The use of medicinal plants to cure human illness has been practiced from time immemorial. Nowadays, the vast majority of people still rely on their traditional materia medica for their daily health care needs. The use of plant species for treatment of various human ailments has been mentioned in Ayurveda and other Indian literature. Some of these drugs are believed to enhance the natural resistance of body to infection. So there are many plants having immunostimulatory activity. This paper reviews plants which have shown reported immunostimulatory activity.

Holoptelea integrifolia Roxb. (Indian Elm) is a very useful and popular traditional medicinal plant in India. During the last three decades, apart from the chemistry of plant compounds, considerable progress regarding the biological activity and medicinal applications of Indian Elm has been achieved. Ethno-medically, the leaves and stem bark of this plant have been used by tribes as antiviral, antioxidant, antimicrobial, abortifacient preparations and in the management of cancer. Recent studies on plant show that it has potential to fight against tumor and obesity as well. Phytochemical investigation shows the presence of chemical constituents such as terpenoids, alkaloids, glycosides, carbohydrates, steroids, sterols, saponins, tannins, proteins and flavanoids. The isolated principles such as β-amyrin, β-sitosterol, holoptelin-A, holoptelin-B, hederagenin, hexacosanol, β-D-glucose, friedelin, epifriedelin, 2-amino naphthoquinone, 1,4-naphthalenedione, are considered as responsible for various activities. This review highlights the traditional uses, reported biological/pharmacological activities, isolated compounds and therapeutic applications of Holoptelea integrifolia which might be helpful for scientists and researchers to find out new chemical entities responsible for its claimed traditional uses.

Open anterior dislocation of the hip is a very rare injury, especially in adults. It is a hyperabduction, external rotation and extension injury. Its combination with open posterior dislocation of the elbow has not been described in English language-based medical literature. Primary resuscitation, debridement, urgent reduction of dislocation, and adequate antibiotic support resulted in good clinical outcome in our patient. At 18 months follow-up, no signs of avascular necrosis of the femoral head or infection were observed.
Accidents, Traffic ; Elbow Joint ; injuries ; Hip Dislocation ; complications ; pathology ; Humans ; Joint Dislocations ; complications ; Male ; Soft Tissue Injuries ; complications ; Young Adult

Double tooth is a dental anomaly consequent to fusion of two or more teeth or gemination of a single tooth. This report describes a unique case of double tooth in relation to a mandibular lateral incisor exhibiting the presence of four root canals. The role of conventional radiography and advanced three-dimensional imaging techniques in the better assessment of complex root canal systems and their aid in endodontic management has also been highlighted.
Dental Pulp Cavity ; Fused Teeth ; Imaging, Three-Dimensional ; Incisor ; Multidetector Computed Tomography ; Tooth ; Tooth Abnormalities ; Tooth, Supernumerary

OBJECTIVETo present a detailed pharmacognostic study of the leaf of Cayratia trifolia (C. trifolia) Linn. (Vitaceae), an important plant in the Indian system of medicine.

METHODSThe macroscopy, microscopy, physiochemical analysis, preliminary testing, fluorescence analysis of powder of the plant and other WHO recommended methods for standardization were investigated.

RESULTSLeaves are trifoliolated with petioles (2-3 cm) long. Leaflets are ovate to oblong-ovate, (2-8 cm) long, (1.5-5 cm) wide, pointed at the tip. The leaf surface shows the anisocytic type stomata covered with guard cells followed by epidermis layer. Leaf surface contents including veins, vein islet and vein termination were also determined. Transverse section of leaf shows the epidermis layer followed by cuticle layer and vascular bandles (xylem and phloem). The mesophyll is differentiated into palisade and spongy parenchyma. Abundant covering trichomes emerge from the upper epidermis. Trichomes are uniseriate and multicellular. Strips of collenchyma are present below and upper layer of epidermis.

CONCLUSIONSIt can be concluded that the pharmacognostic profile of the C. trifolia is helpful in developing standards for quality, purity and sample identification.

Fall from height is a common cause of unintentional injuries in children and accounts for 6% of all trauma-related childhood deaths, usually from head injury. We report a case of a 2-year-old child with multiple fractures of the bilateral lower limbs due to this reason. A child fell from a height of around 15 feet after toppling from a balcony. He developed multiple fractures involving the right femoral shaft, right distal femoral epiphysis (Salter Harris type 2), right distal metaphysis of the tibia and fibula, and undisplaced Salter Harris type 2 epiphyseal injury of the left distal tibia. There were no head, abdominal or spinal injuries. The patient was taken into emergency operation theatre after initial management which consisted of intravenous fluids, blood transfusion, and splintage of both lower limbs. Fracture of the femoral shaft was treated by closed reduction and fixation using two titanium elastic nails. Distal femoral physeal injury required open reduction and fixation with K wires. Distal tibia fractures were closely reduced and managed nonoperatively in both the lower limbs. All the fractures united in four weeks. At the last follow-up, the child had no disability and was able to perform daily activities comfortably. We also proposed the unique mechanism of injury in this report.
Accidental Falls ; Femoral Fractures ; therapy ; Fibula ; injuries ; Fracture Fixation ; methods ; Humans ; Infant ; Male ; Multiple Trauma ; Tibial Fractures ; therapy

