Curculigo orchioides Gaertn. (family Amarylladaceae) is an endangered rasayana herb which is popularly known as "Kali Musli". The plant is native to India, and holds a special position as a potent adaptogen and aphrodisiac in Ayurvedic system of medicine. It is an important ingredient of many Ayurvedic preparations and is considered to have aphrodisiac, immunostimulant, hepatoprotective, antioxidant, anticancer and antidiabetic activities. Various chemical constituents like mucilage, phenolic glycosides, saponins and aliphatic compounds from the plant have been reported. The plant is also considered as an important component of various herbal preparations of the Chinese and Kampo medicine. The present review is an attempt to enumerate various biologically tested activities and evaluation of different phytochemicals present in this important medicinal plant.

Objective: Andrographis paniculata is a well-known medicinal plant in Southeast Asia, India and China. The plant contains andrographolide (AN), a very important phytochemical used in various health problems. However, AN is low in oral absorption bioavailability of AN due to the rapid clearance and high protein binding capacity. Methods: The present study was aimed to develop a nano-phytovesicular formulation of semi-purified AN extracts from a naturally occurring phospholipid (soya phosphatidylcholine) in order to increase the oral absorption and antihyperglycemic activity in rats. Results: The nano-phyto vesicle of semi-purified AN extracts equivalent to 25 mg /kg AN significantly protected the hyperglycemic condition of rats. The in vitro and in vivo experiments results proved that the nano- phytovesicular system of plant extracts containing AN produced better oral absorption, bioavailability and improved antihyperglycemic activity compared with that of free AN at dose of 50 mg/kg. Conclusion: Hence, the prepared semi-purified extract nano-phytovesicular system is helpful in solving the problem of rapid clearance of AN.

OBJECTIVE: To examine the efficacy of adjunctive right prefrontal high-frequency repetitive transcranial magnetic stimulation (rTMS) treatment in adolescent mania patients as compared to sham stimulation. METHODS: Twenty six right handed patients aged 12-17 years diagnosed with bipolar mania were randomized to receive daily sessions of active or sham rTMS (20 Hz, 110% of motor threshold, 20 trains, 10 s intertrain interval) over the right dorsolateral prefrontal cortex for 10 days. Mania was rated using Young Mania Rating Scale (YMRS) and Clinical Global Impression (CGI) at baseline, and after 5th and 10th rTMS. RESULTS: For YMRS scores, repeated measures analysis of variance (ANOVA) showed a significant main effect (F=44.49, degree of freedom [df]=1.2/29.29, p<0.001, Greenhouse-Geisser corrected, effect size eta 2=0.65), but the interaction effect was not significant (F=0.03, df=1.2/29.29, p=0.912, Greenhouse-Geisser corrected). For CGI-Severity, repeated measures ANOVA showed a significant main effect (F=24.49, df=1.42/34.21, p<0.001, Greenhouse-Geisser corrected, effect size eta2=0.51), but the interaction effect was not significant (F=0.06, df=1.2/29.29, p=0.881, Greenhouse-Geisser corrected). CONCLUSION: High-frequency right prefrontal rTMS was found to be ineffective as add-on to standard pharmacotherapy in adolescent mania.
Adolescent* ; Bipolar Disorder* ; Drug Therapy ; Freedom ; Hand ; Humans ; Prefrontal Cortex* ; Transcranial Magnetic Stimulation*

Objective: The present study was aimed to investigate the preliminary phytochemical analysis and HPTLC profiling and the antibacterial activity of P. pterocarpum methanolic flower extracts against the bacteria isolated from human infections. Methods: The preliminary phytochemical screening was performed according to the Harborne method. HPTLC studies were carried out using Harborne and Wagner et al method. The methanolic flower extracts of P. pterocarpum were tested against Salmonella typhi (MTCC 733), Staphylococcus aureus (MTCC 96), Proteus mirabilis (MTCC 742), Bacillus subtilis (MTCC 441) and Escherichia coli (MTCC 443). The antimicrobial activity was tested through well diffusion method. Results: The phytochemical studies on methanolic flower extract of Peltophorum pterocarpum (DC.) Baker ex Heyne. revealed the presence of glycosides, flavonoids, phenolics, saponins, catechin and alkaloids. The HPTLC separation was achieved using ethyl acetate-methanol-ethanol-water (8.1: 1.1: 0.4: 0.8) as the mobile phase. The methanolic extract of P. pterocarpum showed four different Rf values 0.16, 0.31, 0.77 and 0.82 which indicated various glycosides present in the flower extract. The methanolic extract of P. pterocarpum showed the maximum zone of inhibition against Proteus mirabilis followed by Salmonella typhi. Conclusion: Bio-assay revealed the presence of specific and selective antimicrobial compounds in the fractions. Broad range activity of plant extracts as per observations in this study was due to presence of multiple antimicrobial compounds or synergic effects of these compounds. Therefore, standardization of active fractions and study for in vivo efficacy may result in development of better antimicrobial drugs.

