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   2012| September-December  | Volume 2 | Issue 3  
    Online since August 8, 2012

 
 
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REVIEW ARTICLES
Pomegranate (Punica granatum L). Ancient seeds for modern cure? Review of potential therapeutic applications
Prasan R Bhandari
September-December 2012, 2(3):171-184
DOI:10.4103/2231-0738.99469  
Pomegranate (Punica granatum L), in addition to its ancient historical uses, has been used in several systems of medicine for a variety of ailments. Pomegranate juice is a polyphenol-rich juice with high antioxidant capacity. In studies of human and murine models, pomegranate juice has been shown to exert significant antiatherogenic, antioxidant, anti-carcinogenic, and anti-inflammatory effects. In the past decade, numerous studies on the antioxidant, anti-carcinogenic, and anti-inflammatory properties of pomegranate constituents have been published, focusing on the treatment and prevention of cancer, cardiovascular disease, diabetes, dental conditions, and ultraviolet radiation-induced skin damage. Other potential applications include infant brain ischemia, male infertility, Alzheimer's disease, arthritis, and obesity. The aim of the present review is to discuss the cumulative evidence, which suggests that pomegranate consumption possesses a diverse array of biological actions and may be helpful in the prevention of some inflammatory-mediated diseases, including cancer. The search strategy included Pubmed, using terms 'pomegranate' or 'Punica granatum'. Citations relevant to the topic were screened.
  27 28,800 1,881
ORIGINAL ARTICLES
Influence of mothers' chronic energy deficiency on the nutritional status of preschool children in Empowered Action Group states in India
Ravishankar Athimulam Kulasekaran
September-December 2012, 2(3):198-209
DOI:10.4103/2231-0738.99471  
Introduction: Malnutrition not only blights the lives of individuals and families, but also acts as a major barrier to social and economic progress In India, particularly in the EAG states. Under this backdrop, this study aims to assess degree of chronic energy deficiency and its determinants and to investigate the impact of low BMI of women on children's health status. Materials and Methods: Data drawn from the National Family Health Survey-III, conducted 2005-06, from Empowered Action Group (EGA) states. A multiple linear regression analysis was done to see the relation between CED status of women and different socioeconomic factors and to find out the influence of CED on children's health status. Results: The 20th century witnessed a significant proportion of overweight and obese individuals coexist with the undernourished in many developing countries however the EAG states experiencing high prevalence of under-nutrition (34percent) and low incidence of overweight (13percent). Jharkhand, Bihar and Chhattisgarh reported significantly higher profession of chronic energy deficiency than the rest of the EAG states. The results of the multivariate logistic regression analyses show that age of women, place of residence, caste, women's education, and wealth index are significantly associated with underweight. The chronic energy deficiency women produce more number of anaemic children than the counterparts. Around forty percent of the low weight babies are born to the chronic energy deficit women. Conclusion: The burden of chronic energy deficiency indicates that there is a need for special public health programs that are able to address chronic energy deficiency.
  7 6,978 617
REVIEW ARTICLES
Effects of dietary derived antioxidants on the central nervous system
Jade A Guest, Ross S Grant
September-December 2012, 2(3):185-197
DOI:10.4103/2231-0738.99470  
Oxidative stress refers to the pathological state in which the production of reactive oxygen and nitrogen species is increased above the body's antioxidant defense and repair capacity. Functional damage, with subsequent cell death, may occur as a consequence of the oxidization of cellular components, such as, proteins, lipids, and nuclear material. Several features of the brain suggest that it is particularly vulnerable to oxidative stress. The brain possesses the highest oxygen metabolic rate of any organ and is continually exposed to excitatory amino acids and neurotransmitters. The brain also contains a high concentration of oxidizable polyunsaturated fatty acids, but has comparatively limited endogenous antioxidant defense mechanisms. Accumulating evidence indicates that dietary-derived antioxidants may mitigate the development of neurodegenerative diseases, with a number of recent studies focusing on the potential therapeutic benefits of supplementation. This review focuses on our current knowledge of how some of these diet-derived antioxidants may exert their neuroprotective effects.
  6 10,291 482
BRIEF COMMUNICATIONS
Bitter bottle gourd (Lagenaria siceraria): Healer or killer?
