Objective: To determine whether carbamazepine monotherapy in epilepsy patients is or is not associated with prolongation of the QTc interval. Methods: This case-control study enrolled 100 consecutive patients with generalized tonic-clonic seizures. Fifty patients were already taking carbamazepine for a variable time, and the rest (n=50) were not on any antiepileptic drug. The QTc interval was calculated after doing a resting 12-lead ECG examination on a single occasion. Results: Of the 50 patients who had received carbamazepine, 11 patients displayed prolongation of their QTc interval, while 8 patients out of the 50 in the control group had QTc interval prolongation after correction for gender; p value =0.49, OR 1.36, 95% CI 0.54-3.29. Conclusion: This study demonstrated no statistically signifi cant association between carbamazepine monotherapy and prolongation of the QTc interval. Carbamazepine does not seem to prolong the QT interval when used as monotherapy for epilepsy. The presence of prolonged QTc interval in such patients should prompt a search for co-factors that prolong this interval, such as multiple medications, electrolytes disturbances, structural heart disease, and congenital long QT interval syndromes.

Experiments were conducted on 20 fourth instar Anopheles stephensi larvae to explore behavior organisation. Twenty fourth instar larvae were placed in a glass aquarium and filmed using a handy cam video recorder and the recordings analysed in a laptop computer. Data of transitions from one behavior to another for all observations were collated into a matrix of preceding and succeeding behaviors to study sequential organisation and relationship among behaviors. Significant testing for first-order transition was done using G test at P< 0.005 and a kinematic graph constructed from significant transitions. A time budget and transition frequency data constructed for each behavior were subjected to cluster analysis to explore relationship between the behaviors. Result of the analysis showed that fourth instar Anopheles stephensi larvae behaviors occur in clusters in specific locations in their aquatic environment. Furthermore, the sequential organisation of behaviors is influenced by behavior frequency and the amount time a larva spent doing that behavior. When food is kept constant, other factors such as gas exchange requirements, behavior variation due to day-night cycle, presence of a predator, interlarval competition for food and the size of the aquarium (depth and width) maybe determining behavior organization.

Introduction: Children living in orphanages tend to be neglected and may be malnourished. This study assessed the socio-economic background and nutritional status of children living in an orphanage in Dhaka city, Bangladesh. Methods: A cross-sectional study was conducted among the children in Sir Salimullah Muslim Orphanage, Dhaka from January to November 2014. Systematic sampling was adopted to collect data from 232 children using a semi-structured questionnaire. Anthropometric measurements of the children were taken and the WHO reference growth chart was used to determine the children’s nutritional status. Weight-for-age was categorised by mild, moderate and severe malnutrition. The Pearson Chi-square test was performed to determine the association between the extent of malnutrition and socio-demographic characteristics of the children. Results: The majority of the children (60.3%) in the orphanage were malnourished, with mild, moderate and severe malnourished being 43.1%, 16.8% and 0.4%, respectively. Malnutrition was higher among the boys than girls in the age group of 15-18 years. The orphans suffered significantly (P<0.05) from malnutrition compared to those, who had at least one parent alive. Conclusion: Malnutrition is highly prevalent among children and adolescents under residential care and needs to be addressed. In particular, early identification and intervention can improve the quality of nutritional status of the urban orphanage population. An investigation with a large sample is highly desirable to explore the severity of the problem in the national context.

Objective: To isolate compounds from K. pinnata and elucidate their structures and to explore preliminary antioxidant, antimicrobial, cytotoxic and thombolytic activities of extractives of the plant. Methods: The methanol extract of whole plant of K. pinnata has been subjected to different chromatographic separation and purification processes to isolate the secondary metabolites. The structures of the isolated compounds have been elucidated by extensive NMR studies. The free radical scavenging activity of the crude extract and its different Kupchan fractions were determined on stable radical DPPH. In vitro antimicrobial activity was determined by the disk diffusion method. Cytotoxicity screening has been performed against Artemia salina. Total phenolics content, membrane stabilizing activity and thombolytic activities were assessed by following established protocol. Results: The isolated compounds were identified as glut-5(6)-en-3-one, taraxerone, 3β-friedelanol, β-amyrin-3-acetate, 3,5,7,3',5'-pentahydroxyflavone and β-sitosterol. The chloroform soluble fraction showed potent antioxidant activity of (IC50=80.0 μg/mL) and significant cytotoxicity, while the crude extract demonstrated noticeable total polyphenol content (149.24 mg of GAE/gm of extractive), moderate membrane stabilizing activity and inhibition of clot lysis of blood. Conclusions: The obtained results rationalize the folkloric use of the plant and can be further investigated to isolate the active compounds responsible for the biological activities.

