Antibacterial synergy between Rosmarinic acid and antibiotics against Methicillin resistant Staphylococcus aureus

2016-09-21T13-13-14Z
Source: Journal of Intercultural Ethnopharmacology
Sanmuga Priya Ekambaram, Senthamil Selvan Perumal, Ajay Balakrishnan, Nathiya Marappan, Sabari Srinivasan Gajendran, Vinodhini Viswanathan.
Aim/Background: Medicinal plants have ability to resist microorganisms by synthesizing secondary metabolites such as phenols. Rosmarinic acid (RA) is a phenylpropanoid widely distributed in plants and well known as therapeutic and cosmetic agent. Methicillin-resistant Staphylococcus aureus (MRSA) which is resistant to all kinds of β-lactams, threatens even most potent antibiotics. To improve efficiency of antibiotics against multi-drug resistant bacteria and to reduce the antibiotic dose, the antibacterial activity and the synergistic effect of rosmarinic acid with standard antibiotics against Staphylococcus aureus (S. aureus) and MRSA was investigated. Materials and Methods: Antibacterial activity of RA against S. aureus and clinical isolate of MRSA was evaluated by agar well diffusion method. Minimum inhibitory concentration (MIC) of RA was determined by broth dilution method. Synergism of RA with various antibiotics against S. aureus and MRSA was studied by broth checker board method and time kill kinetic assay. Effect of RA on MSCRAMMs (Microbial Surface Components Recognising Adhesive Matrix Molecules) of S. aureus and MRSA was studied using sodium dodecyl sulphate - polyacrylamide gel electrophoresis (SDS-PAGE). Results: MIC of RA was found to be 0.8 mg/ml and 10 mg/ml against S. aureus and MRSA respectively. RA was synergistic with vancomycin, ofloxacin and amoxicillin against S. aureus and only with vancomycin against MRSA. The time kill analysis revealed that synergistic combinations were more effective than individual antibiotics. MSCRAMMs protein expression of S. aureus and MRSA was markedly suppressed by RA + vancomycin combination rather than RA alone. Conclusion: The synergistic effects of RA with antibiotics were observed against S. aureus and MRSA. RA showed inhibitory effect on the surface proteins MSCRAMMs. Even though RA was shown to exhibit synergistic effect with antibiotics, the MIC was found to be higher. Thus further studies on increasing the efficacy of RA can develop it as an adjuvant for antibiotics.


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Evaluation of Anti-epileptic activity of Leaf extracts of Punica granatum on experimental models of epilepsy in mice

2016-09-21T13-13-14Z
Source: Journal of Intercultural Ethnopharmacology
Gollapalle L Viswanatha, Marikunte V Venkataranganna, NBL Prasad Prasad, Godavarthi Ashok.
Aims: This study was aimed to examine the anti-epileptic activity of leaf extracts of Punica granatum in experimental models of epilepsy in swiss albino mice. Methods: Petroleum ether (PLPG), methanolic (MLPG) and aqueous (ALPG) extracts of Punica granatum leaves were initially evaluated against 6-Hz-induced seizure model, the potent extract was further evaluated against maximal electroshock (MES) and pentylenetetrazole (PTZ)-induced convulsions. Further, the potent extractwas evaluated for itsinfluence on Gamma amino butyric acid (GABA) levels in brain, to explore the possible mechanism of action. In addition, the potent extract was subjected to actophotometer test to assess its possible locomotor activity deficit inducing action. Results: In6-Hz seizure test, the MLPG has alleviated 6-Hz-induced seizures significantly and dose dependently at doses 50, 100, 200 and 400 mg/kg. In contrast, PLPG and ALPG did not show any protection, only high dose of ALPG (400 and 800 mg/kg, p.o.) showed very slight inhibition. Based on these observations only MLPG was tested in MES and PTZ models. Interestingly, the MLPG (50, 100, 200 and 400 mg/kg) has offered significant and dose dependent protection against MES (P


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Evaluation of the potential effect of Allium sativum, Momordica charantia, Eugenia jambolana, Ocimum sanctum and Psidium guajava on intestinal P-glycoprotein in rats

