Pharmacognostical,phytochemical and pharmacological evaluation for the antipyretic effect of the seeds of Saraca asoca Roxb.

Objective:To conduct a systemic evaluation of the medicinal value of seeds which include macroscopic and microscopic characterization,physiochomical evaluation,preliminary phylochemical screening and experimental antipyretic activity.Methods:Saraca asoca seed was studied for pharmacognostical,phytochemical and other recommended methods for standardizations.Also,the acetone extract of the seeds was evaluated for acute toxicity study and antipyretic activity using Brewer's yeast induced pyrexia in Wislar rats at oral doses of 300 mg/kg and 500 mg/kg.Results:After phytochemical screening,the acetone extract showed the presence of saponin,tannins and flavonoids which inhibit pyrexia.The therapeutic efficacy achieved at both the dose levels of the research drug and standard drug aspirin(100 mg/kg)showed significant(P<0.01)antipyretic activity when compared to the control group.The highly significant antipyretic effect exhibited at the dose of 500 mg/kg was also found to be sustainable in nature.Conclusions:The antipyretic effect of the acetone extract showed significant results in rats at the dose of 500 mg/kg after following the standard pharmacognostical and phylochemieal met hods.

Bronchodilatory and mast cell stabilising activity of Cressa cretica L.:Evaluation through in vivo and in vitro experimental models

Objective:To evaluate the effect of ethylacetate fraction(Fr-Et) and methanolic fraction(FrMe) obtained from Cressa cretica L.(C.crelica) L on experimental models for bronchodilatory activity and mast cell stabilising activity.Methods:The effect of Fr-Et and Fr-Me were studied on acetylcholine and histamine aerosol-induced broncospasm using guinea pigs as experimental animals.Also,the effects of these fractions were evaluated on the isolated guinea pig tracheal preparations.Besides this mast cell degranulation effect was assessed using egg albumin and compound 48/80 on rat peritoneal mast cells.Results:Significant increase in nreconvulsion time was observed due to pretrealment with the fractions when guinea pigs were exposed to histamine and acetylcholine aerosol.Fr-Et and Fr-Me significantly increased the preconvulsion in a dose depended manner that suggestive of bronchodilating activity.Fr-Et and Fr-Me exhibited a significant concentration dependant relaxant effect on guinea pig trachea pre-contracted with CCh,K^+ and histamine.The results revealed that Fr-Et to be more potent than Fr-Me in relaxing histamine and K^+ and calcium induced contraction than CCh induced conlractions.Studies on the fractions in protecting mast cell degranulation,which were elicited by the egg albumin as well as synthetic compound 48/80 revealed both the fractions significantly protect the mast cell degranulation,which release mediators such as histamine and proinflammatory cytokines through various stimuli in a dose depended manner.Conclusions:Thus our study established the bronchodilator activity,and mast cell stabilizing activity which are important mediators that provoke or sustain in asthma.

Community Based Survey Methodology for Maternal Healthcare Utilization: Gujarat, India

Background: About 60% of institutional births occur in the private sector in Gujarat due to limited availability of obstetricians in the government. Chiranjeevi Yojana (CY), a voucher-like program initiated in 2007, accredits private obstetricians who are reimbursed by the state government to provide free delivery care to eligible women i.e. below poverty line and tribal. One million women have delivered under the CY program yet there are no large community based studies of the program. Methodology of a prospective community study is described here. Methods/Designs: A prospective cohort study was done in 142 villages across 3 districts in Gujarat between July, 2013 and November, 2014. A detailed survey was done by trained researchers to ascertain maternal healthcare information including antenatal, intra-partum and post-partum care, place of delivery, birth outcomes, out of pocket expenses etc. Results: 54,955 households were surveyed. 73% of all households had poverty documentation. 4274 mothers who delivered in the study period were included. Discussion: This paper is description of the methodology of a large community based survey and household and individual level characteristics. The survey was nested in a larger project to evaluate the CY program in the state of Gujarat.

Threefold Increase in the Number of Drug Resistant TB Cases after Introduction of Universal Drug Susceptibility Testing: Experiences from Two South India Districts

