Objective: To assess the In vivo antioxidFant and hepatoprotective activity of methanolic extract of Daucus carota (D. carota) seeds in experimental animals. Methods: Methanolic extracts of D. carota seeds is used for hepatoprotection assessment. Oxidative stress were induced in rats by thioacetamide 100 mg/kg s.c, in four groups of rats (two test, standard and toxic control). Two test groups received D. carota seeds extract (DCSE) at doses of 200 mg/kg and 400 mg/kg. Standard group received silymarin (25 mg/kg) and toxic control received only thioacetamide. Control group received only vehicle. On the 8th day animals were sacrificed and liver enzyme like serum glutamic pyruvic transaminase (SGPT), serum glutamic-oxaloacetic transaminase (SGOT) and alkaline phosphatase (ALP) were estimated in blood serum and antioxidant enzyme like superoxide dismutase (SOD), catalase (CAT), glutathione reductase (GRD), glutathione peroxidase (GPX), glutathione-S-transferase (GST) and lipid peroxidation (LPO) were estimated in liver homogenate. Results: A significant decrease in SGPT, SGOT and ALP levels was observed in all drug treated groups as compared to thioacetamide group (P < 0.001) and in case of antioxidant enzyme a significant (P < 0.001) increase in SOD, CAT, GRD, GPX and GST was observed in all drug treated groups as compared with thioacetamide group. But in case of LPO a significant (P< 0.001) reduction was observed as compared to toxic control group. Conclusions: DCSE has contributed to the reduction of oxidative stress and the protection of liver in experimental rats.

A highly sensitive, selective, and precise ultra-performance liquid chromatography tandem mass spectrometry method was developed and validated for simultaneous quantification of itraconazole and hydroxy itraconazole in human plasma by a single liquid-liquid extraction step. The precursor to product ion transitions of m/z 705.3/392.3, m/z 721.2/408.3 and m/z 708.2/435.4 were used to detect and quantify itraconazole, hydroxy itraconazole and itraconazole-d3 respectively. The lower limit of quantitation was found to be 0.500 ng/mL for itraconazole and 1.00 ng/mL for hydroxy itraconazole. The mean recoveries for itraconazole and hydroxy itraconazole were found to be 100.045% and 100.021%, respectively. This developed method with a chromatographic run time of 2.0 min was successfully applied to a bioequivalence study of 100 mg itraconazole capsule.

A validated ultra-performance liquid chromatography mass spectrometric method (UPLC-MS/MS) was used for the simultaneous quantitation of candesartan (CN) and hydrochlorothiazide (HCT) in human plasma. The analysis was performed on UPLC-MS/MS system using turbo ion spray interface. Negative ions were measured in multiple reaction monitoring (MRM) mode. The analytes were extracted using a liquid-liquid extraction (LLE) method by using 0.1 mL of plasma volume. The lower limit of quantitation for CN and HCT was 1.00 ng/mL whereas the upper limit of quantitation was 499.15 ng/mL and 601.61 ng/mL for CN and HCT respectively. CN d4 and HCT-13Cd2 were used as the internal standards for CN and HCT respectively. The chromatography was achieved within 2.0 min run time using a C18 Pheno-menex, Gemini NX (100 mm ~ 4.6 mm, 5 mm) column with organic mixture:buffer solution (80:20, v/v) at a flow rate of 0.800 mL/min. The method has been successfully applied to establish the bioequivalence of candesartan cilexetil (CNC) and HCT immediate release tablets with reference product in human subjects.

Objectives: Dhat syndrome is a cultural bound syndrome in which affected individuals have morbid pre-occupation with semen loss in their urine and its impact on the body. Previous studies have explored the symptomatology and perception regarding seminal discharge of such patients while there is lacked of literature on the assessment by quacks and practitioner of alternative and complementary practitioners (ACMP). Therefore, in addition to objectives of previous studies, this study explores the reprehensibility of such practitioners as they may not be giving correct advice to such patients. Methods: For duration of three months, this mixed method study was conducted in Rohilkhand Medical College campus; individuals were approached both in and outside the Psychiatric Outpatient Department using purposive sampling procedure. ICD-10 diagnostic criterion was used to include affected individual in the study sample. Subsequently, a semi-structured questionnaire to document their socio-demographic data and symptomatology was used. Further, previous consultation to quack, ACMPs and allopathic practitioners other than psychiatrist and advice given to the patient by them was obtained via in-depth interview. The quantitative data was analyzed through proportions whereas qualitative data via thematic analysis. Results: There were 38 out of 110 with Dhat syndrome. Invariably, they complained of undue concern regarding debilitating effects of seminal discharge and harmful for the body. A total 21.1% had prior consultation to ACMPs and attributing it to masturbation and hot weather. Surprisingly, allopathic practitioners consulted gave incorrect advices. Conclusion: Dhat syndrome affects individuals irrespective of their social and education background. Sex education among the masses and emphasis for awareness of this syndrome among ACMPs and allopathic practitioners other than psychiatrist is necessary to reduce this cultural bound syndrome.

