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   2011| January-June  | Volume 1 | Issue 1  
    Online since June 9, 2011

 
 
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EDUCATION FORUM
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.
  28 12,901 1,791
ORIGINAL ARTICLES
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 9,934 1,133
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.
  19 6,386 760
BRIEF COMMUNICATIONS
Cutaneous adverse drug reactions in a tertiary care teaching hospital: A North Indian perspective
Ruchika Nandha, Anita Gupta, Arif Hashmi
January-June 2011, 1(1):50-53
DOI:10.4103/2229-516X.81982  PMID:23776774
Background: Cutaneous manifestations of adverse drug reactions are a common occurrence and need to be differentiated from other causes of similar manifestations. Active search is essential for identification of these as patients may tend to downplay the causal association between drug use and the subsequent cutaneous manifestation. Purpose: To study the incidence of Cutaneous Adverse Drug Reactions (CADRs) in a tertiary care teaching hospital in North India. Methods: A prospective, observational study was conducted over a period of 6 months; using self-reporting method for selection of cases. The CADRs were graded as definite, possible and probable. Results: During the study period, 91 cases of CADRs were observed. Maximum incidence of CADRs was seen with antimicrobials (48.30%), followed by nonsteroidal anti-inflammatory drugs (21.90%). Maculopapular rash was the most common cutaneous manifestation of ADRs (42.85%). Conclusion: CADRs are a common occurrence and awareness about the same is essential for diagnosis and prevention.
  15 4,585 700
ORIGINAL ARTICLES
Wound healing activity of Argyreia nervosa leaves extract
AK Singhal, H Gupta, VS Bhati
January-June 2011, 1(1):36-39
DOI:10.4103/2229-516X.81978  PMID:23776770
Background: Argyreia nervosa (Convolvulaceae) plant is an example of hallucinogenic plant. The antiseptic, anti-inflammatory, antispasmodic, antibacterial, antiviral, antifungal, anticonvulsant, nootropic, antifertility and aphrodisiac properties have already been reported for this plant. Aim: The aim of present work was to evaluate the wound healing property in normal and diabetic animals by oral and topical administration of ethanolic extract of leaves. Materials and Methods: Phytochemical investigations showed the presence of various biochemicals (alkaloids, flavonoids, carbohydrates, triterpenoids, proteins, saponins, steroids, tannins). A single injection of alloxan monohydrate (120 mg/kg, i.p.) prepared in citrate buffer (0.1 M, pH 4.5) was administered to produce diabetes in rats and mice, after overnight fasting. Excision wounds (sized 300 mm 2 and of 2 mm depth) were used for the study of rate of contraction of wound and epithelization. The means of wound area measurement between groups at different time intervals were compared using one-way analysis of variance (ANOVA), followed by Dunnet's test. Results: Extracts of A. nervosa showed significant wound healing effect in normal (topically treated) and diabetic (both topically and orally treated) rats. In diabetic rats, the topically treated group showed more significant effect than the orally treated groups. Conclusion: The present study demonstrates that A. nervosa leaves extract applied topically promotes healing of wounds more significantly as compared to oral application, in both normal rats and alloxan induced diabetic rats, where healing is otherwise delayed.
  12 5,927 1,058
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.
  12 8,220 1,122
Psychopathology of school going children in the age group of 10-15 years
Pir Dutt Bansal, Rajdip Barman
January-June 2011, 1(1):43-47
DOI:10.4103/2229-516X.81980  PMID:23776772
Background: Psychiatric problems in children are rising and reported cases represent only the tip of the iceberg; large number remains unreported in India. There is limited data on childhood mental disorders and mental health needs in Northern-India. Aims and Objective: The main objective of this research was to study the extent and nature of psychiatric disorders in school children in a defined geographical area and to study their psychosocial correlates. Materials and Methods: In this cross sectional study, Childhood Psychopathology Measurement Schedule (CPMS) was used to measure the magnitude of 982 students in the age group of 10-15 years from four randomly selected schools in a city of North India. Screening stage was followed by detailed evaluation stage in which children were diagnosed by ICD-10 criteria. Statistical analysis was done by percentage and Chi-square test. Results: The results showed that among 982 students, 199 (20.2%) had psychiatric morbidity. Most of them were in the age group of 13-14 yrs, from middle income group and were second in birth order. No significant sexual preference was found regarding distribution of the disorders. Specific phobia; other non organic sleep disorders like sleep talking, bruxism; tension headache found to be the most prevalent disorders followed by sleep terror, hyperkinetic disorder, pica, enuresis. Conclusion: Epidemiological studies should be started early in childhood and carried longitudinally for development of preventive, promotional and curative programme in the community.
