameters; fasting blood glucose and lipid profile. MetS was defined according to the National Cholesterol Education Program/Adult Treatment Panel III criteria. Results: The prevalence of MetS was 58% in the studied Ghanaian population. Hypertension was the commonest risk factor (60%), followed by central obesity (48.67%) and dyslipidemia (37%). Female type 2 diabetics had a higher prevalence of MetS, and carried more components than their male counterparts. Regression analysis showed three factors; femininity, high body mass index and low educational status were the most critical predictive risk factors of MetS, according to this study. Conclusion: With hypertension being the commonest component, future cardiovascular disease prevention strategies should focus attention on its management and prevention, through education.
  20 2,736 623
Biosimilar drugs: Current status
Rajiv Kumar, Jagjit Singh
July-December 2014, 4(2):63-66
DOI:10.4103/2229-516X.136774  PMID:25143877
Biologic products are being developed over the past three decades. The expiry of patent protection for many biological medicines has led to the development of biosimilars in UK or follow on biologics in USA. This article reviews the literature on biosimilar drugs that covers the therapeutic status and regulatory guidelines. Appraisal of published articles from peer reviewed journals for English language publications, search from PubMed, and guidelines from European Medicines Agency, US Food Drug Administration (FDA) and India were used to identify data for review. Literature suggest that biosimilars are similar biological products, i.e., comparable but not identical to the reference product, are not generic version of innovator product and do not ensure therapeutic equivalence. Biosimilars present more challenges than conventional generics and marketing approval is also more complicated. To improve access, US Congress passed the Biologics Price Competition and Innovation act 2009 and US FDA allowed "abbreviated pathway" for their approval. U.S law has defined new standards and terms and EMA scientific guidelines have also set detailed approval standards. India being one of the most preferred manufacturing destinations of biosimilars, there is a need for stringent safety and regulatory guidelines. The New India Guidelines "Draft Guidelines on Similar Biologics were announced in June 2012, by Department of Biotechnology at Boston bio and available online.
  20 5,231 1,540
Assessment of the level of trace element zinc in seminal plasma of males and evaluation of its role in male infertility
Mohammad Shoaib Khan, Safeer Zaman, Mohammad Sajjad, Mohammad Shoaib, Ghulam Gilani
July-December 2011, 1(2):93-96
DOI:10.4103/2229-516X.91152  PMID:23776785
Background: Male infertility is a serious problem all over the world. Nutritional deficiency of trace element Zinc (Zn) may play a role in male infertility as Zn plays an important role not only in normal testicular development, but also in spermatogenesis and sperm motility. Deficiency of Zn is associated with hypogonadism and insufficient development of secondary sex characteristics. Objective: The present study was designed to analyze the level of seminal Zn among different groups of infertile patients and to correlate it with sperm concentration, active, sluggish and immotile fractions of seminal parameters, with an objective to establish the role of Zn in male infertility. Setting and Design: The present study was carried out in five- years period from 2004 to 2009. It was a descriptive analytical study with non probability sampling. Materials and Methods: Semen examination of the patients was carried out according to the standardized method of the World Health Organization. Semen Zn was estimated by color 5 Br. PAPS method. Statistical Analysis: All statistical analyses were performed by using SPSS (Version 14.0 for windows) software, by applying student's t-test. Results: The result showed that seminal Zn was 702.92±10.60, 598.48±12.95, 617.54±9.55, 542.29±22.75, 710.36±7.87, 712.06±7.96, 789.36±21.33, and 762.06±8.99 mg/dl in azoospermic, oligozoospermic, asthenozoospermic, oligoasthenozoospermic, teratozoospermic, normozoospermic, polyzoospermic, and proven fathers group, respectively. Conclusions: Decreased concentration of seminal Zn do affect the sperm count, while increased level of seminal plasma Zn causes decreased sperm motility; so, it is suggested that administration of Zn should be very carefully monitored in such patients having low sperm count but normal sperm motility, as adequate seminal Zn is required for normal sperm function.