Difficult femoral nonunion takes account of infective nonunion and aseptic gap nonunion. Limb length discrepancy and nonunion need to be tackled simultaneously. Conventionally Ilizarov ring fixator is in vogue but it has some limitations. To overcome these, monorail fixator is an effective alternative. Persistent good results can be obtained if we can get a perfect anatomical alignment and good regeneration.
External Fixators ; Femoral Fractures ; surgery ; Fracture Fixation ; instrumentation ; Fractures, Ununited ; surgery ; Humans ; Ilizarov Technique

Hypercalcemia of malignancy due to metastatic gastric adenocarcinoma is extremely rare; in fact, to the best of our knowledge, only three case reports of hypercalcemia associated with metastatic gastric adenocarcinoma have been published in the literature to date. Herein, we report a rare case involving a 61-year-old African-American female who had hypercalcemia at initial presentation and who was later diagnosed with poorly differentiated gastric adenocarcinoma with extensive liver metastases, without bone involvement. She was found to have elevated parathyroid hormone-related peptide and normal parathyroid hormone levels. Despite aggressive treatment, she died within a few months of diagnosis.
Adenocarcinoma* ; Diagnosis ; Female ; Humans ; Hypercalcemia* ; Liver ; Middle Aged ; Neoplasm Metastasis ; Parathyroid Hormone ; Parathyroid Hormone-Related Protein

Upper limb length discrepancy is a rare occurrence. Humerus shortening may need specialized treatment to restore the functional and cosmetic status of upper limb. We report a case of humerus lengthening of 9 cm with a monorail external fixator and the result was observed during a 2-year follow-up. Humerus lengthening needs specialized focus as it is not only a cosmetic issue but also a functional demand. The monorail unilateral fixator is more functional and cosmetically acceptable, and thus becomes an effective treatment option.
Adult ; Bone Lengthening ; instrumentation ; External Fixators ; Female ; Humans ; Humerus ; physiology ; surgery ; Range of Motion, Articular ; Surgery, Plastic ; instrumentation

Neurapraxia frequently occurs following traction injury to the nerve intraoperatively, leading to radial nerve palsy which usually recovers in 5-30 weeks. In our case, we had operated a distal one-third of humeral shaft fracture and fixed it with 4.5 mm limited contact dynamic compression plate. The distal neurovascular status of the limb was assessed postoperatively in the recovery room and was found to be intact and all the sensory-motor functions of the radial nerve were normal. On the second postoperative day, following the suction drain removal and dressing, patient developed immediate radial nerve palsy along with wrist drop. We reviewed the literature and found no obvious cause for the nerve palsy and concluded that it was due to traction injury to the radial nerve while removing the suction drain in negative pressure.
Adult ; Female ; Humans ; Humeral Fractures ; surgery ; Postoperative Complications ; Radial Neuropathy ; etiology

Tissue engineering is a research domain that deals with the growth of various kinds of tissues with the help of synthetic composites. With the culmination of nanotechnology and bioengineering, tissue engineering has emerged as an exciting domain. Recent literature describes its various applications in biomedical and biological sciences, such as facilitating the growth of tissue and organs, gene delivery, biosensor-based detection, etc. It deals with the development of biomimetics to repair, restore, maintain and amplify or strengthen several biological functions at the level of tissue and organs. Herein, the synthesis of nanocomposites based on polymers, along with their classification as conductive hydrogels and bioscaffolds, is comprehensively discussed. Furthermore, their implementation in numerous tissue engineering and regenerative medicine applications is also described. The limitations of tissue engineering are also discussed here. The present review highlights and summarizes the latest progress in the tissue engineering domain directed at functionalized nanomaterials.

Background/Aims: Liver cirrhosis is an important cause of morbidity and mortality globally. Every episode of decompensation and hospitalization reduces survival. We studied the clinical profile and long-term outcomes comparing alcohol-related cirrhosis (ALC) and non-ALC.
Methods: Cirrhosis patients at index hospitalisation (from January 2010 to June 2017), with ≥1 year follow-up were included.
Results: Five thousand and one hundred thirty-eight cirrhosis patients (age, 49.8±14.6 years; male, 79.5%; alcohol, 39.5%; Child-A:B:C, 11.7%:41.6%:46.8%) from their index hospitalization were analysed. The median time from diagnosis of cirrhosis to index hospitalization was 2 years (0.2–10). One thousand and seven hundred seven patients (33.2%) died within a year; 1,248 (24.3%) during index hospitalization. 59.5% (2,316/3,890) of the survivors, required at least one readmission, with additional mortality of 19.8% (459/2,316). ALC compared to non-ALC were more often (P<0.001) male (97.7% vs. 67.7%), younger (40–50 group, 36.2% vs. 20.2%; P<0.001) with higher liver related complications at baseline, (P<0.001 for each), sepsis: 20.3% vs. 14.9%; ascites: 82.2% vs. 65.9%; spontaneous bacterial peritonitis: 21.8% vs. 15.7%; hepatic encephalopathy: 41.0% vs. 25.0%; acute variceal bleeding: 32.0% vs. 23.7%; and acute kidney injury 30.5% vs. 19.6%. ALC patients had higher Child-Pugh (10.6±2.0 vs. 9.0±2.3), model for end-stage liver-disease scores (21.49±8.47 vs. 16.85±7.79), and higher mortality (42.3% vs. 27.3%, P<0.001) compared to non-ALC.
Conclusions One-third of cirrhosis patients die in index hospitalization. 60% of the survivors require at least one rehospitalization within a year. ALC patients present with higher morbidity and mortality and at a younger age.