  8 7,125 846
Status of HER-2/neu receptors and Ki-67 in breast cancer of Indian women
Rajeev Singhai, VW Patil, AV Patil
January-June 2011, 1(1):15-19
DOI:10.4103/2229-516X.81974  PMID:23776766
Background: Breast cancer is a leading cause of death in women. Receptor status is the most important prognostic and predictive marker for breast cancer. Aims: The present study was conducted with an aim to analyze breast cancer of Indian women with discordant receptor status, probably hormone dependent estrogen receptor (ER) positive, progesterone receptor (PgR) negative or ER− negative and PgR+ positive subgroup profile, infiltrating ductal breast cancer (IDC) not otherwise specified. Materials and Methods: Specimens from 100 IDC were grouped into three categories according to hormonal status (group 1: ER+ positive and PgR+ positive, group 2: ER+ positive and PgR− negative or ER− negative and PgR+ positive, group 3: ER− negative and PgR− negative) evaluated prognostic parameters. Statistical Analysis: Statistically significant difference was found between tumor receptor status distribution and menopausal status (P = 0.0235), age of patients (P < 0.001), histopathologic grade (P < 0.001), vascular invasion (P = 0.006), HER-2/neu status (P = 0.004) and Ki-67 proliferation rate (P < 0.001). Results: Group 1 tumors were found exclusively in post-menopausal patients with average age 68.9 years, most of which had intermediate grade II, without vascular invasion, with HER-2/neu status score predominantly 0 or 1+ and lower Ki-67 proliferation rate. Group 2 tumors were found predominantly in younger post-menopausal patients with average age 57.5 years, with vascular invasion found in 23% of cases. Group 3 tumors mostly had higher histopathologic grade, showed the highest percentage of the Ki-67 positive tumor cells and vascular invasion in 30% of the cases. Conclusion: It is concluded that patients with group 2 breast cancer were younger post-menopausal women, with tumors moderately differentiated, HER-2/neu score 0 or 1+ and with lower Ki-67 proliferation rate.
  5 6,905 746
CASE REPORTS
A primary idiopathic superior lumbar triangle hernia with congenital right scoliosis: A rare clinical presentation and management
Ankur Bhupendrakumar Pachani, Ali Reza, Raviraj V Jadhav, Saumya Mathews
January-June 2011, 1(1):60-62
DOI:10.4103/2229-516X.81985  PMID:23776777
Primary lumbar hernias are rarest form of hernias as compared to other ventral abdominal wall hernias. Only scattered reports of hernias of both superior and inferior lumbar triangles have appeared in both the English and foreign literature. There are only about 300 cases of primary lumbar hernia being reported. Being a rare entity, it had always posed diagnostic and treatment dilemma to the surgeons. The diagnosis requires imaging studies in such cases. Treatment of lumbar hernia is always surgical and requires prosthetic reinforcement for the best result. We are reporting here a case of primary lumbar hernia of the superior lumbar triangle with a successful repair with a sheet of polypropylene mesh. In our case, acquired primary lumbar hernia was emerging from superior lumbar triangle, associated with congenital right scoliosis, which is a rare occurrence.
  3 4,540 438
Ameloblastic carcinoma: A case report and literature review
Manas Madan, Jasbir Singh, Rachna Arora, Monika Bansal
January-June 2011, 1(1):54-56
DOI:10.4103/2229-516X.81983  PMID:23776775
Ameloblastic carcinoma (AC) is a rare epithelial odontogenic tumor of the jaws, which exhibits cytological features of ameloblastoma and carcinoma. It has a distinct predilection for mandible. These lesions may initially show histologic features of ameloblastoma that dedifferentiate over time. Others may present with features of epithelial dedifferentiation in ameloblastoma. A case of ameloblastomic carcinoma in a 64-year-old male is reported, who presented with swelling in the left mandible 3 months after the extraction of the left upper molar.
  3 4,409 640
EDITORIAL
H1N1 2009 influenza pandemic: Looking for a blessing in disguise
Rajiv Mahajan, Ajay Grover
January-June 2011, 1(1):3-4
DOI:10.4103/2229-516X.81971  PMID:23776763
  3 4,002 520
ORIGINAL ARTICLES
Acceptable alternatives for forced vital capacity in the spirometric diagnosis of bronchial asthma
Mohamed Faisal Lutfi
January-June 2011, 1(1):20-23
DOI:10.4103/2229-516X.81975  PMID:23776767
Background: In patients with advanced obstructive ventilatory disorders, expiration may last for a relatively long time until the end-of-test standards for forced vital capacity (FVC) are satisfied. This may be difficult for both the patient and the technician. The Forced expiratory volume in 3 seconds (FEV3) and Forced expiratory volume in 6 seconds (FEV6) maneuvers are simple, undemanding and easier to perform when compared with FVC; however, their reliability to be used as alternatives for FVC is controversial. Aim: To judge whether FEV3 and FEV6 can be used instead of FVC in detecting airway obstruction in asthmatic patients. Settings and Design: This study was a cross-sectional case-control laboratory-based study. Materials and Methods: The study involved 40 known asthmatic patients and 40 apparently healthy, gender- and age-matched controls. Spirometery was used for assessing pulmonary function according to the American Thoracic Society and European Respiratory Society criteria. Statistical Analysis: A significant difference in the means between the groups was performed using Student's t-test. The receiver operating characteristic (ROC) curves were used to compare efficiency of the studied spirometric measurements on asthma diagnosis. Results: The mean of FEV3 was not significantly different when compared with the mean of FVC (P = 0.352 for asthmatic patients and P = 0.957 for control group). This was also true when the mean of FEV6 was compared with the mean of FVC (P = 0.805 for asthmatic patients and P = 0.957 for control group). The area under the ROC curves of FEV1/FVC%, FEV1/FEV3% and FEV1/FEV6% were also comparable. Conclusion: FEV3 and FEV6 are accurate and reliable alternatives for FVC in assessing airway obstruction of asthmatic patients.