Intracranial epidermoid cysts are relatively rare congenital inclusion cysts. They are the third most common cerebellopontine angle cistern mass after vestibular schwannoma and meningioma. White epidermoid is a rare variant. We present the first case, to our knowledge, of a white epidermoid cyst anterior to the pontomedullary junction, emphasising its imaging appearance, location and the importance of pre-operative diagnosis, which may reduce operative complications.
Adolescent ; Cerebellar Diseases ; complications ; diagnosis ; Cerebellopontine Angle ; diagnostic imaging ; Epidermal Cyst ; complications ; diagnosis ; Humans ; Male ; Tinnitus ; etiology ; Tomography, X-Ray Computed

BACKGROUND: Street vendors spend relatively more time near roadways and are vulnerable to air pollution related health disorders. However, there is limited information on the quality of the air they breathe. The objectives of this present study were to calculate the mass concentration of atmospheric particulate matter (PM) in eight size fractions (PM0.4–0.7, PM0.7–1.1, PM1.1–2.1, PM2.1–3.3, PM3.3–4.7, PM4.7–5.8, PM5.8–9.0, and PM9.0-–0µm) at commercial (CML) and residential site (RSL) in Dehradun city from November 2015 to May 2016. To estimate the corresponding respiratory deposition dose (RDDs) in alveolar (AL), tracheobronchial (TB), and head airway (HD) region on street vendors working at CML and RSL. To find the association of atmospheric PM with RDDs and the incidence of respiratory related disorders among street vendors. METHODS: Andersen cascade impactor was employed for calculating the PM mass concentration. Questionnaire based health survey among street vendors were carried out through personal interview. RESULTS: A significant difference (p < 0.05; t-test) between the mean PM0.4–10µm mass concentration at CML and RSL was observed with (mean±SD) 84.05±14.5 and 77.23±11.7 µgm−3, respectively. RDDs in AL, TB and HD region at CML was observed to be 9.9, 7.8, and 7.3% higher than at RSL, respectively. Health survey revealed 1.62, 0.96, 0.04, and 0.57 times higher incidence of cold, cough, breathlessness, and chest pain, respectively with street vendors at CML compared to RSL. CONCLUSION: The site characteristics plays a major role in the respiratory health status of street vendors at Dehradun.
Air Pollution ; Chest Pain ; Commerce ; Cough ; Dyspnea ; Head ; Health Surveys ; Humans ; Incidence ; Particulate Matter

Objective: To develop and characterize multiple-unit-type oral floating microsphere of famotidine to prolong gastric residence time and to target stomach ulcer. Methods: The floating microspheres were prepared by modified solvent evaporation method. Eudragit S-100 was used as polymer. Microspheres were characterized for the micromeritic properties, floating behavior, entrapment efficiency and scanning electron microscopy. The in-vitro release studies and floating behavior were studied in simulated gastric fluid at pH 1.2. Different drug release kinetics models were also applied for all the batches. Selected formulations were also subjected for X-ray radiographic study. Results: Floating microspheres were successfully prepared by modified solvent evaporation technique. Microspheres showed passable flow properties. The maximum yield of microspheres was up to (95.11±0.35)%. On the basis of optical microscopy particle size range was found to be ranging from (52.18±182.00) to (91.64±5.16) μm. Scanning electron microscopy showed their spherical size, perforated smooth surface and a cavity inside microspheres. Microspheres were capable to float up to 20 h in simulated gastric fluid. X-ray radiographic studies also proved its better retention in the stomach. Conclusions: On the basis of the results, such dosage forms may be a good candidate for stomach targeting and may be dispensed in hard gelatin capsules.

Objective: The stress response following traumatic brain injury (TBI) is a preventable cause of secondary brain injury. This can be prevented using sedation in the intensive care unit (ICU). To date, the choice of sedative agent for preventing stress response is not well-studied in literature. Methods: This prospective randomized controlled trial included 60 patients with severe TBI admitted to ICU. The patients were randomized into 2 study groups according to the choice of sedation: propofol (group I) and midazolam infusion (group II). The serum cortisol was measured as the primary outcome at admission to ICU and 48 hours following sedation infusion. The baseline Glasgow coma scale, hemodynamic, optic nerve sheath diameter (ONSD), and computed tomography scan findings were noted at admission. Glasgow outcome scale (GOS) was measured as a neurological outcome at discharge from ICU. Results: There was a statistically significant reduction in serum cortisol level in both the study groups (Δ cortisol, p-value=134.91 (50.5,208.2), 0.00 and 118.8 (42.6,160.4), 0.00, in group I and II, respectively). Serum cortisol levels were comparable among both groups at baseline and 48 hours. Similarly, there was a statistically significant difference in ONSD in both groups, but there was no difference in ONSD value between the groups at 48 hours. The GOS was also similar in both groups at discharge from ICU. Conclusion The study demonstrated a similar reduction in serum cortisol levels following 48 hours of propofol or midazolam infusion in patients with severe TBI.