1.In vivo anti-inflamatory potential of various extracts of Sida tiagii Bhandari
Asian Pacific Journal of Tropical Biomedicine 2012;(z2):947-952
Objective: The present study is an attempt to explore the anti-inflammatory activity of n-Hexane extract (HS), Ethyl acetate extract (EAS) and Residual ethanolic extract (RES) of fruits of Sida tiagii Bhandari by using carrageenan and egg-albumin induced paw edema, xylene induced ear edema and cotton wool granuloma animal models. Methods: The biochemical markers like or lysosomal enzymes viz. serum glutamic oxaloacetic transaminase (SGOT), serum glutamic pyruvic transaminase (SGPT) and alkaline phosphatase (ALP) were also found out in blood serum. Results:There was decrease in edema volume in EAS and RES administered animals in carrageenan and egg-albumin induced edema models. The percentage inhibition of inflammation in EAS (34.15%) and RES (39.66%) was found comparable with that of the standard drug, diclophenac sodium (46.69%). The two extracts EAS and RES was found to have good anti-inflammatory activity as compared to standard drug. Conclusions: Thus the plant can be used as a potential anti-inflammatory candidate in animals.
2.Tenofovir-induced nephrotoxicity: A retrospective cohort study
The Medical Journal of Malaysia 2016;71(6):308-312
Background: Tenofovir (TDF) has been associated with renal
function deterioration, but local data regarding the incidence
and risk factors for this adverse event were lacking.
Objectives: To determine the incidence of nephrotoxicity in
HIV-infected patients on tenofovir-based regimens and to
evaluate risk factors involved in tenofovir-associated renal
function decline.
Methods: This is a single-centre retrospective cohort study
of 440 HIV-infected adults who were started on tenofovirbased
antiretroviral regimens. Data were extracted from
electronic medical and pharmacy records.
Results: A decline in eGFR of 25% or more was seen in 67
patients (15.2%) with an estimated incidence rate of 12 per
100 person-years. Among all 440 subjects, 22 discontinued
TDF-based therapy due to renal complication. From
multivariate analysis, the odds of developing >25% decrease
in eGFR with tenofovir-containing regimen was three times
higher for patients with baseline moderate renal impairment
(HR 3.19; 95% CI, 1.43-7.12; p=0.005) and 14 times higher for
patients with baseline severe renal impairment (HR 14.2;
95% CI, 11.20-170.7; p=0.036) as compared to those without
pre-existing renal insufficiency. Age above 50 years and CD4
cell count of less than 50 were significantly associated with
>25% decrement in eGFR.
Conclusion: The incidence rate of tenofovir-related renal
dysfunction was found to be 12 per 100 person-years. Preexisting
renal impairment, age 50 and above, and CD4 cell
count below 50 as were predictors for renal function decline.
Given that the use of tenofovir is escalating in Malaysia,
increased awareness about this adverse event is essential.
3.6-gingerol, an active ingredient of ginger, protects acetaminophen-induced hepatotoxicity in mice.
Sabina, Evan Prince ; Pragasam, Samuel Joshua ; Kumar, Suresh ; Rasool, Mahaboobkhan
Journal of Integrative Medicine 2011;9(11):1264-9
To investigate the hepatoprotective efficacy of 6-gingerol against acetaminophen-induced hepatotoxicity in mice.
4.Cockayne‟s Syndrome: a case report.
Raghavendra MN ; Pai A ; Suresh KV ; Ronad YAA ; Mounesh Kumar CD.
Pacific Journal of Medical Sciences 2012;10(1):42-46
Cockayne's syndrome (CS) is a rare, autosomal recessive disease resembling progeria. The features of CS do not appear until 4 to 5 years of age. Most patient presents with cachectic dwarfism, cutaneous photosensitivity, loss of adipose tissue, mental retardation, skeletal and neurological abnormalities, similar to the current case. The additional feature observed in the present case was actinic chelitis. We report a case of Cockayne‟s syndrome with pronounced oral manifestations and an unusual feature of actinic chelitis.