  3 4,076 514
BRIEF COMMUNICATIONS
Knowledge and awareness of palliative medicine amongst students of a rural dental college in India
Rajiv Saini, Santosh Saini, RS Sugandha
January-June 2011, 1(1):48-49
DOI:10.4103/2229-516X.81981  PMID:23776773
Objectives : To determine the current knowledge and awareness among undergraduate dental students in a rural dental college regarding palliative medicine. Materials and Methods: This cross-sectional observational study was conducted on students of a rural dental college located in western India. They were asked to fill a pre-designed questionnaire. The variables assessed were their knowledge and awareness towards palliative medicine and a dentist role in palliative team. Results : A total of 150 students participated. The male:female ratio was 1:2; mean age of respondent was 20.66 ΁ 1.01 years. On an average, 59.23% were correct and 40.67% were incorrect for knowledge about palliative medicine, while 81.55% were correct and 18.45% were incorrect regarding awareness about oral care in palliative medicine. Conclusion: Results indicate that students had good awareness and perception level about awareness of oral care in palliative treatment.
  - 3,264 482
CASE REPORTS
Anaesthetic management of a vaginal hysterectomy case with an unanticipated failure of epidural injection due to fused lumbar spine
Sukhminder Jit Singh Bajwa, Sukhwinder Kaur Bajwa, Jasbir Kaur, Amarjit Singh, Seema Prasad
January-June 2011, 1(1):57-59
DOI:10.4103/2229-516X.81984  PMID:23776776
Epidural anesthesia is one of the easier and safer techniques for lower abdominal surgery. It has a very high success rate in the experienced hands, and failure rates are minimal when it is administered by the experienced anesthesiologists. As it is a blind technique, failures can be encountered even by a senior anesthesiologist in many situations and one must analyze retrospectively the various causes responsible for such failures. We report a case of 45-year-old female, weighing 60 kg, who was scheduled for elective vaginal hysterectomy under regional anesthesia. Initial four to five attempts were unsuccessful in establishing the epidural block as the epidural injection encountered bony resistance each time, but subarachnoid block could be achieved with a 23 G spinal needle in the paramedian site of entry in the third attempt. Postoperatively, lumbar and cervical spine X-rays were done which revealed an isolated lumbar spine bony fusion. She was diagnosed as a rare case of isolated lumbar spine fusion without any involvement of cervical spine, other articular joints or any systemic manifestations of diseases like ankylosing spondylitis.
  - 5,723 530
FROM THE ASSOCIATION OFFICE
Basic Medical Scientists Association: A forum for research integration
Sheela Jain, Jaswinder Singh, Navyug Raj Singh, Vishal Bansal, Rajiv Mahajan
January-June 2011, 1(1):1-2
DOI:10.4103/2229-516X.81970  PMID:23776762
  - 2,837 553
LETTER TO THE EDITOR
The need to develop and sustain a symbiotic relationship between the industry and academia in the field of clinical pharmacology in India
Sandeep Kumar Gupta
January-June 2011, 1(1):63-64
DOI:10.4103/2229-516X.81986  PMID:23776778
  - 3,384 501
ORIGINAL ARTICLES
Coronary risk factors in maintenance hemodialysis patients: Who is the culprit - hemodialysis or chronic renal failure?
Kapil Gupta, Rajiv Mahajan
January-June 2011, 1(1):11-14
DOI:10.4103/2229-516X.81973  PMID:23776765
Objective: Dyslipidemia, common in uremic patients subjected to maintenance hemodialysis (HD), represents an independent risk factor for atherosclerosis; but the association between long-term HD and uremic dyslipidemia is not crystal clear. The present study was aimed to ascertain any association. Materials and Methods: The effects of chronic renal failure (CRF) and HD duration on serum lipids, lipoproteins and homocysteine (HC) were studied in 84 patients suffering from CRF subjected to maintenance HD and were compared with 68 healthy, age-, sex- and race-matched control cohorts. Results: Increase in serum free cholesterol (FC), triglycerides, very low-density lipoprotein cholesterol and HC levels, and decrease in esterified cholesterol (EC), EC/FC ratio, high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol levels were highly significant (P < 0.001) in pre-dialysis patients compared to controls. Further disturbances were observed (P < 0.05) by repeated HD, resulting in further significant increase in FC, and decrease in EC/FC ratio and HDL-C levels after 40 dialysis schedules. Conclusion: Levels of HDL-C, plasma FC, and ratio of EC/FC appeared to be clearly altered by HD duration, submitting patients to a greater risk of atherosclerosis due to maintenance HD.
  - 3,324 591
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