International Journal of Current Pharmaceutical Research

PHOTOTHERAPY OUTCOMES AND BILIRUBIN ASSESSMENT TECHNIQUES IN PRETERM NEONATES: A TERTIARY CARE EXPERIENCE

AISHWARAYA MANTHALE — 2025-01-15

Objective: Management of neonatal jaundice, particularly in preterm neonates, is a significant challenge in neonatal care, with phototherapy serving as the primary treatment modality. This study evaluates the outcomes of phototherapy and the efficacy of different bilirubin assessment techniques in a tertiary care environment.

Methods: A hospital-based prospective observational study was conducted involving 100 preterm neonates. Transcutaneous (TcB) and total serum bilirubin (TSB) levels were measured before, during, and after phototherapy to assess correlations and differences.

Results: Statistically significant correlations were found between TcB and TSB post-phototherapy (r-value = 0.8154, p-value<0.0001) and during phototherapy (r-value = 0.6069, p-value<0.0001). However, TcB tended to underestimate bilirubin levels compared to TSB post-phototherapy, with a mean difference of -0.42 mg/dl (p-value = 0.0117).

Conclusion: Despite discrepancies with traditional serum bilirubin (TSB) measurements during and after phototherapy, TcB proves to be an effective tool in clinical practice. The findings suggest that with further refinement and adjustment for influencing factors, TcB can serve as an equivalent to serum assessments, reducing the need for invasive procedures in neonatal jaundice management.

ASSESSMENT OF UNIVERSAL NEONATAL HEARING SCREENING: OUTCOMES AND PREVALENCE AT A TERTIARY CARE CENTER

TRIVENI DESAI — 2025-01-15

Objective: Early detection of hearing impairment through Universal Neonatal Hearing Screening (UNHS) is crucial for timely intervention. This study assesses the outcomes and prevalence of hearing loss in neonates screened at a tertiary care center.

Methods: This prospective observational study involved 1175 neonates born at SDM Medical College and Hospital between December 2019 and November 2020. Neonates underwent initial and, if necessary, repeat hearing screenings using the Otoacoustic Emission (OAE) technique. Data on gender and birth weight distribution were also analyzed to explore demographic correlations with screening outcomes.

Results: Of the neonates screened, 99.40% passed the initial hearing test, while 0.60% were referred for further evaluation. Among those referred, 71.43% passed on repeat screening, with 28.57% continuing to show potential hearing issues. The majority of neonates weighed over 2.5 kg, indicating a lower presence of very low birth weight infants in the screened population.

Conclusion: The high pass rate in initial screenings demonstrates the effectiveness of the OAE method in a tertiary care setting, though the importance of follow-up testing for those referred remains critical. The study highlights the successful implementation of UNHS and underscores the need for continuous monitoring and adaptation of screening protocols to address all potential risks in neonatal hearing loss.

ANALYZING RISK FACTORS AND OUTCOMES OF NEONATAL HEARING SCREENING

TRIVENI DESAI — 2025-01-15

Objective: Neonatal hearing loss can significantly impact a child's developmental trajectory. This study evaluates the risk factors associated with neonatal hearing impairment and analyzes the outcomes of a hearing screening program at a tertiary care center.

Methods: This prospective observational study involved 1175 neonates screened for hearing loss using Otoacoustic Emissions (OAE). Data were collected on high-risk factors such as consanguinity, family history of deafness, ototoxic drug exposure, and low birth weight, and their association with screening outcomes.

Results: The prevalence of high-risk factors included consanguinity (13.53%), family history of deafness (0.17%), ototoxic drug intake (0.26%), and low birth weight (19.91%). Of those initially referred for additional testing, 50% were lost to follow-up, and 50% confirmed for further diagnostic evaluation. Associations were noted between consanguinity and referral rates, as well as a strong correlation between family history and referrals.

Conclusion: The study highlights the effectiveness of initial neonatal hearing screenings but indicates the need for improved follow-up systems to ensure comprehensive care for all neonates at risk of hearing loss.

THE ROLE OF BREAST IMAGING MODALITIES IN THE DIAGNOSIS AND MANAGEMENT OF BENIGN BREAST DISEASES

PIYUSH JAIN — 2025-01-15

Objective: Accurate diagnosis and management of benign breast diseases are crucial aspects of breast healthcare. Breast imaging modalities such as mammography, ultrasound, and magnetic resonance imaging (MRI) play a pivotal role in differentiating benign from malignant lesions and guiding appropriate management strategies.