  18 4,310 563
Evaluation of Phenol Red Thread test versus Schirmer test in dry eyes: A comparative study
Satinder Vashisht, Sativir Singh
January-June 2011, 1(1):40-42
DOI:10.4103/2229-516X.81979  PMID:23776771
Background: Dry eye is the most common ocular morbidity found in elderly patients. There is no gold standard/standard test for diagnosing dry eye. Objectives: The present study was conducted to compare the potential of Phenol Red Thread (PRT) test versus Schirmer Test in diagnosing dry eye. Materials and Methods: The study was conducted on 50 patients, aged 40 years and above. History of dry eye symptoms was taken and the symptoms were graded. Six-questions Bandeen Rosch questionnaire was administered to those having symptoms of dry eye. Patients whose response to any of the questions was often/all the time were included in the study. After performing standard clinical examination, Schirmer and PRT tests were done. Results: PRT is equally sensitive in detecting dry eye, and in addition, it has many advantages as compared to Schirmer. PRT is simpler and more comfortable to the patient and can be done in children. It causes less reflex tearing. Most important is the lesser time consumed (15 seconds) in comparison to Schirmer (5 minutes). Conclusion: Kappa value between PRT and Schirmer was found to be 0.96 in this study and shows a strong agreement between the two. So, PRT can be considered equally good in detecting dry eye.
  17 5,618 655
Use of Bayesian statistics in drug development: Advantages and challenges
Sandeep K Gupta
January-June 2012, 2(1):3-6
DOI:10.4103/2229-516X.96789  PMID:23776799
Mainly, two statistical methodologies are applicable to the design and analysis of clinical trials: frequentist and Bayesian. Most traditional clinical trial designs are based on frequentist statistics. In frequentist statistics prior information is utilized formally only in the design of a clinical trial but not in the analysis of the data. On the other hand, Bayesian statistics provide a formal mathematical method for combining prior information with current information at the design stage, during the conduct of the trial, and at the analysis stage. It is easier to implement adaptive trial designs using Bayesian methods than frequentist methods. The Bayesian approach can also be applied for post-marketing surveillance purposes and in meta-analysis. The basic tenets of good trial design are same for both Bayesian and frequentist trials. It has been recommended that the type of analysis to be used (Bayesian or frequentist) should be chosen beforehand. Switching to an analysis method that produces a more favorable outcome after observing the data is not recommended.
  15 3,908 845
Vaptans: A new option in the management of hyponatremia
Suruchi Aditya, Aditya Rattan
July-December 2012, 2(2):77-83
DOI:10.4103/2229-516X.106347  PMID:23776817
Arginine vasopressin (AVP) plays an important role in water and sodium homeostasis. It acts via three receptor subtypes-V 1 a, V 1 b, and V 2 -distributed widely throughout the body. Vaptans are nonpeptide vasopressin receptor antagonists (VRA). By property of aquaresis, VRAs offer a novel therapy of water retention. Conivaptan is a V 1 a/V 2 nonselective VRA approved for euvolemic and hypervolemic hyponatremia. Tolvaptan is the first oral VRA. Other potential uses of this new class of drugs include congestive heart failure (CHF), cirrhosis of liver, syndrome of inappropriate secretion of antidiuretic hormone, polycystic kidney disease, and so on. These novel drugs score over diuretics as they are not associated with electrolyte abnormalities. Though much remains to be elucidated before the VRAs are applied clinically, the future holds much promise.
  15 9,030 1,915
Recent advances in antibacterial drugs
Jaswant Rai, Gurpreet Kaur Randhawa, Mandeep Kaur
January-June 2013, 3(1):3-10
DOI:10.4103/2229-516X.112229  PMID:23776832
The incidence of antimicrobial resistance is on continued rise with a threat to return to the "pre-antibiotic" era. This has led to emergence of such bacterial infections which are essentially untreatable by the current armamentarium of available treatment options. Various efforts have been made to develop the newer antimicrobials with novel modes of action which can act against these multi-drug resistant strains. This review aims to focus on these newly available and investigational antibacterials approved after year 2000, their mechanism of actions/resistance, and spectrum of activity and their phases of clinical trials. Newer unexploited targets and strategies for the next generation of antimicrobial drugs for combating the drug resistance and emerging pathogens in the 21 st century have also been reviewed in the present article.