2016-09-21T13-13-14Z
Source: Journal of Intercultural Ethnopharmacology
Devendra Kumar, Neerja Trivedi, Rakesh K Dixit.
Aims/Background: This study was evaluated synergistic effect of Polyherbal formulation (PHF) of Allium sativum L., Eugenia jambolana Lam., Momordica charantia L., Ocimum sanctum Linn and Psidium guajava L on p-glycoprotein of intestine. These five herbs were traditionally used for diabetes. These herbs are commonly present in ayurvedic product as antidiabetics in India. Methodology: PHF was prepared by five indigenous herbs. Different doses (50, 100 and 200 mg/kg/day) of was orally administered to Sprague-Dawley rats of different groups for multiple weeks except control groups. Alteration in Pgp expression was evaluated by RT-PCR and western blotting while modulation in activity of Pgp was evaluated using rhodamine 123 as transport substrate by in-situ absorption and everted gut sac method. Results: In PHF pretreated group received 50, 100 and 200 mg/kg/day for seven days, mRNA level decreased by 1.75, 2.45 and 2.37 fold respectively as compared to control. Similarly when PHF at dose of 100 mg/kg/day was given consequently for four weeks maximum decrease in Pgp expression level was observed only after one week and further increase in the treatment duration did not produce significant decrease compared to first week treatment. Pgp mediated transport of rhodamine 123 was significantly decreased with everted gut sac prepared from PHF pretreated rats (one week) compared to those prepared from vehicle treated rats. Conclusions: In conclusion, we report that PHF pretreatment down regulated the expression of intestinal Pgp and this down regulated intestinal Pgp would result in decreased functional activity. Additionally this down regulated Pgp expression might affect the bioavailability of antidiabetic Pgp substrate drugs.


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A study to analyze characteristics of primary hypothyroid patients not achieving target TSH values despite being prescribed adequate thyroxine dose

2016-09-21T09-41-17Z
Source: International Journal of Medical Science and Public Health
Abhishek Singhai, Vishal Yadav, Rajesh Kumar Jha.
Background: Hypothyroidism is a common endocrine disorder in India. The aim of therapy in hypothyroidism is to achieve euthyroid state, assessed by measuring serum TSH levels. Despite the fact that treatment of hypothyroidism should be straight forward, a significant percentage of hypothyroid patients treated with thyroxine have TSH values outside the normal range. Objective: To assess the percentage of primary hypothyroid patients with abnormal thyroid functions despite being prescribed levothyroxine for at least 2 months prior to enrolment. Materials and Methods: This was an observational, cross sectional study which included adult patients with primary hypothyroidism, who were on treatment with stable dose of levothyroxine for at least 2 months. A total of 500 subjects,who came for routine visit, were included in the study after fulfilling inclusion criteria. A comprehensive Statistical Analysis Plan (SAP) version 11 was used for the data analysis. Result: A total of 500 patients with primary hypothyroidism were enrolled in the study. Average daily dose of levothyroxine was found to be 1.24 μg/kg/day. The majority of patients (80%) were compliant to treatment. Twelve percent patients were moderately compliant while 8% patients were non-compliant to treatment. Among the 500 patients, 280 (56%) patients were found to have abnormal thyroid function, out of 280 patients, 198 (39.6%) were under-treated and 82 (16.4%) patients were over-treated. Conclusion: This study revealed that although being largely compliant to treatment, a significant number of Indian patients with primary hypothyroidism have abnormal serum TSH values, despite being prescribed a stable dose of levothyroxine for at least 2 months.


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Estimating height and weight in old-age from other anthropometric measurements – a community based cross-sectional study from central Kerala

2016-09-21T07-44-33Z
Source: International Journal of Medical Science and Public Health
Jaimy Ann Philip, Ivin P Zacharia, Sherin Susan Paul, Arun N Bhatt.
Background: Measuring height and weight in old age is often difficult due to imbalance or immobility. Measuring weight and height is important in geriatrics for a number of reasons. Study on estimation of weight and height for bedbound elderly are lacking in India. Objective: To derive equations for weight and height, for elderly from other convenient measurements. Materials and Methods: This community based cross sectional study is from a rural setting in central Kerala among 64 ambulant elderly. Weight, height, knee height (KH), calf circumference (CC), and mid arm circumference (MAC) were measured by standard techniques. Sum of circumferences (SC) was calculated by adding MAC and CC. Result: Summary (mean, SD) of anthropometric measurements are as follows- body mass index (BMI) (23.01, 3.59), weight(55.19, 10.49), height(154.67, 8.43), MAC(27.08, 3.65), CC(31.14, 3.76), SC(58.22, 6.75), and KH(49.13, 3.08). Weight had significant correlation (p


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Hepatoprotective effect of olive oil and camel milk on acetaminophen-induced liver toxicity in mice