Background/Aims: Gluten-free diet has an excess of fats and simple sugars and puts patients with celiac disease at risk of metabolic complications including metabolic syndrome and fatty liver. We assessed prevalence of metabolic syndrome and fatty liver in two cohorts of celiac disease. Methods: Study was done in 2 groups. In group 1, 54 treatment naïve patients with celiac disease were recruited. Of them, 44 returned after 1-year of gluten-free diet and were reassessed. In group 2, 130 celiac disease patients on gluten-free diet for ≥1 year were recruited. All patients were assessed for anthropometric and metabolic parameters and fatty liver. Metabolic syndrome was defined as per consensus definition for Asian Indians. Fatty liver was defined as controlled attenuation parameter value >263 decibels by FibroScan. Results: In group 1, of 44 treatment naïve patients with celiac disease, metabolic syndrome was present in 5 patients (11.4%) at baseline and 9 (18.2%) after 1 year of gluten-free diet. Patients having fatty liver increased from 6 patients (14.3%) at baseline to 13 (29.5%) after 1year of gluten-free diet (P=0.002). In group 2, of 130 patients with celiac disease on gluten-free diet for a median duration of 4 years, 30 out of 114 (26.3%) and 30 out of 130 patients (23%) had metabolic syndrome and fatty liver, respectively. Conclusions Patients with celiac disease are at high risk of developing metabolic syndrome and fatty liver, which increases further with gluten-free diet. These patients should be assessed for nutritional and metabolic features and counseled about balanced diet and physical activity regularly.

Purpose: This study aimed to evaluate the knowledge, attitudes, and practices (KAP) of parents or caregivers of children suffering from migraines at a tertiary care center in North India. Methods: We conducted a cross-sectional study involving 100 parents or caregivers, using convenience sampling. A 20-item questionnaire was administered in English and also translated into the local language (Hindi). The study included children with migraines who visited the pediatric outpatient department within a 6-month period (December 2022 to May 2023). Results: Over 60% of caregivers were aware of the chronic nature of the illness, its triggering factors, the role of family history, and the importance of lifestyle modifications. However, only 46% understood the pathophysiology of the illness, and 53% were aware of the medication used for childhood migraines. More than 85% of caregivers believed that recurrent headaches necessitate a doctor’s consultation, may require regular visits for optimal treatment, and were willing to alter their child’s lifestyle to prevent headaches. However, a significant percentage of caregivers (47%) practised self-medication for their children’s headaches. Most caregivers believed that lifestyle modifications and avoiding triggers were the best treatments for migraines. There were significant associations (P<0.05) between the level of education and responses to questions related to migraine definition, prophylaxis, treatment, investigations, lifestyle modifications, and screen time. Conclusion Most participants were well-educated on migraine, and their KAP regarding migraine prevention and treatment were generally adequate. However, the practice of self-medication without professional guidance is a significant concern.

STUDY DESIGN: Prospective study. PURPOSE: To establish the significance of cerebrospinal fluid (CSF) nitric oxide metabolite (NOx) concentration in acute spinal cord injury (SCI) patients to assess the neurological severity and prognosis. OVERVIEW OF LITERATURE: Quantitative analysis of specific biomarkers in CSF will assess neurological severity more accurately and permit the formulation of a more precise management plan. METHODS: Forty SCI patients represented the cases and 20 lower limb injury patients were the controls. NOx concentration in CSF was measured at week 1, 2, and 4 by Griess method. Magnetic resonance imaging (MRI, T2-weighted) done in each case to measure cord edema and neurological severity was assessed using the Frankel classification. RESULTS: CSF NOx concentration peaked at week 2 and declined to normal by week 4. The concentration remained normal in controls. Mean NOx concentration was directly proportional to the severity of acute SCI as correlated with cord edema seen in MRI and neurological severity assessed. CONCLUSIONS: CSF NOx concentration can be considered a specific quantitative biomarker in acute stage of SCI to predict the severity and prognosis of SCI patients.
Biomarkers ; Cerebrospinal Fluid* ; Classification ; Edema ; Humans ; Lower Extremity ; Magnetic Resonance Imaging ; Methods ; Nitric Oxide* ; Prognosis ; Prospective Studies ; Spinal Cord Injuries