  15 9,892 1,294
Impact of self-assessment by students on their learning
Rajeev Sharma, Amit Jain, Naveenta Gupta, Sonia Garg, Meenal Batta, Shashi Kant Dhir
July-September 2016, 6(3):226-229
DOI:10.4103/2229-516X.186961  PMID:27563593
Context: Tutor assessment is sometimes also considered as an exercise of power by the assessor over assesses. Student self-assessment is the process by which the students gather information about and reflect on their own learning and is considered to be a very important component of learning. Aim: The primary objective of this study was to analyze the impact of self-assessment by undergraduate medical students on their subsequent academic performance. The secondary objective was to obtain the perception of students and faculty about self-assessment as a tool for enhanced learning. Materials and Methods: The study was based on the evaluation of two theory tests consisting of both essay type and short answer questions, administered to students of the 1st year MBBS (n = 89). They self-assessed their performance after 3 days of the first test followed by marking of faculty and feedback. Then, a nonidentical theory test on the same topic with the same difficulty level was conducted after 7 days and assessed by the teachers. The feedback about the perception of students and faculty about this intervention was obtained. Results: Significant improvement in the academic performance after the process of self-assessment was observed (P < 0.001). There was a significantly positive correlation between student and teacher marking (r = 0.79). Both students and faculty perceived it to be helpful for developing self-directed learning skills. Conclusions: Self-assessment can increase the interest and motivation level of students for the subjects leading to enhanced learning and better academic performance, helping them in development of critical skills for analysis of their own work.
  15 2,960 472
Chromobacterium violaceum : A rare bacterium isolated from a wound over the scalp
M Ravish Kumar
January-June 2012, 2(1):70-72
DOI:10.4103/2229-516X.96814  PMID:23776815
Infection due to Chromobacterium violaceum, a large motile gram-negative bacillus, is a rare entity that typically starts with a localized skin infection or localized lymphadenitis after contact with stagnant water or soil. It can progress to fulminating septicemia, with necrotizing metastatic lesions and multiple abscesses in the liver, lung, spleen, skin, lymph nodes, and brain, and result in fatal multiorgan failure. We report a case of a young male with a history of fall from a bike into stagnant water who subsequently developed C violaceum infection at the site of the sutured scalp wound.
  14 6,213 546
Endocrine dysfunction and recurrent spontaneous abortion: An overview
Ramandeep Kaur, Kapil Gupta
April-June 2016, 6(2):79-83
DOI:10.4103/2229-516X.179024  PMID:27127734
Miscarriage is the spontaneous loss of a fetus before it is viable, occurring at a rate of 15–20%. Recurrent spontaneous abortion (RSA) or habitual miscarriage is defined as repeated occurrence of 3 or more miscarriages before 20th week of gestation accounting for the most common complication of early pregnancy in humans. Various etiological factors responsible for recurrent miscarriage are anatomical, genetical, endocrinological, immunological, and infectious. The endocrinological abnormalities may be polycystic ovarian syndrome, hyperprolactinemia, luteal phase defect, thyroid dysfunction, diabetes, or hyperandrogenism contributing to recurrent pregnancy loss. In the present article, the role of endocrinological disorders in patients with RSA has been reviewed. The article search was done using electronic databases, Google scholarly articles, and PubMed based on different key words. We have further combined the searches and made grouping as per various endocrine abnormalities, which might be responsible to cause spontaneous loss of fetus.