2016-09-21T07-44-33Z
Source: International Journal of Medical Science and Public Health
Mahrous Abdel Basset Ibrahim, Farooq Ahmed Wani, Shaik Rahiman.
Background: Acetaminophen overdose is a major cause of drug-induced liver failure. Objective: To investigate the hepatoprotective effects of Extra Virgin Olive Oil (EVOO) and camel Milk (CM) on histopathological changes and changes in oxidant &antioxidant systems in liver caused by acetaminophen(APAP)-induced liver toxicity in mice. Materials and Methods: Mice were randomly divided into 6 groups, with 6 mice per group; control, EVOO,CM, APAP, EVOO + APAP, CM +APAP. In APAP group, mice were treated with single dose acetaminophen (500mg/kg). Prophylactic groups were given EVOO and CM for 28 days before APAP administration, in the same dose as that of the toxic group. Liver enzymes, lipid profile, malondialdehyde (MDA) and total antioxidant (TAC) activities were assessed. Result: In the toxicity group, increased concentrations of MDA and decreased TAC activities were found compared to the control groups (p

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Introduction of case based scenarios (learning) in endocrine pharmacology

2016-09-21T06-28-50Z
Source: International Journal of Basic & Clinical Pharmacology
Anshu Gupta, Karun Bhatti, Akshay Sadhotra, Rani Walia.
Background: In conventional lectures students are passive receivers of information and therefore are not involved in process of learning. Active learning method such as case based learning is a student-centered approach with a focus on collaborative-cooperative learning and student reflection on the way they think. It can clarify difficult concepts, motivate thinking, foster enthusiasm and motivate for learning. The objective of the study is to determine the perspective of students regarding case based scenario as a teaching method. Methods: Fourth semester undergraduate medical students participated in a case based scenario sessions in endocrine pharmacology classes. After the completion of session, students completed questionnaire on the innovative method of teaching used. Students provided reflections and answered questions in relation to the activity as a teaching learning method and development of critical thinking. Descriptive statistics were used to analyze data. Results: 132 (88%) students completed evaluation forms. Most students (n=112; 90.3%) supported case based scenarios to be conducted in class. Students considered it a feasible and interesting way of learning (83.3%). Hundred and fourteen (86.4%) agreed that they improved understanding of the topic. The sessions stimulated critical thinking in (75%) of students. Improvement in interaction with the teacher and the peers was identified as an advantage of the sessions by 66 of the participants. Students were of the view that the case based learning was useful and lead encouragement to discuss the topic. Conclusions: CBL sessions were valued by students in the acquisition of detailed knowledge of treatment plan and rational therapeutic drug use during pharmacology classes which will be of help in real settings.


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Transfusion transmissible infections in blood donors at a tertiary care rural medical institute of Rohilkhand region, India

2016-09-21T05-48-54Z
Source: International Journal of Medical Science and Public Health
Milan Jaiswal.
Background: Blood transfusion is an integral component of modern medicine; however, it is also associated with life-threatening complications and risks of transmitting blood borne infections like HIV, Hepatitis B and C, syphilis and many more. Objective: The aim of this study was to observe the prevalence of transfusion transmissible infections in blood donors and their distribution among various socio demographic variables. Material and Methods: Blood donor records of all sero-reactive cases were reviewed retrospectively from January 2014 to December 2015 at the blood bank of Shri Ram Murti Smarak Institute of Medical Sciences, Bareilly, Uttar Pradesh. Distribution of sero-reactive donors among various socio-demographic variables was analyzed in terms of frequency, percentage, and ratio. Difference between proportions of sero-reactive donors was evaluated by Z test and p value of less than 0.05 was considered statistically significant at 95% confidence interval. Data was analyzed using MS Excel 2007. Result: A total of 12,001 donors were selected for blood donation comprising 98.18% males and 1.82% females. Seroprevalence of HIV, HBV, HCV, and syphilis was 0.09%, 1.44%, 1.11%and 0.53%, respectively and overall being 3.2%. Statistically, significant difference in proportion in gender was found only for HBV. Majority of sero-reactive donors were from rural areas (72.47%) and agriculture (39.22%) was the most common occupation. There was significant difference in proportions of donors sero-reactive for HBV and HCV from low and high education levels. Conclusion: Transfusion transmissible infections were more common in males and those from rural background. There was a significant difference in proportions of donors sero-reactive for HBV and HCV in low and high education groups. Voluntary donors are safer than both family and replacement donors.