5.Prospects to the formation and control of potential dimer impurity E of pantoprazole sodium sesquihydrate
Awasthi Kumar ARUN ; Kumar LALIT ; Tripathi PUNIT ; Golla MADHAVA ; Reddy Suresh CIRANDUR ; Kumar PRAMOD
Journal of Pharmaceutical Analysis 2019;9(3):170-177
Pantoprazole sodium, a substituted benzimidazole derivative, is an irreversible proton pump inhibitor which is primarily used for the treatment of duodenal ulcers, gastric ulcers, and gastroesophageal reflux disease (GERD). The monographs of European Pharmacopoeia (Ph. Eur.) and United States Pharmaco-poeia (USP) specify six impurities, viz.; impurities A, B, C, D, E and F, respectively for its active phar-maceutical ingredient (API). The identification and synthesis of all impurities except impurity E are well described in the literature; however, there is no report related to impurity E. The prospects to the for-mation and controlling of impurity E up to ≤0.03% in the synthesis of pantoprazole sodium sesquihydrate (PAN) were discussed in detail for the first time. The present work described the journey towards the successful development of an optimal preparation procedure of dimer impurity E. The most plausible mechanism involved in the formation of impurity E has been proposed.
6.Effect of preoperative incentive spirometry on fentanyl-induced cough: a prospective, randomized, controlled study.
Vipin Kumar GOYAL ; Suresh Kumar BHARGAVA ; Birbal BAJ
Korean Journal of Anesthesiology 2017;70(5):550-554
BACKGROUND: Fentanyl-induced cough (FIC) has a reported incidence of 13–65% on induction of anesthesia. Incentive spirometry (IS) creates forceful inspiration, while stretching pulmonary receptors. We postulated that spirometry just before the fentanyl (F) bolus would decrease the incidence and severity of FIC. METHODS: This study enrolled 200 patients aged 18–60 years and with American Society of Anesthesiologists status I or II. The patients were allocated to two groups of 100 patients each depending on whether they received preoperative incentive spirometry before fentanyl administration. Patients in the F+IS group performed incentive spirometry 10 times just before an intravenous bolus of 3 µg/kg fentanyl in the operating room. The onset time and number of coughs after fentanyl injection were recorded as primary outcomes. Any significant changes in blood pressure, heart rate, or adverse effects of the drug were recorded as secondary outcomes. RESULTS: Patients in the F+IS group had a significantly lower incidence of FIC than in the F group (6% vs. 26%) (P < 0.05). The severity of cough in the F+IS group was also significantly lower than that in group F (mild, 5 vs. 17; moderate 1 vs. 7; severe, 0 vs. 2) (P < 0.05). The median onset time was comparable in both groups (9 s [range: 6–12 s] in both groups). CONCLUSIONS: Preoperative incentive spirometry significantly reduces the incidence and severity of FIC when performed just before fentanyl administration.
Anesthesia
;
Blood Pressure
;
Cough*
;
Fentanyl
;
Heart Rate
;
Humans
;
Incidence
;
Motivation*
;
Operating Rooms
;
Prospective Studies*
;
Spirometry*
7.Citrobacter Koseri Bacteraemia Complicated by Paraspinal Abscess and Spondylodiscitis - A Case Report
Nor Hayati Shaharuddin ; Chee Loon Leong ; Suresh Kumar Chidambaram ; Christopher Lee
The Medical Journal of Malaysia 2012;67(3):337-339
Paraspinal abscess and spondylodiscitis due to Citrobacter
koseri is a very rare condition. We report a remarkable case of Citrobacter koseri bacteraemia complicated by paraspinal abscess and spondylodiscitis in a patient who has successfully been treated in our hospital. Our patient
demonstrates one of the common challenges in the practice
of infectious disease medicine, wherein an innocuous
presentation may and often underlie a serious infection. This case report elucidates to us that the diagnosis of a paraspinal abscess and spondylodiscitis requires a high index of suspicion in at risk patient presenting with compatible signs and symptoms.