  14 4,769 919
Study of lipid peroxidation, nitric oxide end product, and trace element status in type 2 diabetes mellitus with and without complications
Sanjukta Mishra, Bana Bihari Mishra
April-June 2017, 7(2):88-93
DOI:10.4103/2229-516X.205813  PMID:28584737
Background: Oxidative stress has become a real entity in etiopathogenesis of Type 2 diabetes mellitus (DM). It may result from steady flux of free radicals and lipid peroxides in vivo. Malondialdehyde (MDA) is a stable end product of lipid peroxidation. Accumulative evidences suggest that hyperglycemia in Type 2 DM can produce major changes in nitric oxide (NO) production as well as in its action. Alteration in metabolism of trace elements is also observed in DM. Objective: To evaluate oxidative stress, status of NO, and trace elements zinc (Zn) and magnesium (Mg) in type 2 DM and to correlate these parameters with disease process. Materials and Methods: Ninety-two cases with diabetes were included in the study, out of which 51 were type 2 DM without any complication and 41 were type 2 DM with complications. Fifty-one nondiabetic healthy controls from hospital staff were selected for the study. Blood samples were collected after an overnight fast for estimation of fasting plasma glucose, postprandial glucose, glycated hemoglobin (HbA1c), lipid profile, trace element status, MDA, and NO. Results: Study revealed a rise in MDA levels in both uncomplicated and complicated cases with diabetes (2.47 ± 0.53, 3.98 ± 0.42 nmol/ml, respectively) as compared to controls (1.43 ± 0.23 nmol/ml), which was statistically significant (P < 0.05). The mean levels of NO, Zn, and Mg were significantly lower in both the diabetic groups than the control group (P < 0.05). MDA showed a significant positive correlation with plasma glucose, lipid profile parameters (except high-density lipoprotein cholesterol), and significant negative correlation with Zn (r = −0.44, P< 0.05) and Mg (r = −0.31, P< 0.05). NO levels were correlated significantly with plasma glucose, dyslipidemia, and HbA1c (P < 0.05). The effects of glycemic status on trace element concentrations were evident from a significant negative correlation between Zn and Mg with fasting plasma glucose and HbA1c. Conclusion: Findings of the present study may establish the role of hyperglycemia, oxidative stress, impaired NO, and trace elements in pathogenesis and long-term vascular complications of type 2 DM.
  14 2,538 378
Study of central nervous system depressant and behavioral activity of an ethanol extract of Achyranthes aspera (Agadha) in different animal models
Uma A Bhosale, Radha Yegnanarayan, Prachi D Pophale, Mandar R Zambare, Rahul S Somani
July-December 2011, 1(2):104-108
DOI:10.4103/2229-516X.91154  PMID:23776787
Background: Achyranthes aspera Linn., an indigenous herb, has been reported to have antifertility, antihyperlipidemic, antidiabetic, immunomodulatory, anticarcinogenic, diuretic, cardiotonic, analgesic anti-inflammatory, hypnotic, antifungal, antibacterial, and central antinociceptive activities. Aims: This study was designed to evaluate depressant effects on central nervous system (CNS) and behavioral effects of ethanol extract of A. aspera (EEAA) and to find the phytochemical responsible for these activities. Materials and Methods: The pharmacological assays used to study CNS depressant effect in albino mice were rota rod and actophotometer performance test. Effects on behavioral activity were studied using open field test. The extract was given intraperitoneally (i.p.) at a dose of 400 mg/kg. Diazepam (2 mg/kg body weight i.p.) was used as standard. Statistical Analysis Used: Data were analyzed by using analysis of variance followed by Dunnett's test. P < 0.05 was considered significant. Results: Phytochemical screening revealed presence of triterpenoids, saponins, alkaloids (betaine, achyranthine), and steroids as major constituents. The result of this study reflected that EEAA (400 mg/kg i.p.) decreased locomotor activity, produced muscle relaxation, and showed anxiolytic activity. Conclusions: EEAA exhibit CNS depressant and significant anxiolytic activity comparable to diazepam.