Methods: This retrospective study was conducted at [Institution Name] from January 2018 to December 2022. It involved a review of medical records, imaging results, and management outcomes of patients diagnosed with benign breast diseases. Imaging modalities included mammography, ultrasound, and MRI. The diagnostic accuracy of each modality was assessed by comparing imaging findings with histopathological results. Statistical analyses were performed using SPSS version 26.0.

Results: A total of 200 patients were included, with a mean age of 45.3±12.6 y. Mammography showed a sensitivity of 85% and specificity of 78%, while ultrasound had a sensitivity of 92% and specificity of 84%. MRI exhibited the highest accuracy with a sensitivity of 95% and specificity of 90%. Combined imaging modalities achieved the highest diagnostic performance. Management strategies varied, with watchful waiting, medication, minimally invasive procedures, and surgical interventions employed based on the specific condition.

Conclusion: Breast imaging modalities are indispensable in diagnosing and managing benign breast diseases. The integration of mammography, ultrasound, and MRI provides comprehensive diagnostic information, guiding optimal management strategies and improving patient outcomes. Future advancements in imaging technology promise to further enhance diagnostic capabilities.

A COMPARATIVE STUDY BETWEEN MIPH VERSUS OPEN HAEMORRHOIDECTOMY

PIYUSH JAIN — 2025-01-15

Objective: Hemorrhoidal disease is a prevalent anorectal disorder that significantly impacts patients' quality of life. Surgical intervention, including Minimally Invasive Procedure for Hemorrhoids (MIPH) and Open Hemorrhoidectomy, plays a crucial role in managing symptomatic hemorrhoids. However, the comparative effectiveness and safety of these surgical techniques remain debated.

Methods: This retrospective cohort study compared the clinical outcomes, safety profile, and cost-effectiveness of MIPH versus Open Hemorrhoidectomy. A total of 130 patients diagnosed with symptomatic hemorrhoids underwent either MIPH or Open Hemorrhoidectomy at our institution. Data on demographic characteristics, presenting complaints, degree of hemorrhoids, operative outcomes, and postoperative complications were collected and analyzed. Statistical analysis was performed using appropriate tests to compare outcomes between the two groups.

Results: The study included 65 patients in each group (MIPH and Open Hemorrhoidectomy). MIPH was associated with shorter mean duration of surgery, reduced postoperative bleeding and intraoperative blood loss, shorter hospital stay, lower incidence of residual prolapse, faster wound healing, and quicker return to work compared to Open Hemorrhoidectomy. However, Open Hemorrhoidectomy demonstrated advantages in direct tissue visualization and precise surgical technique.

Conclusion: Minimally Invasive Procedure for Hemorrhoids (MIPH) offers several benefits, including shorter operative duration, reduced postoperative pain, and faster recovery, making it a viable option for patients with hemorrhoids. However, Open Hemorrhoidectomy remains a suitable alternative, particularly in cases where MIPH may not be feasible or contraindicated. Individualized decision-making, considering patient preferences and surgeon expertise, is essential in selecting the optimal surgical approach for hemorrhoidal disease.

FORMULATION OF TOLNOFTATE LOADED CUBOSOMES FOR EFFECTIVE TRANSDERMAL DELIVERY: AN IN VITRO AND EX-VIVO STUDY

SAYALI T. PATIL — 2025-01-15

Objective: The novel topical application has several benefits over traditional dosing forms, such as preventing gastrointestinal discomfort, lowering liver drug metabolism, and increasing medication bioavailability. Tolnaftate is used as potential anti-fungal agent various fungal infections.

Methods: The cubosomes were formulated by emulsification technique using probe sonicator. The formulation was optimized using different concentrations of glyceryl monooleate and poloxamer 407.

Results: The formed cubosomes dispersion was subjected to entrapment efficiency, surface morphology, particle size, in vitro release, anti-fungal study and ex-vivo study. The improved formulation was then transformed to a cubosomal hydrogel by the addition of carbopol 934. The average particle size of the optimised cubosomes was 208.0 nm. Zeta potential has been found to be 49.8 mV, with an entrapment efficiency of almost 90.0%. The drug steady-state flux (Jss) values for Tolnaftate Cubosomal formulation, marketed formulation, and plain drug gel were nearly 11.98, 10.23, and 10.06 g/cm². h. As compared to standard marketed preparation, the cubosome-loaded formulation demonstrated enhanced penetration, extended deposition, and prolonged drug release.

Conclusion: The drug had low solubility and permeability; it was overcome and produced superior outcomes in the form of cubosomes, which considerably increased the drug's solubility and permeability.