OBJECTIVEToxic metal ions have been implicated in the generation of reactive oxygen species (ROS) and nitric oxide (NO). Metallothionines (MT) and plant flavonoids have been reported in the intervention against oxidative damage. We investigated the effect of zinc induced MT and green tea polyphenol (GTP) in reducing the oxidative responses induced by nickel and platinum.

METHODSZinc (10 mg/kg b. wt, sc) was administered to rats twice at a gap of 24 hrs and GTP (10 mg/100 mL in drinking water) was fed ad libitum for 8 days. Nickel chloride (150 umol/kgb.wt, ip) and cisplatin (50 mumol/kg b.wt, sc) was administered to rats 24 h after Zn or GTP pre-treatment. Animals of all the groups were sacrificed 16 hrs after treatment and biochemical markers for toxicity were monitored.

RESULTSZinc or GTP pre-treatment caused significant protection against nickel or cisplatin enhanced mortality in rats, and reduction in lipid peroxidation and NO.

CONCLUSIONIt is proposed that inhibition of ROS and NO by GTP and zinc may prove useful as a selective pharmacological agent in the amelioration of metal toxicity.

Animals ; Antioxidants ; pharmacology ; Biomarkers ; Cisplatin ; administration & dosage ; toxicity ; Flavonoids ; administration & dosage ; pharmacology ; Free Radical Scavengers ; pharmacology ; Lipid Peroxidation ; drug effects ; Metallothionein ; metabolism ; Mortality ; Nickel ; administration & dosage ; toxicity ; Nitric Oxide ; metabolism ; Phenols ; administration & dosage ; pharmacology ; Polyphenols ; Rats ; Tea ; chemistry ; Time Factors ; Zinc ; administration & dosage ; pharmacology

Background: Inflammatory bowel disease (IBD) is a chronic inflammatory immune-mediated condition that affects the gastrointestinal system and alters bone growth and bone mineral density (BMD). Here we aimed to study the prevalence and predictors of a low BMD in pediatric patients with IBD. Methods: This retrospective cross-sectional analytical study included pediatric patients with IBD in whom BMD was evaluated using dual energy X-ray absorptiometry of the total body and lumbar spine. Osteoporosis was defined as a BMD Z-score ≤-2, osteopenia as -2 to -1, and normal as >-1. Clinical and laboratory findings were compared between patients with and without osteoporosis. Results: Of the 48 patients, 30 (62.5%) were males, 35 (72.9%) had Crohn’s disease, and 13 (27.1%) had ulcerative colitis. The mean age at diagnosis was 9.9±2.8 years. The median age at the time of the BMD scans was 11.9 (interquartile range, 9.9–14.3) years. Total body BMD scans identified 13 (27.1%) and 16 (33.3%) patients with osteoporosis and osteopenia, respectively. Spinal BMD scans revealed that 17 (39.5%) and 14 (32.6%) patients had osteoporosis and osteopenia, respectively. A low body mass index (BMI) Z-score (p=0.038), ileocolonic disease location (p=0.008), and a low calcium level (p=0.008) were significant predictors of osteoporosis on the total body BMD scans. A low BMI Z-score (p=0.039), decreased hemoglobin level (p=0.018), low calcium level (p=0.033), and infliximab use (p=0.019) were significant predictors of osteoporosis on the spinal BMD scans. Conclusions This study showed a high prevalence of low BMD among pediatric patients with IBD. A low BMI, ileocolonic disease location, low hemoglobin and calcium levels, and infliximab use were significantly associated with osteoporosis.

Objective: To investigate the antioxidant, antibacterial, and chemical ingredients of Ardisia elliptica (A. elliptica) methanolic extracts. Methods: The plant was extracted using methanol. Antibacterial and antioxidant activ-ities were evaluated. Results: The results showed that both fruit and leaf extract of A. elliptica have significant antibacterial activities against Gram-positive and Gram-negative bacteria. Fruit extracts showed higher content of phenolic (71 ± 0.03 GAE/mg extract dry weight), in com-parison to the leaf extracts (37 ± 0.05 GAE/mg extract dry weight). Flavonoid content, and Fe2+chelating activity of fruit extracts were higher than leaf extract. The percentage radical inhibition of fruit extract is found to be higher (70%) than that of leaf extract (60%). LCMS results indicated that the major compounds in the fruit extract were Gingerol, Aspidin, Kampherol, and Stercuresin, while the leaf extract contained Gingerol, Aspidin, Triangularin, and Salicyl acyl glucuronide. Furthermore, the results of GCMS indicated that fruit extract contained these major compounds:Vitamin E Tocopherol, 5-hepylresornicol, 2-Nonylmalonic acid, 5-pentadecylresornicol, and Stigmasta-7-22-dien-3-ol. However, leaf extract of A. elliptica contained these major compounds: Alpha Amyrenol, 4,4, 6, 6a, 6b, 8, 8a, 9,10, 11,12,12a, 14, 14a, 14b octadehydro-2H-picen-3-one, and Lonasterol, 4-t-Butyl-2-[4-nitrophenyl] phenol. Conclusions: The results provide evidence that fruit and leaf of A. elliptica extracts might indeed be used as a potential source of effective natural antimicrobial and anti-oxidant agents in pharmaceutical and food industries.