Background: In India, tuberculosis (TB) is a major public health problem, and the advent of drug resistance TB (DR-TB) has worsened the situation. The Revised National TB Control Programme (RNTCP) has introduced universal drug susceptibility testing (UDST) for all diagnosed TB cases in 2018. We conducted this study to know the advantage of implementing UDST when compared to selective testing existent in 2017 on key diagnostic cascade parameters and to identify the challenges in the implementation of UDST. Methods: The study was conducted in two districts of Karnataka, India during January 2017-December 2018. The quantitative part consisted of before-and-after design and the qualitative part consisted of descriptive design. Results: In 2017 (during selective testing/“before” period) out of the 2440 TB patients, 80 (3%) were diagnosed with Isoniazid and Rifampicin resistance patients;in contrast in 2018 (during UDST/“after” period) of the 5129 TB patients 258 (5%) were diagnosed with Isoniazid and Rifampicin resistance. However, the proportion of eligible patients tested for rifampicin resistance during the “after” period was 60% when compared to 100% during the “before” period and median turnaround time for testing was also longer during the “after” period when compared to the “before” period (32.5 days vs 27.5 days). Major reasons for these two gaps were found to be difficulties in collecting sputum specimens and transportation. Conclusion: The rollout of UDST has led to a three-fold increase in a number of DR-TB cases detected in the region. There is a need for the programme to increase the proportion tested for DST by increasing the laboratory capacity and address the challenges in sputum collection and transportation.

Therapeutic efficacy of artemisinin combination therapies and prevalence of S769N mutation in PfATPase6 gene of Plasmodium falciparum in Kolkata,India

Objective:To study the in vivo efficacy of these two ACTs in the treatment of Plasmodium falciparum {P.falciparum malaria) in Kolkata and to detennine the prevalence of mutant S769N codon of the PfATPase6 gene among field isolates of P.falciparum collected from the study area. Methods:A total of 207 P.falciparum positive cases were enrolled randomly in two study arms and followed up for 42 days as per WHO(2009) protocol.A portion of PfATPase6 gene spanning codon S769N was amplified and sequenced by direct sequencing method.Results:It was observed that the efficacy of bodi the ACT regimens were highly effective in the study area and no mutant S769N was detected from any isolate.Conclusions:The used,combination AS+SP is effective and the other combination AM+I.F might be an alternative,if needed.

Combination of nutritional ketosis and hyperoxygenation therapy-promising ground for integrative cancer treatment: a systematic review

Though the cancer is a multifactorial disease,where various types of cancers exhibit varying mechanisms,pathways,genetic and cellular defects,the study of tumor micro-environment confirms that upregulated glycolysis and hypoxia are the part and parcel of almost every cancer subtypes.Therefore,targeting them with nutritional ketosis and hyper-oxygenation therapies could create an unfavourable environment for cancers to thrive.The aim of this review is to study the significance of these interventions in the integrative cancer treatment.Extensive search has been carried out through the online scientific database like PubMed and other medical journals with the search words,‘cancer metabolism’,‘tumor micro environment’,‘hypoxia and tumor’,‘ketosis and cancer treatment’,‘hyperbaric oxygen therapy and cancer’and‘ozone therapy and cancer’.All biomolecule studies,preclinical and clinical studies,received as search results are reviewed.In addition,a nutritional book,named‘Healing with Whole Foods:Asian Traditions and Modern Nutrition’by Paul Pitchford is also referred.These studies recommend the use of various therapeutic approaches like ketogenic diet,ketone supplementation,hyperbaric oxygen therapy and intravenous ozone therapy,individually or in combination with standard therapies,based on its antitumor effects,safety,tolerability,its ability to potentiate the radio and chemo therapy,while decreasing its side effects and its efficiency to improve the quality of life.Rewardingly,when combined,the synergistic action of nutritional ketosis and hyperoxygenation therapies elicited profound,supra additive anti-cancer effects.As per present studies,these therapies are safe to include in an Integrative cancer treatment,though large clinical trials are needed to systematize its clinical usage.

Fabrication and evaluation of carboxymethyl guar gum-chitosan interpenetrating polymer network (IPN) nanoparticles for controlled drug delivery

Guar gum(GG)has drawn more interest from researchers in the last several decades for the controlled delivery of drugs.The aim of the research is to fabricate and evaluate an interpenetrating polymer network(IPN)based nanocarriers system employing chemically modified GG to achieve controlled release of drug.In present study,we have reported the synthesis of carboxymethyl GG-chitosan IPN nanoparticles for controlled release of metformin hydrochloride.Carboxymethyl guar gum(CMGG)was synthesized and employed for developing IPN nanoparticles in combination with chitosan in varying polymeric ratios.A cross-linking agent,sodium tripolyphosphate(Na-TPP)was used for the synthesis of IPN colloidal suspension of nanoparticles which was lyophilized to obtain nanoparticles.The carboxymethylation of GG was confirmed through Fourier transform infra-red spectroscopy.The mean particle size was 440.6 nm indicating a polydispersity index of 0.528.The drug entrapment efficiency was found to vary between 67.461.64%to 88.232.02%.The differential scanning calorimetry study revealed the presence of amorphous metformin hydrochloride as a homogenous dispersion in nanoparticles(NPs)matrix.In vitro drug release study indicated controlled release ability of developed IPN matrix.A2 formulation(chitosan:CMGG-1:1)exhibited 78.110.27%release after 8 h.Antidiabetic evaluation performed in alloxan-treated diabetic rat model exhibited a prolonged hypoglycemic efficacy over 6 h,for A2 formulation treated group,compared to the group receiving only metformin HCl,which demonstrated a reduction in blood glucose levels for up to 4 h.The study findings demonstrated the efficacy of the CMGG-chitosan based IPN nanoparticulate system for sustained delivery of therapeutic agents.