Anupama Sukhlecha
September-December 2012, 2(3):276-277
DOI:10.4103/2231-0738.99488  
  4 35,816 334
ORIGINAL ARTICLES
Study of cardiovascular effects of caffeine in healthy human subjects, with special reference to pulse wave velocity using photoplethysmography
Raveendranadh Pilli, MUR Naidu, Usha Rani Pingali, Ramesh Kumar Rao Takallapally
September-December 2012, 2(3):243-250
DOI:10.4103/2231-0738.99478  
Introduction: Caffeine is one of the most widely used pharmacologically active substances. It increases blood pressure and peripheral vascular resistance by stimulation of the sympathetic nervous system. Studies on the cardiovascular effects of caffeine have often produced contradictory results. Arterial stiffness and pulse wave reflections are important determinants of the efficient performance of the cardiovascular system, with prognostic value for cardiovascular risk. Materials and Methods: This is a randomized, double-blind, placebo-controlled, parallel-design study, comparing the effects of a single oral dose of 250 mg or 500 mg caffeine and placebo on arterial stiffness and pulse wave reflections in 36 healthy male subjects by measuring arterial pulse wave velocity by recording fingertip second derivative of photoplethysmogram (SDPTG) and ECG simultaneously. Blood pressure, heart rate, pulse wave velocity, and b/a ratio (SDPTG index) were measured at baseline and at 30 and 60 minutes after administration of caffeine. Results: Compared to baseline, systolic and diastolic blood pressures were increased significantly at 30 minutes and 60 minutes with caffeine, while heart rate decreased significantly at 30 minutes (P<0.05 for 250mg and P<0.01 for 500mg caffeine) but showed no significant change at 60 minutes. Pulse wave velocity increased significantly with both the doses of caffeine at 30 minutes (P<0.05) and 60 minutes (P<0.001). Similarly, the b/a ratio also increased significantly at 30 minutes (P<0.01) and 60 minutes (P<0.01) with 250 mg, but the change was insignificant with 500 mg. No significant changes were observed after administration of placebo. Conclusion: Acute administration of caffeine produced rise in blood pressure, arterial stiffness, and change in wave reflections in healthy subjects as indicated by pulse wave velocity and b/a ratio.
  3 8,038 223
Monosodium glutamate modulates the circadian rhythms of biochemical variables and behavioral activity in rats under constant light
Palanisamy Kumaravel, Selvaraju Subash, Krishnamoorthy Swarnam Seethalakshmi, Natarajan Murugan, Ragunathan Yuvarajan, Perumal Subramanian
September-December 2012, 2(3):251-257
DOI:10.4103/2231-0738.99479  
Introduction: Suprachiasmatic nuclei (SCN) contained a variety of neurotransmitters and neuropeptides, and many of them could influence the activities of the circadian pacemaker. Glutamate was the major excitatory neurotransmitter in the mammalian central nervous system (CNS) and in SCN. Materials and Methods: Monosodium glutamate (MSG) (50 mg / kg body weight) was administered subcutaneously for 60 days to Wistar rats; open-field behavioral activity and 24-hour rhythms of glucose, cholesterol, total protein, phospholipids, aspartate transaminase (AST), and alkaline phosphatase (ALT) were studied under conditions of constant light (LL). Results: An open-field behavioral test showed that peripheral movement, central movement, rearing and grooming, were significantly decreased in LL, MSG and LL (MSG-treated) rats when compared with the control rats . The study revealed that the acrophase, amplitude, and mesor values of the glucose, protein, lipid profile, and liver marker enzymes of these rhythms were found to be altered in the experimental group rats when compared with the control rats. Conclusion: Monosodium glutamate, under constant light, modulated the circadian rhythms of lipid profiles and liver marker enzymes, which could be due to glutamate conveying the photic information to the SCN.
