Holoptelea integrifolia Roxb. (Indian Elm) is a very useful and popular traditional medicinal plant in India. During the last three decades, apart from the chemistry of plant compounds, considerable progress regarding the biological activity and medicinal applications of Indian Elm has been achieved. Ethno-medically, the leaves and stem bark of this plant have been used by tribes as antiviral, antioxidant, antimicrobial, abortifacient preparations and in the management of cancer. Recent studies on plant show that it has potential to fight against tumor and obesity as well. Phytochemical investigation shows the presence of chemical constituents such as terpenoids, alkaloids, glycosides, carbohydrates, steroids, sterols, saponins, tannins, proteins and flavanoids. The isolated principles such as β-amyrin, β-sitosterol, holoptelin-A, holoptelin-B, hederagenin, hexacosanol, β-D-glucose, friedelin, epifriedelin, 2-amino naphthoquinone, 1,4-naphthalenedione, are considered as responsible for various activities. This review highlights the traditional uses, reported biological/pharmacological activities, isolated compounds and therapeutic applications of Holoptelea integrifolia which might be helpful for scientists and researchers to find out new chemical entities responsible for its claimed traditional uses.

The use of medicinal plants to cure human illness has been practiced from time immemorial. Nowadays, the vast majority of people still rely on their traditional materia medica for their daily health care needs. The use of plant species for treatment of various human ailments has been mentioned in Ayurveda and other Indian literature. Some of these drugs are believed to enhance the natural resistance of body to infection. So there are many plants having immunostimulatory activity. This paper reviews plants which have shown reported immunostimulatory activity.

OBJECTIVETo present a detailed pharmacognostic study of the leaf of Cayratia trifolia (C. trifolia) Linn. (Vitaceae), an important plant in the Indian system of medicine.

METHODSThe macroscopy, microscopy, physiochemical analysis, preliminary testing, fluorescence analysis of powder of the plant and other WHO recommended methods for standardization were investigated.

RESULTSLeaves are trifoliolated with petioles (2-3 cm) long. Leaflets are ovate to oblong-ovate, (2-8 cm) long, (1.5-5 cm) wide, pointed at the tip. The leaf surface shows the anisocytic type stomata covered with guard cells followed by epidermis layer. Leaf surface contents including veins, vein islet and vein termination were also determined. Transverse section of leaf shows the epidermis layer followed by cuticle layer and vascular bandles (xylem and phloem). The mesophyll is differentiated into palisade and spongy parenchyma. Abundant covering trichomes emerge from the upper epidermis. Trichomes are uniseriate and multicellular. Strips of collenchyma are present below and upper layer of epidermis.

CONCLUSIONSIt can be concluded that the pharmacognostic profile of the C. trifolia is helpful in developing standards for quality, purity and sample identification.

Open anterior dislocation of the hip is a very rare injury, especially in adults. It is a hyperabduction, external rotation and extension injury. Its combination with open posterior dislocation of the elbow has not been described in English language-based medical literature. Primary resuscitation, debridement, urgent reduction of dislocation, and adequate antibiotic support resulted in good clinical outcome in our patient. At 18 months follow-up, no signs of avascular necrosis of the femoral head or infection were observed.
Accidents, Traffic ; Elbow Joint ; injuries ; Hip Dislocation ; complications ; pathology ; Humans ; Joint Dislocations ; complications ; Male ; Soft Tissue Injuries ; complications ; Young Adult

Double tooth is a dental anomaly consequent to fusion of two or more teeth or gemination of a single tooth. This report describes a unique case of double tooth in relation to a mandibular lateral incisor exhibiting the presence of four root canals. The role of conventional radiography and advanced three-dimensional imaging techniques in the better assessment of complex root canal systems and their aid in endodontic management has also been highlighted.
Dental Pulp Cavity ; Fused Teeth ; Imaging, Three-Dimensional ; Incisor ; Multidetector Computed Tomography ; Tooth ; Tooth Abnormalities ; Tooth, Supernumerary

