Introduction: Diagnosis of subungual glomus tumour is mostly based on detailed history and clinical examination. Recently, Magnetic Resonance Imaging (MRI) and Ultrasound have been proposed as the imaging modality to confirm the clinical diagnosis and in planning the surgical management of these tumours. However, these imaging modalities are not routinely available in rural setting and also are expensive. Due to these limitations, we set out to establish that diagnosis and management of these rare tumours can be based solely on a battery of clinical tests and history taking. Materials and Methods: Retrospectively, we reviewed nine cases of glomus tumour. A clinical evaluation proforma was developed on the basis of clinical history and specific clinical test for diagnosis of these tumours. All the cases were evaluated and treated surgically by a single surgeon with a specific technique. Post-operatively, diagnosis was confirmed by histopathological examination. Results: Females (77.78%) were predominantly affected in this series and the tumours commonly occurred in the right hand (66.66%). Spontaneous pain, cold sensitivity test and Love’s Pin test was positive in all cases (100%). Hildreth’s test was positive in 88.89%. In none of the cases the tumours recurred during minimum follow-up of one year. In all cases, histopathological examination confirmed the preoperative diagnosis of glomus tumours. Conclusion: Diagnosis of glomus tumours can be made clinically based on history taking and clinical examination. Magnetic Resonance Imaging and Ultrasound are not necessary for diagnosis and management of typical subungual tumours.

The alkaloid securinine was assessed against spore germination of some plant pathogenic and saprophytic fungi (Alternaria alternata, Alternaria brassicae, Alternaria brassicicola, Curvularia lunata, Curvularia maculans, Curvularia pallenscens, Colletotrichum musae, Colletotrichum sp., Erysiphe pisi, Helminthosporium echinoclova, Helminthosporium spiciferum, Heterosporium sp.). Spore germinations of all the tested fungi were inhibited. Alternaria brassicicola, C. lunata, C. pallenscens and H. spiciferum were highly sensitive as complete inhibition of spore germination was observed at very low concentrations (200 ppm).
Alternaria ; Azepines ; Brassica ; Colletotrichum ; Fungi ; Germination ; Helminthosporium ; Heterocyclic Compounds, Bridged-Ring ; Lactones ; Musa ; Phyllanthus ; Piperidines ; Plants ; Spores

OBJECTIVE: Major depressive disorder (MDD) is projected to be a leading cause of disability globally by 2030. Only a minority of patients remit with antidepressants. If assay of polymorphisms influencing central nervous system (CNS) bioavailability could guide prescribers to more effectively dose patients, remission rates may improve and the burden of disease from MDD reduce. Hepatic and blood brain barrier (BBB) polymorphisms appear to influence antidepressant CNS bioavailability. METHODS: A 12-week prospective double blind randomized genetically guided versus unguided trial of antidepressant dosing in Caucasian adults with MDD (n=148) was conducted. RESULTS: Subjects receiving genetically guided prescribing had a 2.52-fold greater chance of remission (95% confidence interval [CI]=1.71-3.73, z=4.66, p<0.0001). The number needed to genotype (NNG)=3 (95% CI=1.7-3.5) to produce an additional remission. CONCLUSION: These data suggest that a pharmacogenetic dosing report (CNSDose(R)) improves antidepressant efficacy. The effect size was sufficient that translation to clinical care may arise if results are independently replicated.
Adult ; Antidepressive Agents ; Biological Availability ; Blood-Brain Barrier ; Central Nervous System ; Depression* ; Depressive Disorder, Major ; Genotype ; Humans ; Precision Medicine ; Pharmacogenetics ; Prospective Studies

Background & Objectives: Low serum folate level is often reported as an adverse drug sequela of long term phenytoin usage seen with prolonged duration of phenytoin therapy. There is no previous study to prospectively track the serum folate level with usage of phenytoin, which is the objective of this study. Methods: Twenty-fi ve patients between the ages of 18-50 years diagnosed to have epilepsy and planning to start phenytoin were recruited in this study. Assessment of serum folic acid was done by chemiluminiscent method prior to the start of phenytoin and after 6 months of treatment. The serum folate level of 10 age and sex matched healthy control was also taken. Results: The average serum folate level was 7.48 + 2.04 ng/mL prior to the start of phenytoin therapy, which fell to 3.9 + 1.95 ng/mL after 6-month of phenytoin therapy (p-value <0.001). The average serum folate level for the age and sex matched 10 control samples was 14.46 + 2.81 ng/mL. Conclusion: A signifi cant fall of serum folic acid levels is seen in epilepsy patients after 6 months treatment with phenytoin.

Background: The role of oxygen free radicals in the initiation, promotion and progression of carcinogenesis and the protective role of anti-oxidant defenses have been the subject of much speculation in the recent past with confl icting reports in the literature. Objectives: The aim of this study was to measure the concentration/levels of serum total proteins, albumin and advanced oxidation protein products as markers of oxidative stress in sera of patients with an oral pre-cancerous lesion and frank oral cancer. Materials and methods: The study consisted of sera analysis of 30 new patients of histologically proven well-differentiated, oral squamous cell carcinoma and 10 patients, clinically diagnosed with a potentially malignant epithelial lesion, speckled leukoplakia, aged between 40 to 60 years, in addition to 25 healthy controls. One way analyses of variance were used to test the difference between groups. The normality of data was checked before the statistical analysis was performed. Results: The study revealed variations in sera levels of albumin and advanced oxidation protein products to be statistically signifi cant (p < 0.001). Conclusion: The results obtained emphasize the need for more studies with larger sample sizes to be conducted before a conclusive role could be drawn in favour of sera levels of total protein, albumin and advanced oxidation protein products as markers of diagnostic signifi cance and of the transition from the various oral pre-cancerous lesions and conditions into frank oral cancers.