COMPARISON OF CLONIDINE AND DEXMEDETOMIDINE AS ADJUVANTS TO LEVOBUPIVACAINE FOR SUPRACLAVICULAR BRACHIAL PLEXUS BLOCK IN UPPER LIMB SURGERY UNDER ULTRASOUND GUIDANCE

SWATI SINGHAL — 2025-01-15

Objective: The addition of adjuvants to local anesthetics can significantly improve the efficacy of regional blocks. This study compares the effectiveness of Clonidine and Dexmedetomidine as adjuvants to Levobupivacaine in a supraclavicular brachial plexus block for upper limb surgeries.

Methods: This observational comparative study included 68 patients divided into two groups to receive either Dexmedetomidine or Clonidine with Levobupivacaine. The onset and duration of the sensory block and the time to first rescue analgesia were evaluated.

Results: Dexmedetomidine demonstrated a slightly faster onset and a significantly longer duration of sensory block and analgesia compared to Clonidine. Both drugs were well-tolerated without significant adverse effects.

Conclusion: Dexmedetomidine surpasses Clonidine in prolonging the effects of Levobupivacaine in supraclavicular brachial plexus blocks, suggesting its advantageous use in clinical settings for extended analgesia.

COMPARATIVE EVALUATION BETWEEN INTRATHECAL HYPERBARIC ROPIVACAINE 0.75% ALONE VERSUS INTRATHECAL HYPERBARIC ROPIVACAINE 0.75% AND DEXMEDETOMIDINE IN LOWER ABDOMINAL SURGERIES

AAYUSHI — 2025-01-15

Objective: Spinal anesthesia is preferred for lower abdominal surgeries due to its benefits like reduced stress response and lower risk of complications. However, the limited duration of local anesthetics has led to the exploration of adjuvants like dexmedetomidine, which is known to enhance and prolong the anesthetic effect without significant respiratory depression.

Methods: This prospective, randomized study involved 60 ASA I-II patients undergoing lower abdominal surgery, divided into three groups: Group A received intrathecal hyperbaric ropivacaine 0.75% with normal saline, Group B with ropivacaine 0.75% and 2.5 mcg dexmedetomidine, and Group C with ropivacaine 0.75% and 5 mcg dexmedetomidine. The study measured onset and duration of sensory and motor block, hemodynamic parameters, and side effects.

Results: Adding dexmedetomidine enhanced the onset and duration of both sensory and motor blocks. Group C, which received 5 mcg dexmedetomidine, showed the fastest onset and longest duration of block, with stable hemodynamics and minimal side effects compared to ropivacaine alone.

Conclusion: The study concludes that intrathecal dexmedetomidine at 5 mcg with ropivacaine 0.75% significantly improves the efficacy of spinal anesthesia for lower abdominal surgeries, suggesting that this combination could be an effective and safe option for enhancing surgical anesthesia.

ANESTHETIC CONSIDERATIONS FOR CRITICALLY ILL PATIENTS WITH SEPSIS

DIKSHA SIROHI — 2025-01-15

Objective: Sepsis is a life-threatening condition characterized by organ dysfunction due to a dysregulated host response to infection. Critically ill patients with sepsis often require surgical interventions, presenting significant anesthetic challenges due to profound physiological alterations and multiple organ dysfunctions.

Methods: This systematic review aims to synthesize current evidence on anesthetic management strategies for critically ill patients with sepsis. A comprehensive literature search was conducted in PubMed, Embase, and Cochrane Library databases for studies published up to October 2023. Inclusion criteria encompassed clinical trials, observational studies, reviews, and guidelines focusing on anesthetic considerations in septic patients.

Results: Key findings indicate that thorough preoperative assessment, vigilant hemodynamic monitoring, careful selection of anesthetic agents, and tailored ventilatory strategies are crucial for improving perioperative outcomes. Hemodynamic instability necessitates the use of invasive monitoring and vasoactive medications like norepinephrine. Etomidate and ketamine are preferred induction agents due to their hemodynamic stability, with considerations for their side effects. Maintenance anesthesia often favors total intravenous techniques to minimize cardiovascular depression. Protective lung ventilation strategies are essential due to the high risk of acute respiratory distress syndrome (ARDS). Postoperative care requires multidisciplinary collaboration to manage ongoing sepsis and prevent complications.

Conclusion: This review highlights the importance of individualized anesthetic plans and suggests that adherence to evidence-based practices can enhance patient outcomes in this high-risk group.