  13 6,426 691
Ferric carboxymaltose: A revolution in the treatment of postpartum anemia in Indian women
Setu Rathod, Sunil K Samal, Purna C Mahapatra, Sunita Samal
January-April 2015, 5(1):25-30
DOI:10.4103/2229-516X.149230  PMID:25664264
Objectives: The objective of the present study is to compare the safety and efficacy of ferric carboxymaltose (FCM), intravenous (IV) iron sucrose and oral iron in the treatment of post = partum anemia (PPA). Materials and Methods: A total of 366 women admitted to SCB Medical College, Cuttack between September 2010 and August 2012 suffering from PPA hemoglobin (Hb) <10 g/dL were randomly assigned to receive either oral iron or IV FCM or iron sucrose. FCM, IV iron sucrose, and oral iron were given as per the protocol. Changes in hemoglobin (Hb) and serum ferritin levels at 2 and 6 weeks after treatment were measured and analyzed using ANOVA. Adverse effects to drug administration were also recorded. Results: A statistically significant increase in Hb and serum ferritin level were observed in all three groups, but the increase in FCM group was significantly higher (P < 0.0001) than conventional iron sucrose and oral iron group. The mean increase in Hb after 2 weeks was 0.8, 2.4, and 3.2 g/dL and 2.1, 3.4, and 4.4 g/dL at 6 weeks in oral iron, iron sucrose and FCM groups, respectively. The mean increase in serum ferritin levels after 2 weeks was 2.5, 193.1, and 307.1 and 14.2, 64, and 106.7 ng/mL after 6 weeks in oral iron, iron sucrose and FCM groups, respectively. Adverse drug reactions were significantly less (P < 0.001) in FCM group when compared with other two groups. Conclusion: Ferric carboxymaltose elevates Hb level and restores iron stores faster than IV iron sucrose and oral iron, without any severe adverse reactions. There was better overall satisfaction reported by the patients who received FCM treatment.
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Factors precipitating outbreaks of measles in district Kangra of North India: A case-control study
Surender Nikhil Gupta, Ramachandran Vidya, Naveen Gupta, Mohan D Gupte
January-June 2011, 1(1):24-30
DOI:10.4103/2229-516X.81976  PMID:23776768
Background: Globally, measles is the fifth killer disease among children under five years of age. Despite high immunization coverage in Himachal, outbreaks are occurring. Upon two outbreaks in a hilly district in North India, a case control study was conducted to identify factors contributing to outbreaks and to recommend remedial measures to prevent further outbreaks. Materials and Methods: Factors were reviewed under three heads: program related, health care providers, and beneficiaries related. Cold chain maintenance was determined and responses were compared between workers from study Shahpur and control Nagrota Bagwan blocks. All 69 mothers of age and sex matched children with measles were enrolled. A pre-designed pre-tested data collection instrument was used. For statistical analysis, the odds ratio (OR) and adjusted odds ratio with 95% confidence interval (C.I.) among women of children exposed and unexposed to selected characteristics were calculated. Results: Poor cold chain maintenance and gaps in knowledge of health workers supplemented with beneficiary-related issues precipitated outbreaks in case area. Univariate analysis yielded strong statistical significance to 17 variables. Important statistically significant variables are educational status; OR 27.63 (C.I. 9.46-85.16); occupation; OR 0.35 (C.I. 0.16-0.75); income; OR 5.49 (C.I. 2.36-13.00); mode of transport to health care facility; OR 8.74 (C.I. 2.90-28.23); spread of illness from one person to another; OR 5.60 (95% C.I. 1.40-25.97); first help for sick child OR 2.12 (C.I. 1.00-4.50), and place of visit after recovery; OR 3.92 (C.I. 1.80-8.63). Multiple logistic regression yielded significant association with educational status, drinking water sources, and time taken to reach the nearest health facility. Conclusion: Measles outbreaks were confirmed in high immunization coverage areas. We recommend 2nd dose opportunity for measles (MR) between 5 and 17 years; refresher trainings to workers; mobile access to health care facility, and Information Education Communication activities for social behavioral change in affected areas.
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* Source: CrossRef