Chaerophylline and berberine hydroxide, both being alkaloids, isolated from Corydalis chaerophylla and C. longipes respectively were assayed against spore germination of some fungi, e.g. Alternaria solani, A. brassicola, A. brassicicola, Helminthosporium penniseti, Helminthosporium sp., Heterosporium sp., Curvularia penniseti, C. maculens and C. palliscens. While chaerophylline inhibited spore germination of most of the fungi at 1000 ppm, being also effective at 50, 100, 200 and 500 ppm, berberine hydroxide was significantly effective at much lower concentration, i.e., 400 ppm against several fungi. This compound was also effective against some fungi at 50, 100, 150, 200 ppm. There was 100% inhibition of spore germination in several fungi at highest concentration of both the compounds. Some of the fungi showed similar results even at lower concentrations.
Alkaloids ; Alternaria ; Berberine* ; Corydalis* ; Fungi ; Germination ; Helminthosporium ; Spores

Introduction: Kratom (Mitragyna speciosa Korth) dependence is a common psychiatric complication associated with regular kratom use in Malaysia. Hence, it is important to assess the severity of kratom dependence among regular kratom users. The Kratom Dependence Scale (KDS) was introduced to evaluate the degree of severity of kratom dependence among users. This study aimed to translate the original English version of the KDS into Malay and examine the psychometric properties of the KDS (Malay) among Malaysian kratom users. Methods: Initially, parallel translation and back translation of the original English version of the KDS was performed. The KDS (Malay) then was administered to 20 active Malaysian kratom users to assess face and content validities in a pilot study. Finally, the final version was administered to 150 active kratom users to evaluate its internal consistency (Cronbach’s α), face and content validities, discriminative validity, and construct validity, i.e. via exploratory factor analysis (EFA). Results: The KDS (Malay) Cronbach’s α of 0.94 exhibited excellent internal consistency. It also demonstrated construct validity, as EFA showed that all items of the KDS (Malay) fit into a single domain, similar to the original English version. Discriminative validity was also demonstrated by the KDS (Malay), as it could differentiate kratom dependent users from non-kratom dependent users. Conclusion: The KDS (Malay) has acceptable psychometric properties and is suitable to assess severity of kratom dependence in Malaysian kratom users.

Disorders of the gut-brain interaction (DGBIs) are presently classified into mutually exclusive anatomical area-related symptom-based categories according to the Rome IV criteria. The pathophysiology of visceral nociception, which contributes to the wide range of symptoms of DGBIs, involves complex psychobiological processes arising from the bidirectional interactions of multiple systems at the gut and brain levels, which affect symptom expression and illness behaviors. The attitude toward an illness and expression of pain and bowel habit vary across cultures with variable interpretation based on sociocultural beliefs, which may not tally with the medical definitions.Thus, psychological factors impact DGBI definitions, their severity and health care utilization. Due to the poor localization and multisegment referral of visceral pain, the anatomical site of pain may not correspond to the affected segment, and there may be a variable degree of overlap among symptoms. The somewhat restrictively defined Rome IV criteria assume one-to-one correlation of symptoms with underlying pathophysiology and ignore overlapping DGBIs, nonstandardized symptom categories, and change or shift in category over time. The microorganic nature of DGBIs resulting from systemic, metabolic or motility disorders, gut dysbiosis and inflammation are not addressed in the Rome IV criteria. Although there is a multidimensional clinical profile that does address these factors, it is not followed rigorously in practice. Threshold changes for diagnostic criteria or addition/deletion of symptoms leads to wide variation among different DGBI criteria resulting in uncertain comparability of results. Although the Rome IV criteria are excellent for research studies and therapeutic trials in homogenous populations, further improvement is needed for their wider applicability in clinical practice.

The effect of methanolic extract of cashewnut (Anacardium occidentale) shell extract was seen on conidial germination of Erysiphe pisi and powdery mildew development in pea (Pisum sativum). Maximum conidial germination inhibition of E. pisi on glass slides was observed at 300 ppm. Similar effect on floated pea leaves was observed after 48 h at the same concentration. Conidial germination on intact untreated pea leaves was also assessed on II and IV nodal leaves while IV and II nodal leaves were treated with the extract and vice versa. There was tremendous reduction in conidial germination on all the nodal leaves. The disease intensity of pea powdery mildew was significantly reduced by methanolic extract of cashewnut shells. Maximum reduction was observed with 200 ppm where 39% disease intensity was recorded in comparison to 96.53% in the control. The phenolic acid content of pea leaves following treatments with this extract varied and no definite pattern was observed. Out of several phenolic compounds, namely, gallic, ferulic, chlorogenic, and cinnamic acids, only gallic acid was found to be present consistently in all the treatments with varied amounts.
Anacardium ; Gallic Acid ; Germination ; Glass ; Hydroxybenzoates ; Methanol ; Peas ; Phenol

Biochemical variability among 20 Indian isolates of Sclerotinia sclerotiorum collected from different hosts/soil samples from different localities in India is reported. High Performance Liquid Chromatographic (HPLC) analysis of ethyl acetate fraction of culture filtrate, mycelia, sclerotia and sclerotial exudate showed 15~23 peaks but only 11 could be identified. They were tannic, gallic, oxalic, caffeic, vanillic, ferulic, O-coumeric, chlorogenic, cinnamic, salicylic and gentisic acids. The amount of phenolic compounds varied among the culture filtrates, mycelia, sclerotia and sclerotial exudates of S. sclerotiorum.
Ascomycota* ; Exudates and Transudates ; India ; Phenol