COMPARISON OF TWO DIFFERENT DOSES OF TABLET CLONIDINE (100MCG AND 150MCG) GIVEN 90 MIN PRIOR TO SURGERY TO ATTENUATE HAEMODYNAMIC CHANGES DURING ENDOTRACHEAL INTUBATION

SHEETAL GAMBHIR — 2025-01-15

Objective: Endotracheal intubation can elicit significant haemodynamic responses, posing risks for patients with cardiovascular conditions. Clonidine, an alpha-2 adrenergic agonist, is used to mitigate these responses, but the optimal dosing is uncertain. This study compares the efficacy and safety of two doses of oral clonidine, 100 μg and 150 μg, administered 90 min before surgery.

Methods: Sixty patients aged 18–55 y, classified as ASA physical status I or II and scheduled for elective lower abdominal surgeries, were randomly assigned to two groups. Group A received 100 μg of oral clonidine, and Group B received 150 μg. Haemodynamic parameters-heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), and mean arterial pressure (MAP)-were recorded at baseline, during induction, immediately after intubation, and at intervals up to 15 min post-intubation. Side effects and the need for rescue analgesia were also assessed.

Results: Group A demonstrated significantly lower SBP and HR at induction and during the immediate post-intubation period compared to Group B (p < 0.05). No significant differences were observed in DBP and MAP at most time points. The incidence of hypotension was higher in Group B but not statistically significant. Group B required significantly less rescue analgesia postoperatively (p < 0.001).

Conclusion: A 100 μg dose of oral clonidine is more effective in attenuating haemodynamic responses during endotracheal intubation compared to a 150 μg dose. While the higher dose offers improved postoperative analgesia, it does not enhance haemodynamic stability and may increase the risk of hypotension.

A STUDY ON BACTERIOLOGICAL PROFILE OF SURGICAL SITE INFECTION AND THEIR ANTIMICROBIAL SUSCEPTIBILITY PATTERN AT A TERTIARY CARE HOSPITAL IN TIRUPATI

PAVADHARANI S. — 2025-01-15

Objective: Surgical Site Infections (SSIs) are defined as infections apparent within 30days of an operative procedure and most often between the 5^th and 10^th postoperative days. It constitutes a major public health problem worldwide; It is one of the most common causes of nosocomial infection. They are responsible for increasing the treatment cost, length of hospital stays and significant morbidity and mortality. Despite the technical advances in infection control and surgical practices, SSI still continue to be a major problem, even in hospitals with most modern facilities. The present study conducted to isolate and identify microbes from pus samples collected from patients who were suspected for SSI and to determine their antimicrobial susceptibility profiles in a tertiary care hospital.

Methods: This is a cross-sectional study conducted in the Department of Microbiology, Sri Venkateswara Medical College, Tirupati for a period of 6 mo. A total of 390 various clinical samples were collected and processed. Isolates were tested for antibiotic susceptibility by a Kirby-Bauer disk diffusion method.

Results: Out of 390 pus/wound discharge samples processed, 132 (34%) samples were culture positive, among which 107 (81%) were Gram-negative bacilli and 25 (19%) were Gram-positive cocci. Male to female ratio was 2:1. Most common age group affected was>50yrs. Predominant isolates were Klebsiella pneumoniae (73.47%) followed by Pseudomonas aeruginosa (26.53%) and Staphylococcus aureus (17.4%). Gram-negative bacilli showed maximum susceptibility to Imipenam, Piperacillin-Tazobactam and Amikacin and Gram-positive cocci showed 100% to Linezolid, Vancomycin.

Conclusion: SSI remains to be a significant challenge for the surgeon’s inspite of sterile surgical techniques and prophylactic use of antibiotics. Hospital infection control measures like hand hygiene, strict adherence to pre-operative measures, rational use of antibiotics and establishing active surveillance can reduce the prevalence of SSIs.

COMPARATIVE ANALYSIS OF EPIDURAL ROPIVACAINE 0.75% VERSUS ROPIVACAINE 0.75% WITH CLONIDINE IN LOWER LIMB SURGERIES: EFFICACY, HEMODYNAMICS, AND SAFETY PROFILE

DEVASHISH SINGH SHEKHAWAT — 2025-01-15

Objective: Epidural ropivacaine is extensively used for lower limb surgeries due to its effective analgesic properties and safety profile. The addition of clonidine as an adjuvant may enhance these effects, but its implications on efficacy, hemodynamics, and safety are not fully established.