  3 5,709 157
Drug utilization pattern among geriatric patients assessed with the anatomical therapeutic chemical classification / defined daily dose system in a rural tertiary care teaching hospital
Rima B Shah, Bharat M Gajjar, Sagun V Desai
September-December 2012, 2(3):258-265
DOI:10.4103/2231-0738.99480  
Aim: To use the ATC/DDD system to study the drug utilization pattern among geriatric patients in a rural tertiary care teaching hospital. Materials and Methods: A cross-sectional prospective observational study involving 400 geriatric patients was carried out from August 2007 to October 2009. Relevant information was obtained by personal interview and from perusal of case files. Results: The majority of the patients (72%) were in age group of 65-74 years. There was a male preponderance (60.03%). Of the total 1026 disease conditions, cardiovascular diseases were the most common (86.75%), followed by musculoskeletal conditions (32.25%); psychiatric diseases (0.5%) had the lowest prevalence. Comorbid conditions were present in 315 (78.75%) patients. A total of 2924 drug formulations, containing 3254 active ingredients, were prescribed, of which 339 (11.59%) were fixed-dose combinations (FDCs). The mean number of drug formulations per prescriptions was 7.31±4.39. Polypharmacy and high polypharmacy were prevalent in 52% and 23.25% of patients, respectively. Only 15.6% formulations were prescribed by their generic names and only 51.7% were drugs that were included in the World Health Organization's Essential Medicines List (WHO-EML) Drugs acting on the cardiovascular system (22.81%) were the most frequently prescribed drugs, followed by antimicrobials (16.89%) and drugs acting on the gastrointestinal system (13.61%). Ranitidine (A02BA02) 150 mg was most frequently prescribed drug having DDD of 162, followed by aspirin (B01AC06) 75 mg, diclofenac sodium (M01AB05) 50 mg, and amlodipine (C08CA01) 5 mg with numbers of DDD 118UD, 94, and 88, respectively. Conclusion: Drug utilization data can help in assessing the quality of care given to the geriatric patients and promote rational use of medicines.
  2 5,308 583
Chronotherapeutic effect of morin in experimental chronic hyperammonemic rats
Selvaraju Subash, Perumal Subramanian
September-December 2012, 2(3):266-271
DOI:10.4103/2231-0738.99483  
Aim: Ammonia is a neurotoxin that has been strongly implicated in the pathogenesis of hepatic encephalopathy and a major pathogenic factor associated with inborn errors of urea cycle. In this present work we aimed to evaluate the chronotherapeutic effect of morin (3,5,7,2',4'-pentahydroxyflavone), a plant component, on ammonium chloride (AC) (100 mg/kg; intraperitoneal)-induced hyperammonemia in Wistar rats (180-200 g). Materials, Methods and Results: Morin (30 mg/kg body weight) was administered to rats at 06:00, 12:00, 18:00, and 24:00 hours in hyperammonemia. The influence of morin on AC-induced hyperammonemia at different time points (06:00, 12:00, 18:00, and 24:00 hours) was evaluated by analyzing the circulatory levels of ammonia; urea; thiobarbituric acid reactive substances (TBARS); hydroperoxides (HP); liver markers [alanine transaminase (ALT), aspartate transaminase (AST), and alkaline phosphatase (ALP)]; glutathione peroxidase (GPx); superoxide dismutase (SOD); catalase (CAT); reduced glutathione (GSH); and vitamins A, C, and E. The levels of these components were significantly elevated in AC-treated rats but were decreased significantly after treatment with morin. Administration of morin at 24:00 h caused significantly greater reduction in these parameters than administration at other time points (P<0.05; Duncan's multiple range test). Conclusion: The chronotherapeutic effect of morin in hyperammonemic rats may be due to various factors, including (i) temporal variations of metabolic enzymes involved in the degradation of morin; (ii) temporal variations of lipid peroxidation and of antioxidants, urea cycle enzymes etc.; and (iii) temporal variation in bioavailability of morin. However, the exact underlying mechanism(s) is/are still unclear and further investigations are needed.