Treatment Initiation among Patients with Multidrug Resistant Tuberculosis in Bhopal District, India

Revised national tuberculosis control programme in India has limited co-hort-wise information about what happens to patients diagnosed with multidrug resistant TB (MDR-TB). We determined the pre-treatment loss to follow-up (non-initiation of treatment by programme within 6 months of diagnosis) and time from diagnosis to treatment initiation in Bhopal district, central India (2014). Pre-treatment loss to follow-up was 13% (0.95 CI: 7%, 23%), not significantly different from the national estimates (18%) and median time to initiate treatment was seven days, lower than that reported elsewhere in the country. Bhopal was performing well with reference to time to treatment initiation in programmatic settings.

Disordered eating behaviour and eating disorder among adolescents with type 1 diabetes:An integrative review

BACKGROUND Type 1 diabetes(DT1)in adolescents brings behavioural changes,altered nutritional habits,and eating disorders.AIM To identify and analyze the validated instruments that examine the disordered eating behaviour and eating disorders among adolescents with DT1.METHODS An integrative review was accomplished based on the following databases:PubMed,LILACS,CINAHL,Scopus,Web of Science,and Reference Citation Analysis(RCA),including publications in Portuguese,English,or Spanish,without time limit and time published.RESULTS The main instruments to evaluate disordered eating behaviour were The Diabetes Eating Problem Survey-Revised,The Diabetes Eating Problem Survey,and the eating attitudes test-26,and for eating disorders the main instruments used were The Bulimic Investigation Test of Edinburgh,The Binge Eating Scale,The Child Eating Disorder Examination,The five questions of the(Sick,Control,One,Fat and Food),and The Mind Youth Questionnaire.These instruments showed an effect in evaluating risks regarding nutritional habits or feeding grievances,with outcomes related to weight control,inadequate use of insulin,and glycaemia unmanageability.We did not identify publication bias.CONCLUSION Around the world,the most used scale to study the risk of disordered eating behaviour or eating disorder is The Diabetes Eating Problem Survey-Revised.International researchers use this scale to identify high scores in adolescents with DT1 and a relationship with poorer glycemic control and psychological problems related to body image.

On the transmission pattern of Kyasanur Forest disease (KFD) in India

Kyasanur Forest disease(KFD),a tick-borne viral hemorrhagic fever,is endemic in five districts of Karnataka state,India.Recent reports of the spread of disease to neighboring districts of the Western Ghats,namely Chamarajanagar district in Karnataka,Nilgiri district in Tamil Nadu,Wayanad and Malappuram districts in Kerala,and Pali village in Goa are a cause for concern.Besides vaccination of the affected population,establishing an event-based surveillance system for monkey deaths in the national parks,wildlife sanctuaries and reserve forests of the Western Ghats would help detect the disease early and thereby help implement appropriate control measures.

Recent advances in alginate based gastroretentive technologies for drug delivery applications

The efficacy of orally delivered medicines can be maximized through enhancing the gastric residence period and modifying the drug release pattern according to therapeutic need.Several technologies were investigated through recent years for increasing gastric retention of medicines.Biopolymers are one of the widely studied materials for increasing the retention of drug delivery systems in the stomach region.The biodegradability,biocompatibility and non-toxic behavior in combination with the easy fabrication technologies has made biopolymers an interesting option to pharmaceutical scientists for developing gastroretentive drug delivery systems(GRDDS).Several gastroretentive approaches are reported to be efficacious to localize the drug delivery system in the gastric region.Alginates are commonly employed polysaccharide for developing various GRDDS including low density systems,mucoadhesive systems,swellable systems,hydrogel forming systems,in situ gelling systems,raft forming systems,magnetic systems.The abundant availability from marine and bacterial sources in combination with its attractive physicochemical nature has encouraged pharmaceutical researchers to investigate its suitability in developing various drug delivery system.The mucoadhesive,hydrogel forming and raft forming behavior of alginates makes alginate suitable for GRDDS.The attractive properties of alginate makes it a useful biopolymer in the biomedical field.This review focuses on the source and chemistry of alginates and describes the applications of alginates in developing novel gastroretentive drug delivery systems.