Objective: To study detailed Pharmacognosy of the bark of Nyctanthes arbortristis Linn (Oleaceae), an important plant in Indian system of medicine. Methods: the macroscopy, microscopy, physicochemical analysis, preliminary phytochemical testing of powder of the plant bark and other WHO recommended methods for the standardization was done. Results: Trunk bark consists of two distinct regions i.e. outer bark and inner bark. Outer bark consists of broad periderm of a wide phellem and inner phelloderm regions. Inner bark is broader than the outer part and it includes all the secondary phloem tissues. It can be distinguished into 2 zones viz. collapsed secondary phloem and non-collapsed secondary phloem regions. Collapsed secondary phloem region consist of thick blocks of phloem sclereids and radially oblique dark streaks of crushed sieve tubes and dilated axial parenchyma cells. Non-collapsed secondary phloem region is the conducting part of the phloem where the sieve elements are intact. It consists of intact sieve tube members, companion cells, axial parenchyma cells and narrow undilated ray. Calcium oxalate crystals are abundant in collapsed phloem region. Conclusions: it can be concluded that the pharmacognostic profile of N. arbortristis bark is helpful in developing standards for quality, purity and sample identification.

Delftia acidovorans (earlier known as Comamonas acidovorans) is an aerobic, non-fermentative, Gram negative rod, classified in the Pseudomonas rRNA homology Group III. Reports of isolation of the organism from serious infections like central venous catheter associated bacteremia, corneal ulcers, otitis media exist. The microbiologists can identify this organism based on an orange indole reaction. This reaction demonstrates the organism's ability to produce anthranilic acid from tryptophan on addition of Kovac's reagent; which gives the media its characteristic“pumpkin orange” colour. Here we report the isolation of this organism from the Endotracheal tube aspirate of a 4 year old child. With the increasing use of invasive devices, it has become important to recognize these non fermentative gram negative bacilli as emerging source of infection even in immunocompetent individuals.

Background: Oxidative stress is implicated as a major factor for nigral neuronal cell death. It has been suggested that nitric oxide (NO) might be responsible in the neuronal degeneration of substantia nigra compacta in patients with Parkinson’s disease (PD). Methods: To elucidate the possible role of NO as a risk factor for PD, we determined the plasma levels of nitrate in 80 PD patients and 80 age and sex-matched controls. Results: There was a signifi cant difference between the mean plasma nitrate level of PD patients (34.5 ± 4.2 μmol/l) vs. controls (31.8 ± 3.15 μmol/l) (P<0.001). Moreover, there was a positive correlation in PD patients between plasma nitrate level and age, age at disease onset, duration of disease, Hoehn and Yahr stage, and Unifi ed Parkinson’s Disease Rating Scale (UPDRS) score. However, PD patients with short disease duration did not have elevated plasma nitrate levels compared to control subjects. Conclusion: Our results argue against the hypothesis that NO is important in the development of PD in West Bengal.

Delftia acidovorans (earlier known as Comamonas acidovorans) is an aerobic, non-fermentative, Gram negative rod, classified in the Pseudomonas rRNA homology Group III. Reports of isolation of the organism from serious infections like central venous catheter associated bacteremia, corneal ulcers, otitis media exist. The microbiologists can identify this organism based on an orange indole reaction. This reaction demonstrates the organism's ability to produce anthranilic acid from tryptophan on addition of Kovac's reagent; which gives the media its characteristic "pumpkin orange" colour. Here we report the isolation of this organism from the Endotracheal tube aspirate of a 4 year old child. With the increasing use of invasive devices, it has become important to recognize these non fermentative gram negative bacilli as emerging source of infection even in immunocompetent individuals.
Anti-Bacterial Agents ; pharmacology ; therapeutic use ; Child, Preschool ; Delftia acidovorans ; Drug Resistance, Bacterial ; Empyema ; Fatal Outcome ; Gram-Negative Bacterial Infections ; Humans ; Shock, Septic

A new impurity was detected during high performance liquid chromatographic (HPLC) analysis of eslicarbazepine acetate active pharmaceutical ingredient. The structure of unknown impurity was postulated based on liquid chromatography mass spectrometry using electrospray ionization and ion trap analyzer (LC/ESI-IT/MS) analysis. Proposed structure of impurity was unambiguously confirmed by synthesis followed by characterization using 1H, 13C nuclear magnetic resonance spectrometry (NMR), 1H-1H correlation spectro-scopy (COSY) and infrared spectroscopy (IR). Based on the spectroscopic and spectrometric data, unknown impurity was characterized as 5-carbamoyl-10,11-dihydro-5H-dibenzo[b,f]azepin-10-yl propionate.

No abstract available.

With the advent of robotic surgery as an effective means of minimally invasive surgery in the last decade, more and more surgeries are being performed robotically in today’s world. Robotic surgery has several advantages over conventional laparoscopic surgery, such as three-dimensional vision with depth perception, magnified view, tremor filtration, and, more importantly, degrees of freedom of the articulating instruments. While the literature is abundant on robotic cholecystectomy and highly complex hepatobiliary surgeries, there is hardly any literature on robotic small bowel resection with intracorporeal anastomosis. We present a case of a 50-year-old male patient with a symptomatic proximal jejunal ischemic stricture who underwent robotic-assisted resection and robot-sewn intracorporeal anastomosis in two layers. He did well in the postoperative period and was discharged on postoperative day 4 with uneventful recovery. We hereby discuss the advantages and disadvantages of robotic surgery in such a scenario with a review of the literature.

Hepaticojejunostomy is currently the best treatment for post-cholecystectomy biliary strictures. Laparoscopic repair has not gained popularity due to difficult reconstruction. We present case of 43-year-old-female with Bismuth type 2 stricture following laparoscopic converted open cholecystectomy with bile duct injury done elsewhere. Position was modified Llyod-Davis position and four 8-mm robotic ports (including camera) and 12-mm assistant port were placed. The procedure included noticeable steps such as adhesiolysis, identification of gallbladder fossa, identification of common hepatic duct, lowering of hilar plate etc. Operating and console time were 420 and 350 minutes and blood loss was 100 mL. Patient was discharged on postoperative day 4. Robotic repair (hepaticojejunostomy) of biliary tract stricture after cholecystectomy is safe and feasible with good outcomes.

Background/Aims: Peroral endoscopic myotomy (POEM) is a novel procedure for the treatment of achalasia and spastic esophageal disorders. Experience with POEM is limited, but its reported outcomes are excellent. It is deemed safe even for patients with prior interventions. Methods: This retrospective review included patients who underwent POEM at a tertiary US center. POEM was performed in a multidisciplinary approach by advanced endoscopists and foregut surgeons. Clinical success was defined as a post-POEM Eckardt score ≤3. Results: A total of 125 patients were included. Median follow-up period was 18 months (interquartile range, 10–22 months). Clinical success was achieved in 92% of patients and persisted at 12 months in 88% of patients. Mucosal barrier failure (MBF) occurred in 7 patients, 2 of whom required surgical intervention. MBF was more common in patients with prior laparoscopic Heller myotomy (19% vs. 3%, p=0.015). MBF requiring surgical intervention occurred early in the learning curve. Conclusions POEM is safe and effective in the treatment of achalasia and spastic esophageal disorders even after failed prior interventions.