In this case report, a middle aged lady presenting with persistent vomiting of 12 years duration, not responding to conventional management and showing dramatic response to combinations of low dose Imipramine and Trifluperazine is discussed. Method: In our case, a middle aged lady presenting with chronic, recurrent episodes of severe vomiting for approximately 12 years with poor treatment outcome was evaluated and treated with low dose imipramine and Trifluperazine, which was found to be highly effective. Results: Low dose Trifluperazine and imipramine is effective in the treatment of cyclic vomiting syndrome. Conclusion: Cyclic Vomiting Syndrome is often missed and appropriate psychiatric intervention gives a better outcome.

Objectives: Executive function is an important cognitive function affected in many psychiatric disorders but limited data is available regarding its course in patients recovered from acute and transient psychotic disorder. The aim of this study was to assess the executive function of recovered patients of acute and transient psychotic disorder and to evaluate different factors affecting the executive function of patients recovered from acute and transient psychotic disorder. Method: This was a non-invasive, one point, comparative study where the executive function was assessed after clinical recovery from acute and transient psychotic disorder. The patients were divided into two groups (poor and fair) on the basis of their executive performance. Retrograde analyses of different factors affecting executive performance were carried out. Results: A total of 28 patients had undergone assessment on Wisconsin Card Sorting Test (WCST) out of which 13 patients had poor and 15 patients had fair executive performance. The fair executive performance group had shorter duration of psychosis, male preponderance and more years of education. Conclusion: Average duration of psychosis seems to be a reliable predictor of better or poor executive functioning.

One unknown impurity(Imp-II)during the analysis of laboratory batches of isoproterenol hydrochloride was detected in the level ranging from 0.04% to 0.12% by high performance liquid chromatography with UV detection. The unknown impurity structure was proposed as 4-[2-(propan-2-ylamino)ethyl]benzene-1,2-diol (Imp-Ⅱ)using the liquid chromatography–mass spectrophotometry(LC–MS)analysis.Imp-Ⅱ was isolated by semi-preparative liquid chromatography from the impurity-enriched reaction crude sample. Its proposed structure was confirmed by nuclear magnetic spectroscopy such as 1H, 13C,DEPT(1D NMR),HSQC(2D NMR) and infrared spectroscopy(IR),and retention time and purity with HPLC followed by the chemical synthesis. Due to less removable nature of Imp-II during the purification,the synthetic process was optimized proficiently to control the formation of Imp-II below to the limit<0.12% in the course of reaction.The new chemical route was developed for the preparation of this impurity in required quantity with purity to use as reference standard. The most probable mechanism for the formation of Imp-II was discussed in details.

Metastatic carcinoma is the most common malignancy of the bone. Metastases to the upper limbs of the skeleton are extremely uncommon, with only 10–15% occurring in this region. Metastases to the hand and wrist comprise about 0.15% of all hand tumours, and only 0.1% of all metastases. Carpal bone metastases are much rarer than those to the metacarpal and phalangeal bones. They usually masquerade as more common hand pathology such as arthritis or osteomyelitis. Given the bleak prognosis of carpal metastatic disease in lung cancer, treatment of a metastasis to the hand is usually palliative. Contrary to earlier beliefs, palliative radiotherapy plays a significant role in pain relief and improving hand mobility in patients diagnosed with metastatic disease of the hand. We report a case of adenocarcinoma of the lung with metastases to the capitate bone of the carpus treated with palliative radiotherapy.

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.

Treatable ataxias are a group of ataxic disorders with specific treatments. These disorders include genetic and metabolic disorders, immune-mediated ataxic disorders, and ataxic disorders associated with infectious and parainfectious etiology, vascular causes, toxins and chemicals, and endocrinopathies. This review provides a comprehensive overview of different treatable ataxias. The major metabolic and genetic treatable ataxic disorders include ataxia with vitamin E deficiency, abetalipoproteinemia, cerebrotendinous xanthomatosis, Niemann-Pick disease type C, autosomal recessive cerebellar ataxia due to coenzyme Q10 deficiency, glucose transporter type 1 deficiency, and episodic ataxia type 2. The treatment of these disorders includes the replacement of deficient cofactors and vitamins, dietary modifications, and other specific treatments. Treatable ataxias with immune-mediated etiologies include gluten ataxia, anti-glutamic acid decarboxylase antibody-associated ataxia, steroid-responsive encephalopathy associated with autoimmune thyroiditis, Miller-Fisher syndrome, multiple sclerosis, and paraneoplastic cerebellar degeneration. Although dietary modification with a gluten-free diet is adequate in gluten ataxia, other autoimmune ataxias are managed by short-course steroids, plasma exchange, or immunomodulation. For autoimmune ataxias secondary to malignancy, treatment of tumor can reduce ataxic symptoms. Chronic alcohol consumption, antiepileptics, anticancer drugs, exposure to insecticides, heavy metals, and recreational drugs are potentially avoidable and treatable causes of ataxia. Infective and parainfectious causes of cerebellar ataxias include acute cerebellitis, postinfectious ataxia, Whipple’s disease, meningoencephalitis, and progressive multifocal leukoencephalopathy. These disorders are treated with steroids and antibiotics. Recognizing treatable disorders is of paramount importance when dealing with ataxias given that early treatment can prevent permanent neurological sequelae.

AIMTo evaluate the possible antifertility activity of Sarcostemma acidum (Roxb) Voigt. stem extract in male rats.

METHODMale rats were given 70% methanol extract of S. acidum stem orally at dose levels of 50 and 100 mg/kg/day for 60 days. Fertility was evaluated with mating test. Sperm motility and sperm density in cauda epididymides were also assessed. Biochemical and histological analyses were performed on blood samples and on the reproductive organs.

RESULTSS. acidum stem extract resulted in an arrest of spermatogenesis without any systemic side effect. Sperm motility as well as sperm density was reduced significantly. Treatment caused a 80% reduction in fertility at the 50 mg dose and complete suppression of fertility at the 100 mg dose. There was no significant change in RBC and WBC count, hemoglobin, haematocrit, sugar and urea in the whole blood and cholesterol, protein and phospholipid in the serum. The protein and glycogen content of the testes, fructose in the seminal vesicle and protein in epididymides were significantly decreased. Cholesterol in the testes was elevated. Treatment at both of the doses caused a marked reduction in the number of primary spermatocytes (preleptotene and pachytene), secondary spermatocytes and spermatids. The number of mature Leydig cells was decreased, and degenerating Leydig cells was increased proportionately.

CONCLUSIONS. acidum stem extract arrests spermatogenesis in male rats without noticable side effects.

Animals ; Blood Cell Count ; Body Weight ; drug effects ; Cholesterol ; metabolism ; Contraceptive Agents, Male ; pharmacology ; Glycogen ; metabolism ; Leydig Cells ; drug effects ; metabolism ; Male ; Phospholipids ; blood ; Plant Extracts ; pharmacology ; Plants, Medicinal ; Rats ; Rats, Sprague-Dawley ; Spermatids ; drug effects ; Spermatocytes ; drug effects ; Spermatogenesis ; drug effects

No abstract available.