Methods: In a double-blind, randomized controlled trial, 80 patients undergoing lower limb surgeries were assigned to receive either ropivacaine 0.75% or ropivacaine 0.75% with clonidine epidurally. Parameters such as onset and duration of sensory and motor blocks, hemodynamic changes, postoperative pain scores, and side effects were meticulously recorded and analyzed.

Results: Clonidine significantly improved the onset and duration of sensory and motor blocks, maintained better hemodynamic stability, and provided superior pain control compared to ropivacaine alone. There were no significant adverse effects requiring intervention beyond standard care.

Conclusion: Clonidine is an effective adjuvant to ropivacaine in epidural anesthesia for lower limb surgeries, enhancing analgesic quality and duration while being hemodynamically stable and safe.

ENHANCING SPINAL ANESTHESIA WITH DEXMEDETOMIDINE: A PROSPECTIVE STUDY ON PROLONGING ANALGESIA AND REDUCING OPIOID REQUIREMENTS IN INFRA UMBILICAL SURGERIES

YASH VIJAY — 2025-01-15

Objective: Pain management in surgical settings poses significant challenges, particularly in minimizing opioid use due to associated risks. Dexmedetomidine, a selective α2-adrenergic agonist, has shown promise as an adjunct in spinal anesthesia to enhance analgesic and anesthetic effects.

Methods: This prospective, randomized, double-blind study involved 60 patients undergoing infraumbilical surgeries, divided into two groups. Group D received intravenous dexmedetomidine, while Group C received a saline placebo. We assessed the duration of sensory and motor blocks, sedation levels, and the time to first postoperative analgesia request.

Results: Group D exhibited significantly longer durations of sensory and motor blocks, higher sedation scores, and extended time before requesting postoperative analgesia compared to Group C. These results suggest improved anesthetic quality and pain control with dexmedetomidine.

Conclusion: Intravenous dexmedetomidine enhances spinal anesthesia by prolonging block durations and improving sedation, potentially decreasing the need for postoperative opioids. This supports its use as an effective adjunct in anesthesia, contributing to safer, more effective pain management strategies.

COMPARISON OF CLONIDINE AND DEXMEDETOMIDINE AS ADJUVANTS TO LEVOBUPIVACAINE FOR SUPRACLAVICULAR BRACHIAL PLEXUS BLOCK IN UPPER LIMB SURGERY UNDER ULTRASOUND GUIDANCE

SWATI SINGHAL — 2025-01-15

Methods: This observational comparative study included 68 patients, divided into two groups to receive either Dexmedetomidine or Clonidine with Levobupivacaine. The onset and duration of the sensory block and the time to first rescue analgesia were evaluated.

PREVALENCE OF HYPERTENSION IN MEDICAL PROFESSIONALS OF SMS, MEDICAL COLLEGE, JAIPUR AND ASSESSING THEIR AWARENESS ABOUT HYPERTENSION AND LIFESTYLE MEASURES TO CURB IT

ANURADHA BHARADWAJ — 2025-01-15

Objective: Hypertension presents a significant public health challenge in India, particularly among medical professionals who are notably vulnerable to this condition. Assessing their awareness about hypertension and lifestyle measures is crucial for effective intervention.

Methods: This cross-sectional study was conducted at SMS Medical College, Jaipur, involving 220 medical professionals aged 23 to 60 years, including 145 males and 75 females. The study aimed to estimate the prevalence of hypertension, assess knowledge regarding the condition, and gauge awareness of lifestyle interventions to curb it.

Results: Among the participants, 45.4% were normotensive, 43.2% had Stage I hypertension, and 11.3% had Stage II hypertension. The prevalence of hypertension was notably higher among those with higher body mass indices (BMI): 70% in the obese category, 56% in the overweight category, and 41.8% in the normal BMI group. Regarding awareness, 85% of the participants had good knowledge about hypertension, and 78% were aware of lifestyle measures to manage it. However, only 60% reported implementing these measures in their daily lives.

Conclusion: The study uncovered a high prevalence of hypertension among medical professionals. While awareness about hypertension and lifestyle measures is relatively high, actual implementation is suboptimal. Addressing BMI and promoting the adoption of lifestyle modifications could help mitigate the impact of hypertension within this group.

EVALUATION OF EFFECTIVENESS OF PULSE OXIMETER PERFUSION INDEX OVER ANAL SPHINCTER TONE AS AN ASSESSMENT TOOL IN PREDICTING SUCCESSFUL CAUDAL BLOCK IN PEDIATRIC PATIENTS-A PROSPECTIVE OBSERVATIONAL STUDY

BHAVANA KOSGI — 2025-01-15

Objective: Caudal epidural block is widely used in pediatric surgeries for analgesia below the umbilicus. Traditional assessment methods like loss of anal sphincter tone are subjective and may not provide reliable feedback. The perfusion index (PI), measured non-invasively via the Masimo Radical-7 Pulse CO-Oximeter, may offer an objective alternative to predict block success.