Background: The outcomes of patients 50–55 years old or younger undergoing prosthetic shoulder arthroplasty (PSA) may not generalize to younger patients. We report outcomes following PSA in a consecutive series of patients 40 years or younger. We hypothesize that total shoulder arthroplasty (TSA) provides better outcome and durability than resurfacing hemiarthroplasty (RHA). Methods: Patients were stratified by diagnosis and surgical procedure performed, RHA or TSA. Active range of motion and self-assessed outcome were evaluated preoperatively and at final follow-up. Results: Twenty-nine consecutive PSAs were identified in 26 patients, comprising 9 TSAs and 20 RHAs, with a minimum of 2-year follow-up. Twelve PSAs were performed for chondrolysis. Mean active forward elevation, abduction, external rotation, and internal rotation improved significantly (p<0.001 for all). Mean pain score improved from 6.3 to 2.1, Simple Shoulder Test from 4.0 to 9.0, and American Shoulder and Elbow Surgeons score from 38 to 75 (p<0.001 for all). Patients undergoing RHA and TSA had similar outcomes; but three RHAs required revision, two of these within 4 years of implantation. Four of five patients undergoing revision during the study period had an original diagnosis of chondrolysis. Conclusions PSA in young patients provides substantial improvement in active range of motion and patient reported outcomes irrespective of diagnosis and glenoid management. However, patients undergoing RHA, especially for chondrolysis, frequently require subsequent revision surgery, so that RHA should be considered with caution in young patients and only after shared decision-making and counsel on the risk of early revision to TSA.

BACKGROUND/AIMS: Functional gastrointestinal disorders (FGIDs), diagnosed by symptom-based criteria due to lack of biomarkers, need translated-validated questionnaires in different languages. As Bengali, the mother tongue of Bangladesh and eastern India, is the seventh most spoken language in the world, we translated and validated the Enhanced Asian Rome III questionnaire (EAR3Q) in this language. METHODS: The EAR3Q was translated in Bengali as per guideline from the Rome Foundation. The translated questionnaire was validated prospectively on Bengali-speaking healthy subjects (HS, n = 30), and patients with functional dyspepsia (FD, n = 35), irritable bowel syndrome (IBS, n = 40) and functional constipation (FC, n = 12) diagnosed by clinicians using the Rome III criteria. The subjects were asked to fill-in the questionnaire again after 2 weeks, to check for its reproducibility. RESULTS: During translation, the original and the backward translated English versions of the questionnaire demonstrated high concordance. Sensitivity of the Bengali questionnaire to diagnose patients with FD, IBS, FC, and HS was 100%, 100%, 75%, and 100%, respectively, considering diagnosis by the clinicians as the gold standard. On test-retest reliability analysis, Kappa values for FD, IBS, FC, and HS were 1.0, 1.0, 0.83, and 1.0, respectively. The Bengali questionnaire detected considerable overlap of FD symptoms among patients with IBS, IBS among patients with FD, and FD among patients with FC, which were not detected by the clinicians. CONCLUSIONS: We successfully translated and validated the EAR3Q in Bengali. We believe that this translated questionnaire will be useful for clinical evaluation and research on FGIDs in the Bengali-speaking population.
Asian Continental Ancestry Group* ; Bangladesh ; Biomarkers ; Constipation ; Diagnosis* ; Dyspepsia ; Gastrointestinal Diseases* ; Humans ; India ; Irritable Bowel Syndrome ; Mothers ; Prospective Studies ; Tongue

We evaluated the activity of methanolic extracts of Melaleuca cajuputi flowers against the filarial worm Brugia pahangi and its bacterial endosymbiont Wolbachia. Anti-Wolbachia activity was measured in worms and in Aedes albopictus Aa23 cells by PCR, electron microscopy, and other biological assays. In particular, microfilarial release, worm motility, and viability were determined. M. cajuputi flower extracts were found to significantly reduce Wolbachia endosymbionts in Aa23 cells, Wolbachia surface protein, and microfilarial release, as well as the viability and motility of adult worms. Anti-Wolbachia activity was further confirmed by observation of degraded and phagocytized Wolbachia in worms treated with the flower extracts. The data provided in vitro and in vivo evidence that M. cajuputi flower extracts inhibit Wolbachia, an activity that may be exploited as an alternative strategy to treat human lymphatic filariasis.
Adult ; Aedes ; Biological Assay ; Brugia pahangi ; Elephantiasis, Filarial ; Flowers* ; Humans ; In Vitro Techniques ; Melaleuca* ; Methanol* ; Microscopy, Electron ; Polymerase Chain Reaction ; Wolbachia