BACKGROUND/AIMS: Pyomyositis is an infective condition with primary involvement of the skeletal muscles. There is sparse recent literature on patients with pyomyositis. METHODS: This study was carried out at emergency services of a tertiary care center located in subtropical area of Indian subcontinent. RESULTS: Sixty-two patients of primary pyomyositis formed the study cohort. Mean age of occurrence was 29.9 ± 14.8 years. There were 54 men. Twelve patients had underlying medical diseases. Muscle pain was seen in all 62 patients. Forty-eight patients (77.4%) had the fever. Most common site of involvement was thigh muscles (n = 29, 46.8%). Forty-nine patients (79%) presented in the suppurative stage of illness. Patients with comorbidities were older (age: median 36 years [interquartile range (IQR), 25 to 47] vs. 24 years [IQR, 16 to 35], p = 0.024), had higher culture positivity with gram-negative organisms (8/9 [88.89%] vs. 6/29 [20.69%], p = 0.001). Importantly, higher number of these patients received inappropriate antibiotics initially. Patients with positive pus culture result had higher complication rate (32/38 [84.21%] vs. 10/18 [55.56%], p = 0.044). Six patients (9.7%) had in-hospital mortality. Lower first-day serum albumin, initial inappropriate antibiotic therapy, and advanced form of the disease at presentation were associated with increased in-hospital mortality. CONCLUSIONS: Primary pyomyositis is not an uncommon disease entity. Patients with comorbidities were more likely to receive initial inappropriate antibiotic therapy. Patients with positive pus culture report had the higher rate of complications. Lower first-day serum albumin, initial inappropriate antibiotic therapy and advanced form of the disease at presentation were associated with increased in-hospital mortality.
Anti-Bacterial Agents ; Cohort Studies ; Comorbidity ; Emergencies ; Fever ; Hospital Mortality ; Humans ; India* ; Male ; Muscle, Skeletal ; Muscles ; Myalgia ; Outcome Assessment (Health Care)* ; Pyomyositis* ; Serum Albumin ; Suppuration ; Tertiary Care Centers ; Thigh

Gastrointestinal mucormycosis is a rare disease with a significant mortality rate, even when promptly diagnosed and treated. An unusual complication was observed in India during the second wave of coronavirus disease 2019 (COVID-19). Two incidences of gastric mucormycosis were found. A 53-year-old male patient with a history of COVID-19 one month earlier came into the intensive care unit. After admission, the patient developed hematemesis, which was initially treated with blood transfusions and digital subtraction angiography embolization. Esophagogastroduodenoscopy (EGD) revealed a large ulcer with a clot in the stomach. During an exploratory laparotomy, the proximal stomach was necrotic. Histopathological examination confirmed mucormycosis. The patient was started on antifungals, but despite rigorous therapy, the patient died on the tenth postoperative day. Another patient, an 82-year-old male with a history of COVID-19, arrived with hematemesis two weeks earlier and was treated conservatively. EGD revealed a large white-based ulcer with abundant slough along the larger curvature of the body. Mucormycosis was verified by biopsy.He was treated with amphotericin B and isavuconazole. He was discharged after two weeks in a stable condition. Despite quick detection and aggressive treatment, the prognosis is poor. In the second case, prompt diagnosis and treatment saved the patient’s life.

Objective:The aim of present study is to identify the breast cancer screening barriers among the women with breast cancer of Malwa region of Punjab,India.The study was conducted at three government hospitals representing almost all districts of Malwa region.Methods:The quantitative research design was followed using empirical research methods.Study was carried out by one-to-one interview by the field investigator and research assistant.Total of 363 breast cancer patient has been interviewed through the scheduled questionnaire and results has been recorded for further analysis.In this study,five barriers are described namely as personal barriers,socio-cultural barriers,economic barriers,health-system barriers,and treatment barriers which contains various questions regarding barriers to breast cancer screening.Univariate analysis methods have been used for the analysis to access the socio-demographic profile of women.Data has been obtained with the help of 5-point liker scale.Binary logistic model was chosen.Results:Majority of participants were in the age groups 50-＜60 years(38.6％,140/363)and≥60 years(31.1％,112/363).Majority of these women(47.4％,171/363)were illiterate and most of them were housewives.The major barriers to breast cancer screening faced by most of the women were having no knowledge about screening services(90.9％,329/363),the importance of early diagnosis(90.9％,329/363),different screening methods(95.5％,347/363)and place of availing screening services(91.2％,330/363)misguided belief in God and fate(81.5％,295/363)and preferring duties than taking care of health(70.2％,254/363).Education qualification(odds ratio[OR]0.74,β'=-0.309,t=-5.357,P=0.000)and socioeconomic class(OR 1.43,β'=0.354,t=3.399,P=0.001)were found to be significant determinant of the barriers among women.Conclusion:The survey was conducted in the women between the age 40-60 years and as an outcome,the unawareness about screening services,fatalistic attitude,fear of being diagnosed with the cancer,low per capita income was found out significant factors that restricted the women for early check-up for the breast cancer.