  1 2,888 170
Radiosensitizing effect of sesamol on human cervical carcinoma cells
Mohana Shanmugham, Nagarajan Rajendra Prasad
September-December 2012, 2(3):210-216
DOI:10.4103/2231-0738.99472  
Aim: To determine the radiosensitizing effect of sesamol in cervical carcinoma cell line (HeLa) in vitro. Materials and Methods: Sesamol-pretreated (10 μg/ml) HeLa cells were exposed to 4 Gy γ-radiation and the cellular changes were estimated by lipid peroxidation, changes in the enzymatic and non-enzymatic antioxidant status, oxidative DNA damage, % of growth inhibition, and morphological changes in the irradiated and/or sesamol-treated HeLa cells. Results: Sesamol treatment prior to irradiation significantly increased the levels of thiobarbituric acid reactive substances, (TBARS), lipid hydroperoxides (LPH), and conjugated dienes (CD) in HeLa cells. On the other hand, sesamol treatment before irradiation significantly decreased the levels of reduced glutathione (GSH), superoxide dismutase (SOD), catalase (CAT), and glutathione peroxidase activities (GPx). Further, we observed increased % tail DNA, tail length, and tail moment in sesamol plus γ-irradiated cells when compared to irradiation alone. The % of cell death was also increased in sesamol plus γ-irradiated cells, particularly at 48 h incubation. Conclusion: Sesamol pretreatment prior to irradiation enhances the radiation effects in HeLa cell line. This study supports the use of dietary phytochemicals such as sesamol in practical radiotherapy.
  1 3,317 209
Biochemical changes in cardiac tissue upon monosodium glutamate administration in hypercholestremic mice
Kuldip Singh, Arvind Preet Kaur, Pushpa Ahluwalia
September-December 2012, 2(3):217-222
DOI:10.4103/2231-0738.99473  
Background: Monosodium glutamate, a flavour enhancer ubiquitously used all over the World as a flavour enhancer in a variety of foods like two minute noodles, soups, sauces etc. prepared at home or restaurants. Aim:Monosodium glutamate was administrated at dose levels of 4 and 8mg/g body weight to hypercholestremic adult male mice for 6 consecutive days and its effect was observed on 31 st day after the last injection for the genesis of atherosclerosis by evaluating the changes in plasma lipid peroxidation and certain antioxidant enzymes in cardiac tissue of hypercholestremic adult male mice. Materials and Methods: The animals were divided in four groups each comprising 6 mice. Group-I: Control, Group-II: Hypercholestremic animals, Group-III: 4mgMSG/g body weight + hypercholestremic animals and Group-IV: 8mgMSG/g body weight + hypercholestremic animals. Animals were fasted overnight and sacrificed by decapitation. The 10% homogenate was prepared in 100mMpotassium phosphate buffer (pH7.5). The homogenate was centrifuged at 1,000g and supernatant was used for the estimation of lipid peroxidation, xanthine oxidase, superoxide dismutase and catalase. Results:A significant increase was observed in lipid peroxidation and xanthine oxidase levels while a significant decrease was found in superoxide dismutase and catalase levels of all the studied groups. Conclusion: These observations suggested that administration of monosodium glutamate at dose levels of 4 mg/g body weight and above to hypercholestremic animals had no beneficial effect instead it further enhanced the lipid peroxidation and alter the status of free radical initiating (xanthine oxidase) and scavenging (superoxide dismutase and catalase) enzymes and thereby being responsible for the initiation of coronary heart disease/atherosclerosis.
  1 2,995 123
Evaluation of antinociceptive/analgesic activity of SSRIs (fluoxetine and escitalopram) and atypical antidepressants (venlafaxine and mirtazapine): An experimental study
Pranav Sikka, Sadhna Kaushik, Seema Kapoor, Manish Saini, KK Saxena
September-December 2012, 2(3):223-228
DOI:10.4103/2231-0738.99474  
Objective: To evaluate the antinociceptive/analgesic action of selective serotonin reuptake inhibitors (SSRIs; fluoxetine, escitalopram) and atypical antidepressants (mirtazapine, venlafaxine) and to delineate their probable mechanism. Materials and Methods: The study was conducted on albino mice (25-35 g) and Wistar rats (80-100 g) of either sex. Different doses of morphine (0.5 and 1 mg/kg), fluoxetine (2, 5, and 10 mg/kg), venlafaxine (30, 40, and 50 mg/kg), mirtazapine (3, 5, and 7 mg/kg), and escitalopram (2.5, 5, and 10 mg/kg) were administered subcutaneously in order to ascertain their subanalgesic doses using tail flick analgesiometer and writhing method. Tail flick latencies were obtained at 15, 30, 60, and 120 min after drug administration. In another set of experiments, abdominal writhing was produced by employing 4% saline (1 ml/kg; i.p.) as irritant. Pretested sensitive rats were given test drugs 10 min before saline injection and abdominal writhing was noted between 30 seconds and 3 min of administering saline. Naloxone (1 mg/kg) was administered 10 min prior to test drug for testing antagonism in both sets of experiments. Results: In both sets of experiments, fluoxetine (5 and 10 mg/kg), mirtazapine (5 and 7 mg/kg), and venlafaxine (40 and 50 mg/kg) were found to have antinociceptive activity, but not at lower doses. Escitalopram failed to show antinociceptive activity at any of the doses used. The antinociceptive effect of all the drugs was antagonized by naloxone. Further, subanalgesic doses of fluoxetine, mirtazapine, and venlafaxine showed analgesic activity with suboptimal dose of morphine (0.5 mg/kg). Conclusion: Fluoxetine, mirtazapine, and venlafaxine have antinociceptive activity, whereas escitalopram does not have; their site of action seems to be the same as that of opioid analgesics ("mu" receptors). However, involvement of other pathways (cholinergic, histaminic, noradrenergic, GABAergic) cannot be excluded in mediation of their analgesic activity, which requires further elucidation.
