The antifungal activity of methanolic extracts of Centella asiatica and Andrographis paniculata leaves was observed against fourteen fungi, viz., Alternaria alternata, A. brassicae, A. brassicicola, A. solani, A. tenuissima, Cercospora blumae, Curvularia lunata, C. penniseti, and Drechslera monoceras, D. oryzae, D. turitica, Fusarium albizziae and F. udum. Different concentrations of the methanolic extract (1000, 2000, 3000, 5000, 7000, 10000ppm) were used. The effect of mixed leaf extract (1500 ppm of C. asiatica + 1500 ppm of A. paniculata) and its 1:2 ad 1:4 dilutions were also studied. The individual extracts of both the plants showed significant inhibitory effect on spore germination of all the fungi tested. F. udum, F. albizzae, D. oryzae, D. turtica, and D. monoceras were particularly sensitive to these extracts. In general, the extract of C. asiatica showed a higher inhibitory effect in all concentrations against all the fungi as compared to A. paniculata, except for A. brassicae A. solani, D. oryzae, D. penniseti and Curvularia sp. The inhibitory effect of extracts increased when they were used in combination with or without dilutions against A. brassicicola, A. solani A. brassicae, A. alternata, A. tenussima, C. blumae, C. lunata, C. penniseti and Curvularia species. Higher efficacy of active ingredient of these extracts under field condition is envisaged against plant pathogens.
Albizzia ; Alternaria ; Andrographis* ; Brassica ; Centella* ; Fungi ; Fusarium ; Germination ; Methanol* ; Oryza ; Plants ; Spores

This is a report of a study on the long term results of PHILOS plating and percutaneous K-wire fixation in a prospective series of proximal humerus fractures in elderly patients. We reviewed a total of 60 patients with proximal humerus fractures in 30 patients (Group 1), who were treated by open reduction and internal fixation with Proximal Humeral Internal Locking System (PHILOS) plate and 30 patients(Group 2) who were treated with percutaneous K-wire fixation. Functional outcome was assessed using Visual Analogue Scale(VAS) and Constant-Murley Score. Mean Constant-Murley score was 84.6 points (range: 61-100) in Group 1 and - 76.4 points(range:56-100) in Group2 at final follow up. Values varied depending upon the fracture type with worst in 4-part fractures. Mean VAS Score was 2.6(range:0-10) in Group 1 and 3.8(range:0-10) in Group 2. We obtained satisfactory results in both the groups, with each procedure having its advantages and shortcomings. We found that PHILOS plate fixation provided stable fixation with minimal implant problems and enabled early range-ofmotionexercises to achieve acceptable functional results. Fixation with percutaneous K-wires presented an efficient treatment option with the advantages of minimal invasiveness and soft tissue dissection.
Humeral Fractures

Introduction: Body mass index (BMI) has traditionally been the chosen indicator by which to measure body size, composition, and to diagnose underweight and overweight. However, alternative measures that reflect abdominal adiposity, such as waist circumference, waist–hip ratio and waist–height ratio, have been suggested as being superior to BMI in predicting cardio-vascular diseases (CVD) risk. This study was aimed at determining the predictive power of anthropometric indicators like body mass index, waist circumference and waist stature ratio with body fat in an Indian military personnel population group, and to establish cut-off points as discriminators of high body fat. Methods: The study was crosssectional in nature with a sample size of 388 active Gorkha male personnel aged 20-49 years (mean age 33.1±5.33). Anthropometric indicators included body mass index, waist circumference, waist-hip ratio and waist-stature ratio. The analysis of receiver operating characteristic curves (ROC) with a confidence interval of 95% was adopted to identify predictors of obesity. Subsequently, the cut-off points with their relevant sensitivities and specificities were identified. Result: Areas under the ROC curves with 95% confidence intervals were body mass index = 0.86 (0.84-0.88); waist circumference = 0.82 (0.80-0.84); waist- hip ratio = 0.74 (0.71-0.77); waist-stature ratio = 0.81 (0.78-0.84). Different cut-off points of anthropometric indicators with better predictive power and their relevant sensitivities and specificities were identified. The following cut-offs with their corresponding sensitivity and specificity values are suggested for determining obesity for the study population: body mass index= 23.4 (98.00, 62.00), waist circumference= 77.8 (98.00, 60.50) and waist stature ratio= 0.47 (98.60, 68.00) respectively. Conclusion: The results showed that among active military personnel, BMI, WC and WSR may serve well in classifying individuals into broad categories corresponding to percentage fat categories. Further studies on different populations should be undertaken for the verification of the cut-off levels identified.

A female patient aged 48 years presented with sub-acute onset of weakness in right upper and lower limb over the past one month and numbness over left side of body below neck level. Multiple sclerosis (MS) presenting as Brown-Séquard syndrome is very rare. We present a case of hemicord myelitis which presented as Brown-Séquard syndrome as a first manifestation, which was later diagnosed as MS during subsequent relapses.

Intrapancreatic accessory spleen (IPAS) is a benign anomaly of splenic embryology and a rare cause of pancreatic pseudotumour. Here, we report a case of a 70-year-old Malay lady whose IPAS was discovered incidentally during her surveillance computed tomography for her underlying left lower lung fibrosis. Radiologically, the lesion mimicked a neuroendocrine pancreatic tumour and was only diagnosed pathologically as IPAS after surgery. In conclusion, recognising IPAS as a differential for enhancing pancreatic mass allows us to exhaust all non-invasive diagnostic means to diagnose this benign lesion. It will allow the patient to avoid unnecessary surgery and its accompanying complications.
Spleen ; Splenectomy ; Pancrelipase

Cerebral Palsy is a common and devastating neurological disorder, with no medical treatment apart from physiotherapy regimes to alleviate the functional disability. Regenerative medicine using stem cells has gained momentum in recent years as a possible strategy to repair the injured brain. Present study was undertaken in a open label series to evaluate the safety, feasibility and observe for any benefi cial effects of intra-arterial infusion of autologous bone marrow derived mononuclear cells in patients with cerebral palsy with moderate disability. Functional improvement was assessed using the motor power and spasticity scales, dystonia and abnormal movements scale and the activities of daily living scales by modifi ed Barthel Index and modifi ed Rankin Scores. Serial structural imaging with MRI and functional imaging with FDG-PET scans were done. Of the 30 patients injected with an average of 10-30 million cells into each carotid artery, improvements were observed in all clinical scales, and predominantly in the disability scores. No adverse events were noted on a 12 months follow up.

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.

In the present study we have evaluated the repellent activity of mixture of Curcuma longa, Zanthoxylum limonella and Pogostemon heyneanus essential oils in 1:1:2 ratio at 5%, 10% and 20% concentration against blackflies in northeastern India. Initially the essential oil mixture tested here has been found effective against Aedes albopictus mosquitoes. The average protection recorded in 20% concentration (170.56±4.0; 95% CI = 162.09-179.02) was higher as compared to other two concentrations (F = 90.2; p<0.0001; df = 53). Percentage repellency and repellency index was found to be higher in 20% concentration (p<0.017). No appreciable clinical and behavioral signs were observed in the acute dermal toxicity using rat model. No changes were observed in biochemical profiles of treatment group animals. Similarly, no prominent lesions were observed in vital organs of treatment in both the sexes. The study concludes that tested repellent is safe for use and has multi-insects repellent property.

This is a case of a posterior mediastinal mass in an asymptomatic gentleman, which was resected successfully and he has been disease free for more than a year of follow up. The histopathology findings happen to be a rare occurrence.
Liposarcoma