Methods: In this prospective observational study, 50 pediatric patient’s aged 1 to 10 y undergoing elective lower abdominal surgeries received caudal epidural blocks under general anesthesia. Baseline PI values were recorded using the Masimo Radical-7 Pulse CO-Oximeter with the probe attached to the big toe. Measurements were taken at 1-minute intervals for 10 min post-block. Anal sphincter tone was assessed concurrently using a three-point qualitative scale by a blinded anesthesiologist. The primary outcome was the change in PI compared to baseline and its correlation with block success.

Results: Significant increases in PI values were observed in patients with successful caudal blocks. An increase in PI of more than 50% from baseline was associated with a 95% success rate of the block. The perfusion index showed a higher predictive value for block success (AUC = 0.88) compared to anal sphincter tone assessment (AUC = 0.72). The correlation between increased PI and successful block indicates that PI is a reliable indicator of caudal block efficacy.

Conclusion: The pulse oximeter perfusion index, measured using the Masimo Radical-7 monitor, is a more effective and objective tool than anal sphincter tone assessment in predicting successful caudal blocks in pediatric patients. Incorporating PI monitoring into perioperative care can provide immediate and reliable feedback, potentially improving anesthesia outcomes in children.

PREDICTING DIFFICULT INTUBATION IN ELECTIVE SURGICAL PATIENTS: THE ROLE OF BEDSIDE SONOGRAPHIC MEASUREMENTS

ASWIN M. S. — 2025-01-15

Objective: Predicting difficult intubation remains a pivotal challenge in anesthesia, with traditional methods often failing to identify all at-risk patients. This study investigates the efficacy of bedside sonographic measurements as predictors of intubation difficulty in elective surgical patients.

Methods: A prospective observational study was conducted at Gulbarga Institute of Medical Sciences, Kalaburagi, involving 60 adult elective surgery patients. Sonographic measurements, including hyomental distance, pre-epiglottic space, anterior soft tissue distance, and neck circumference were evaluated for their ability to predict difficult intubation.

Results: The study found significant associations between all measured parameters and intubation difficulty. Specifically, shorter hyomental and pre-epiglottic spaces were strongly predictive of difficult intubations. Increased anterior soft tissue thickness and larger neck circumference were also linked to higher intubation difficulty.

Conclusion: Bedside sonographic measurements provide a reliable method for predicting difficult intubations in elective surgical patients. Their integration into preoperative evaluations can significantly enhance the prediction and management of difficult airways.

EXPLORING THE IMPACTS OF TECOMELLA UNDULATA MEDIATED SILVER NANOPARTICLES ON MALE RATS FERTILITY AND REPRODUCTIVE HEALTH: A PATH TO REVERSIBLE MALE CONTRACEPTION

NEHA BHARTI — 2025-01-15

Objective: The present study was designed to evaluate the antifertility effects of AgNPs synthesized using Tecomella undulata methanolic leaf extract in male albino Wistar rats.

Methods: The AgNPs were synthesized and characterized by UV-visible spectrophotometry, FTIR, XRD, SEM-EDX and ZETA potential. The antifertility effects of AgNPs were evaluated, dividing 40 male rats into five treatment Groups, G-I treated with sterile distilled water and G-II, G-III and G-IV with 10, 20 and 30 mg/kg. B. wt/D of T. undulata AgNPs doses for 60 days. Followed by analysis of sperm parameters, fertility, reproductive organ and body weight, testosterone assays and other reproductive health parameters.

Results: The characterization results indicated successful synthesis of AgNPs by their size, shape, crystallinity, elements and stability results. Antifertility activity of AgNPs, showed significant reductions in sperm parameters (P<0.05) and fertility, with minimal adverse effects on body weight and haematological parameters. Degenerative changes were observed in histoarchitecture of testis. Testosterone level was affected across various dose levels (P<0.01) and markedly reduction in tissue protein, cholesterol and sialic acid was observed. These parameters show a significant recovery in treatment Group-V.

Conclusion: These findings suggest that AgNPs synthesized using T. undulata possess promising antifertility potential and can be used as a promising contraceptive agent.