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Reconstruction of soft tissue defects in Fournier’s gangrene at a tertiary care centre

2016-09-21T04-11-39Z
Source: International Journal of Research in Medical Sciences
Abid Saleem, Mir Mohsin, Haroon Rashid Zargar, Peerzada Umar Farooq Baba, Adil Hafeez Wani, Mohammad Inam Zaroo, Sheikh Adil Bashir, Altaf Rasool, Akram Hussain Bijli, Tanveer Ahmed Bhat, Farooq Ahmed Mir, Mushtaq Ahmed Bhat.
Background: Fourniers gangrene is an acute and potentially lethal multi-bacterial necrotizing infection that primarily involves the scrotum but may extend beyond its confines to perineum and abdominal wall. The disease may result in sepsis and death if treatment is delayed. Management consists of timely diagnosis, aggressive debridement, broad-spectrum antibiotics followed by reconstruction which still remains a surgical challenge. Methods: It is a prospective study conducted from Jan 2006 to Dec 2015 on 29 patients of Fourniers gangrene who were referred to the department of Plastic and Reconstructive Surgery, Sheri-Kashmir Institute of Medical Sciences, Srinagar, Kashmir, for reconstruction after initial debridement by general surgeon/urologist. The patients age, predisposing factors, site and the size of the defects, reconstructive options used and outcome were evaluated. Assessment of testicular function was done at 6 months by sperm count and morphology. Results: A total of 29 patients of Fourniers gangrene consisting of 28 males and one female were included in the study. The mean age was 37 years and the most common comorbidity was diabetes mellitus in 18 patients (62%). Wounds were allowed to heal by secondary intension in 8 patients. Scrotal advancement flap was done in seven patients. Split thickness skin grafting (STSG) of extensive wounds was done in 11 patients and testes were placed in medial thigh subcutaneous pocket in one patient. Two elderly diabetic patients succumbed to sepsis and multi organ failure. Overall complication rate was 18.5%. Conclusions: Thorough debridement and early wound cover are essential in the management of Fourniers gangrene for successful rehabilitation. Various reconstructive options are available with no conclusive evidence to support flap rather than skin graft and most of the procedures result in preservation of testicular function in the long term.


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The role of computed tomography in the evaluation of cerebrovascular accidents

2016-09-21T04-11-39Z
Source: International Journal of Research in Medical Sciences
Lokesh Kumar T.
Background: Cerebrovascular accidents (CVA) or stroke ranks first in frequency and important among all the neurological diseases of adult life. 50% of neurological disorders in a hospital are of this type. It is the third leading cause of death throughout the world. The prolonged morbidity and extended hospitalization required by these patients makes the disease one of the most devastating in medicine. The purpose of the present study was to document the presence or absence of hemorrhage or infarct, to determine the size, location of infarct, reasonably assessing the territory to blood vessels involved and to detect the incidence of negative cases of clinically suspected stroke. Methods: 100 cases admitted to KIMS, Hubli and those referred to the NMR scan centre, Hubli with the clinical diagnosis of acute stroke were taken up for the study. The study was done from May 2010 to April 2012. Results: Out of 100 patients clinically suspected of CVA, submitted for CT scan study of the brain, 69 patients had infarcts, 21 patients had hemorrhage, 8 patients had CVT, 1 patient had SAH and 1 patient had normal scans. Infarcts (69%) formed the major group of the CVA cases involving most commonly the LMCA territory in 10 (14.49%) patients. Hemorrhage (21%) formed the second major group of CVA cases involving most commonly the RMCA territory 9 (42.85%) patients. Conclusions: CT scanning is a gold standard technique for the diagnosis and management of stroke and can be ideally done in all cases.


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Antioxidants from stem bark of Kigelia africana inhibits free radicals and membrane lipid damage in rat testes in vitro

2016-09-21T02-03-52Z
Source: Oxidants and Antioxidants in Medical Science
Jacob K. Akintunde, Daniel G. Akintunde, Emmanuel A. Irondi, Kehinde Babaita, Ramat Labaika, Ojo Sunday.
Objective: Bioactive ingredients of plants have been used as a central source of medicine and chemo-therapies for centuries. Nevertheless, the quantification and characterization of phytochemicals in methanol extract stem bark of Kigelia africana (MESBKA) will be highly advantageous if found affirmative. Methods: MESBKA was taken for gas chromatography-mass spectrometry (GC-MS) analysis. Thereafter, its effect on pro-oxidant induced hydroxyl radical and lipid peroxidation in rat's testes was evaluated. Results: The GC-MS analysis provided four peaks of eighteen different active compounds. Also, MESBKA contains antioxidants (polyunsaturated fatty acids, esters and poly alcohols) which are prophylactics of hydroxyl radicals and inhibitors of cyclooxygenase-2 (COX-2) in the testes. Furthermore, MESBKA inhibited pro-oxidants induced hydroxyl radicals and lipid peroxidation in rat's testes in a dose-dependent manner. Conclusion: The antioxidant content of Kigelia africana could have prevented inflammatory responses to enhance male fertility in rat. Isolation and translation of individual components of the plant would help to find new drugs to cure and/or prevent male infertility.


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