Objective: To develop and characterize multiple-unit-type oral floating microsphere of famotidine to prolong gastric residence time and to target stomach ulcer. Methods: The floating microspheres were prepared by modified solvent evaporation method. Eudragit S-100 was used as polymer. Microspheres were characterized for the micromeritic properties, floating behavior, entrapment efficiency and scanning electron microscopy. The in-vitro release studies and floating behavior were studied in simulated gastric fluid at pH 1.2. Different drug release kinetics models were also applied for all the batches. Selected formulations were also subjected for X-ray radiographic study. Results: Floating microspheres were successfully prepared by modified solvent evaporation technique. Microspheres showed passable flow properties. The maximum yield of microspheres was up to (95.11±0.35)%. On the basis of optical microscopy particle size range was found to be ranging from (52.18±182.00) to (91.64±5.16) μm. Scanning electron microscopy showed their spherical size, perforated smooth surface and a cavity inside microspheres. Microspheres were capable to float up to 20 h in simulated gastric fluid. X-ray radiographic studies also proved its better retention in the stomach. Conclusions: On the basis of the results, such dosage forms may be a good candidate for stomach targeting and may be dispensed in hard gelatin capsules.

Objective: The stress response following traumatic brain injury (TBI) is a preventable cause of secondary brain injury. This can be prevented using sedation in the intensive care unit (ICU). To date, the choice of sedative agent for preventing stress response is not well-studied in literature. Methods: This prospective randomized controlled trial included 60 patients with severe TBI admitted to ICU. The patients were randomized into 2 study groups according to the choice of sedation: propofol (group I) and midazolam infusion (group II). The serum cortisol was measured as the primary outcome at admission to ICU and 48 hours following sedation infusion. The baseline Glasgow coma scale, hemodynamic, optic nerve sheath diameter (ONSD), and computed tomography scan findings were noted at admission. Glasgow outcome scale (GOS) was measured as a neurological outcome at discharge from ICU. Results: There was a statistically significant reduction in serum cortisol level in both the study groups (Δ cortisol, p-value=134.91 (50.5,208.2), 0.00 and 118.8 (42.6,160.4), 0.00, in group I and II, respectively). Serum cortisol levels were comparable among both groups at baseline and 48 hours. Similarly, there was a statistically significant difference in ONSD in both groups, but there was no difference in ONSD value between the groups at 48 hours. The GOS was also similar in both groups at discharge from ICU. Conclusion The study demonstrated a similar reduction in serum cortisol levels following 48 hours of propofol or midazolam infusion in patients with severe TBI.

Introduction: This observational study was conducted to assess the knowledge, attitudes, and perceptions (KAP) of Malaysians toward participating in clinical trials. It also aimed to look for factors that will influence people’s willingness to participate in trials. We planned and developed future outreach, education tools, and recruitment strategies to increase clinical trial enrolment. Methods: A cross-sectional study was carried out on a randomly selected sample of 398 Malaysian literate adults. An online questionnaire was created and distributed to the respondents. Descriptive statistics were presented in the form of frequency and percentages. The chi-square test was employed to find the association between independent variables. Results: The majority had good knowledge (61.3%) and high awareness (88.7%) of clinical trials. However, most of them were not willing to take part in a clinical trial if they were assigned to a group of unlicensed drugs (90.2%) or randomly assigned (66.1%). The main reasons for participating in trials were recommendations from doctors (46.5%) and the potential for their own benefit (45.7%). Younger age was positively associated with the necessity and confidentiality of clinical trials. Most respondents indicated negative perceptions towards the safety of clinical trials regardless of demographic variables. Conclusion: We gained a better understanding of Malaysian people who are potential participants in a future clinical trial. These findings could help clinical researchers improve their understanding of the participants and develop effective outreach strategies for clinical trial recruitment and retention.