PRIMARY NEUROENDOCRINE CARCINOMA OF THE CERVIX: RETROSPECTIVE ANALYSIS

PRATEEK TIWARI — 2025-01-15

Objective: Neuroendocrine carcinoma of the cervix is a rare variant of cervical carcinoma with a poorer prognosis. There is no standard treatment for this variant of cervical carcinoma. Due to the rarity of this malignancy, the management of NECC is difficult and associated with uncertainty. An interdisciplinary approach is necessary because most studies investigating the treatment of neuroendocrine tumors have been performed in patients with tumors in organs other than the cervix, mostly the lung and pancreas.

Methods: A retrospective analysis of 32 patients diagnosed by biopsy with neuroendocrine carcinoma of the cervix was done. This study was carried out at Adyar Cancer Institute Chennai. All stage I patients underwent surgery followed by chemotherapy. All stage II and III patients underwent chemoradiotherapy. All stage IV patients underwent palliative chemotherapy. Disease-free survival and overall survival were seen.

Results: Overall, while the mean survival time decreases as the disease progresses from Stage I to Stage IV, the variability (SD) is highest in the early stages (I and II) and relatively lower in the advanced stages (III and IV), though the differences in survival times between the stages were not statistically significant.

Conclusion: We found that NECC is a rare form of cervical cancer with a poor prognosis. Due to the small number of cases and the retrospective nature of this analysis, conclusions are limited, but multimodality treatment with radical surgery and adjuvant or neoadjuvant chemotherapy with etoposide and cisplatin is the mainstay of treatment for early-stage disease while combined chemoradiotherapy and chemotherapy are appropriate for women with locally advanced or recurrent NECC.

A CLINICAL COMPARATIVE STUDY OF RENAL PARAMETERS OF OBESE AND HYPERTENSIVE PATIENTS WITH NON-OBESE HYPERTENSIVE PATIENTS

KALAPALA VANAJA — 2025-01-15

Objective: Obesity is associated with an early onset of glomerulomegaly, hemodynamic changes of a hyper-filtering kidney, and increased albuminuria. It is an important risk factor for incident CKD and increase risk of ESRD. The aim of the present study is to compare the influence of renal parameters among the obese and non-obese hypertensive patients attended to a tertiary care hospital.

Methods: The study was conducted on 120 patients who were divided into 4 groups Group ‘O’ comprises of obese individuals; Group ‘OH’, which comprises of 30 obese and hypertensive individuals; Group ‘NO, H’ which comprises of non-obese and hypertensive individuals and Group ‘C’ which comprises of 30 healthy control group having normal BMI.

Results: The mean±SD of serum creatinine was 0.88±0.06; 1.13±0.1; 0.7±0.08; 0.7±0.06 of all the 4 groups and the Serum urea mean±SD was 26.4±3.8; 36.6±5.42; 21.2±3.2; 20.4±3.2 and the Serum uric acid mean±SD levels were 4.3±0.64; 4.3±0.56; 3.8±0.3; 3.7±0.26 of all the 4 groups and eGFR values were 139.5±1.8; 95.3±23.20; 116.2±7.4;118.6±6.2 in obese, obese hypertensive, non-obese hypertensive and control subjects respectively. The results showed that there was a significant influence of renal parameters among the four tested groups.

Conclusion: The strategies to prevent weight gain and to induce weight loss in patients who are already obese would ultimately reduce the incidence of obesity-mediated renal disease.

ALZHEIMER'S DISEASE: COMPREHENSIVE INSIGHTS INTO RISK FACTORS, BIOMARKERS, AND ADVANCED TREATMENT APPROACHES

SURESH JANADRI — 2025-01-15

Alzheimer’s disease (AD) is a prevalent neurodegenerative disorder primarily affecting individuals over 60. It is a multifactorial disease driven by both modifiable factors, such as lifestyle, diet, and prior health conditions, as well as non-modifiable factors, like age, genetics, and family history. The key pathological features of AD include the buildup of amyloid β plaques and neurofibrillary tangles resulting from hyperphosphorylated tau proteins in the brain. Biomarkers like amyloid β and tau protein levels in cerebrospinal fluid (CSF) and blood are essential for diagnosing and tracking AD progression. Current research focuses on developing drugs targeting multiple aspects of AD pathology, including inflammation, oxidative stress, synaptic dysfunction, and protein accumulation. These treatments aim to slow cognitive decline and neuronal damage. Given the complexity of AD, multi-targeted therapeutic approaches are being explored to enhance treatment efficacy. This review provides an overview of AD risk factors, key biomarkers used for diagnosis, and the latest advances in clinical drug development.