8.Frequency and molecular epidemiology of Panton-Valentine leukocidin gene in Staphylococcus aureus colonising HIV-infected patients
Zaini Mohd-Zain ; Siti Farah Alwani Mohd-Nawi ; Ariza Adnan ; Suresh Kumar
The Malaysian Journal of Pathology 2017;39(2):115-122
Background: HIV-infected patients pose a high risk of contracting skin and soft tissue infections
caused by Staphylococcus aureus. Those who are colonized with methicillin-resistant S. aureus
(MRSA) that carry Panton-Valentine leukocidin (PVL) are predisposed to severe infections that
could lead to necrotic skin infections. However the association of S. aureus specifically methicillin
sensitive S. aureus carrying PVL gene in HIV patients has not been widely reported. Here, we
study the prevalence and the molecular epidemiology of PVL-producing S. aureus in HIV-infected
patients. Methods: Swabs from four body sites of 129 HIV-infected patients were cultured for
S. aureus and identified by standard microbiological procedures. The isolates were subjected to
antimicrobial susceptibility testing by disk diffusion against penicillin, erythromycin, clindamycin,
and cotrimoxazole. PCR was used to detect the PVL gene and genetic relationship between the
isolates was determined by using pulse field gel electrophoresis. Results: A total of 51 isolates of
S. aureus were obtained from 40 (31%) of the patients. The majority (43.1%) of the isolates were
obtained from the anterior nares. Thirteen (25.5%) of all the isolates were resistant to more than
one category of antibiotics, with one isolate identified as MRSA. Thirty-eight (74.5%) isolates
(including the MRSA isolate) carried PVL gene where the majority (44.7%) of these isolates were
from the anterior nares. A dendogram revealed that the isolates were genetically diverse with 37
distinct pulsotypes clustered in 11 groups. Conclusion: S. aureus obtained from multiple sites of
the HIV patients were genetically diverse without any clonality observed.
9.Anti cataract potential of phyllanthus niruri in galactose induced cataractogenesis of rat
Suresh Kumar GUPTA ; Vivekanandhan KALAISELVAN ; Ashish SHARMA ; Sushma SRIVASTAVA ; Shyam Sunder AGRAWAL
International Eye Science 2009;9(6):1011-1015
AIM: To evaluate anti cataract effect of phyllanthus niruri (PN) both in vitro and in vivo galactose induced cataract.METHODS: Aqueous extract of PN was evaluated against galactose-induced cataract both in vitro and in vivo. Galactosaemic cataract was induced in rats by feeding 300g/L galactose diet. PN was administered orally at three-dose levels 75, 150 and 300 mg/kg of body weight. Rat lenses were subjected to osmotic stress in vitro by incorporating galactose (30mmol/L) in the culture medium. The effect of PN (720 and 880μg/mL) on the glutathione (GSH) and polyols levels was studied.RESULTS: PN significantly delayed the onset and progression of cataract in vivo. In addition to the delay in reaching various stages of development of cataract, stage IV did not develop with lower doses till the completion of experimental period. Lenses treated with PN 880μg/mL concentration showed higher levels of GSH and decreased levels of polyols in vitro. In vivo, 75mg/kg significantly delayed the onset and progression of cataract as compared to control.CONCLUSION: PN delayed the process of cataracto-genesis in the experimental models. However, further study is required to extrapolate the use in human beings for the prevention of cataract.
10.Attenuation of Hydrogen Peroxide and Ferric Reducing/Antioxidant Power Serum Levels in Colorectal Cancer Patients with Intestinal Parasitic Infection
Chandramathi Samudi ; Suresh Kumar Govind ; Anita Zarina Bustam ; Umah Rani Kuppusamy
Malaysian Journal of Medical Sciences 2009;16(2):15-20
Background: This study assessed several common oxidative indices in subjects infected with
intestinal parasites, as well as in colorectal cancer (CRC) patients both with and without intestinal
parasites.
Method: Serum levels of malondialdehyde (MDA), ferric reducing/antioxidant power (FRAP),
and hydrogen peroxide (H2O2) were measured, as were plasma levels of advanced oxidation protein
products (AOPP), all according to established methods. The presence of intestinal parasites was
confirmed by stool examination.
Results: All intestinal parasiteinfected subjects and CRC patients showed the presence of
oxidative stress. Thirtysix percent of the CRC patients had intestinal parasitic infections. The levels of
H2O2 and FRAP in parasite-infected subjects were significantly higher than in CRC patients, but these
levels were significantly lower in the CRC patients with parasitic infections.
Conclusion: Parasitic infection and CRC may contribute to oxidative stress independently, but
when present together, the oxidative stress burden imposed by parasites may be attenuated.