REVIEW ON SIZE EXCLUSION CHROMATOGRAPHY COUPLED WITH MASS SPECTROSCOPY

A. VAISHNAVI — 2025-01-15

The hyphenated technique was created by integrating the differentiating technique with directly spectroscopic technology to facilitate detection. It is discussed how SEC and electrospray ionization mass spectrometry (ESI-MS) can be combined, emphasizing the advantages this has for characterizing polymers. The capacity of SEC-ESI-MS to gather polymer structural information as well as to confirm polymer homologous transitions is first described. It's significant that the broad applicability of SEC-ESI-MS is underlined, for instance by its usage in the analysis of precise molecular weight distribution of polymers, the calculation of radical rate of polymerization coefficients, and the thorough exploration of radical photoinitiation systems. Thus, this momentous tutorial review intends to highlight the high potential of SEC-ESI-MS to emerge as a formidable and well-liked analytical method in polymer chemistry and to illustrate the capability of SEC-ESI-MS for the analysis of complicated polymers. The article addresses recent advancements in the uses of a variety of hyphenated techniques, such as the GC-MS method, LC-MS analysis, LC-FTIR, LC-NMR, CE-MS, and others.

PRIMARY NEUROENDOCRINE TUMOR OF THE ENDOMETRIUM, A RARE TUMOR: CASE SERIES

PRATEEK TIWARI — 2025-01-15

Objective: Endometrial NET is a rare disease with a poor prognosis. Due to its rarity, there are no evidence-based standards or international guidelines for the diagnosis and treatment of endometrial NETs.

Methods: In this study, we present our experience with four cases of NETs of the endometrium to describe these rare tumors’ clinical characteristics and behaviour. The clinicopathological characteristics, treatment and prognosis, were analysed.

Results: Most common age group for presentation was 50 to 70 y. Irregular vaginal bleeding was most common symptom at presentation. Three patients underwent surgery followed by adjuvant chemoradiation while one patient with metastatic disease underwent chemotherapy. Overall prognosis was poor with two patients died 12 mo and 24 mo, respectively. One patient was lost to follow-up after 39 mo and one patient was disease free till last follow-up.

Conclusion: Given the aggressive nature of the disease, patients should be carefully observed and followed up regularly. More studies with a higher number of cases are required to establish a standard therapeutic protocol.

CML- A IMPOSTER WITH MANY FACES

ASHISH GUPTA — 2025-01-15

Objective: The classification of chronic myeloproliferative diseases by the World Health Organisation includes eight forms of bone marrow neoplasms, including polycythaemia vera and Breakpoint cluster region-ABL viral oncogene homolog 1(BCR-ABL)-positive CML. Polycythaemia vera is diagnosed in the majority of cases (95%) only when the Janus kinase-2 mutation is present and the Breakpoint cluster region-Abelson murine (BCR-ABL) leukaemia viral oncogene homolog-1 rearrangement is negative.

Methods: Methods are not explicitly stated in the abstract; however, the study seems to have involved genetic testing and diagnostic evaluation to identify specific mutations and rearrangements associated with the conditions.

Results: With no Janus kinase-2 mutation, the presence of the Philadelphia chromosome, and the BCR-ABL leukaemia viral oncogene homolog one fusion gene, we report a case with erythrocytosis as the main feature of chronic myeloid leukaemia.

Conclusion: The case highlights a rare occurrence in the diagnosis of chronic myeloid leukaemia where typical genetic markers of polycythaemia vera are absent, indicating the complexity and variability in the genetic landscape of myeloproliferative diseases.

A FLEETING DARKNESS: TRANSIENT VISION LOSS IN PSEUDOTUMOR CEREBRI A CASE REPORT

SANJAYKUMAR RATHWA — 2025-01-15

The hallmark of pseudotumor cerebri is a neurological condition marked by high intracranial pressure (ICP) without any discernible localizing signs or neurological impairments with normal intracranial structures. Radiographic exclusion of an intracranial mass is necessary for the mainly clinical diagnosis. We reported a case of a 27-year-old lady presented to the department of general medicine with severe headache and bilateral blurring of vision. Ophthalmoscopy revealed bilateral papilledema. Magnetic resonance imaging (MRI) brain with orbit revealed typical alterations, including bilateral flattening of the posterior sclera and protrusion of the optic nerve heads. Above findings were suggestive of pseudotumor cerebri. Treatment designed to reduce discomfort while preserving vision. Initial treatment included methylprednisolone, mannitol and acetazolamide. Acetazolamide and oral Prednisolone were administered after discharge in a tapering dose over a period of 1 mo.