  1 4,039 204
REVIEW ARTICLES
Role of lycopene in the prevention of cancer
Ankita Johary, Vinod Jain, Samir Misra
September-December 2012, 2(3):167-170
DOI:10.4103/2231-0738.99468  
Cancer is a major public health problem in many parts of the world. There are over 100 different types of cancer, affecting various parts of the body. Oxidative stress is an important contributor in cancer. If oxidative damage is left unrepaired, it can lead to mutations and changes in cell biology, which can lead to neoplasia (unregulated accumulation of cells). Increased consumption of fruits and vegetables has been recommended to reduce the incidence of cancer. Fruits and vegetables are good sources of antioxidants and phytochemicals that mitigate the damaging effect of oxidative stress. They play an important role in the prevention of cancer and maintenance of good health. Recently, there has been a lot of interest in the role of lycopene in cancer prevention. Lycopene is one of the dietary carotenoids and a potent antioxidant. It is present in tomatoes (including processed tomato products) and other fruits such as grape, watermelon, orange, and papaya. Dietary intake of tomato and tomato products containing lycopene has been shown to be associated with decreased risk of cancer. The antioxidant properties of lycopene have been documented as being primarily responsible for its beneficial effects. In this article we outline the possible mechanism of action of lycopene and review the current understanding of its role in cancer prevention.
  1 8,020 456
BRIEF COMMUNICATIONS
Curtailing authorship disputes: A structured approach
Anupama Sukhlecha
September-December 2012, 2(3):272-275
DOI:10.4103/2231-0738.99486  
  - 1,872 70
EDITORIAL
Taking note of modifiable neurobiological risk factors in adolescent depression
Ross Grant
September-December 2012, 2(3):165-166
DOI:10.4103/2231-0738.99467  
  - 2,148 83
ORIGINAL ARTICLES
Routine retinal examination in patients with acute stroke in Ahmadu Bello University Teaching Hospital, Shika-Zaria, Nigeria
Emmanuel R Abah, OR Obiako, AF Mahmoud-AJeigbe, O Audu
September-December 2012, 2(3):229-232
DOI:10.4103/2231-0738.99475  
Background: There is high prevalence of hypertension and diabetes in patients with stroke, and these are also major risk factors for potentially blinding retinal diseases. This study was conducted to determine the prevalence and types of retinal abnormalities in patients with acute stroke in Ahmadu Bello University Teaching Hospital, Shika-Zaria, Nigeria. Materials and Methods: A prospective study of 297 consecutive patients with acute stroke was carried out. All the patients recruited had dilated fundoscopy and those who had retinal abnormalities were referred to the eye clinic for follow-up on discharge. Data analysis was by use of statistical package for social sciences (SPSS version 17), with statistical significance set at a P-value of 0.05. Results: Out of the 275 patients examined, 57.4% (n = 158) had retinal abnormalities. Age-related Macular Degeneration (AMD) predominated (36.7%), followed by cotton wool spots (22.2%) and retinal hemorrhage (16.5%). Hard exudates constituted 12.7%. Neovascularization and microaneurysms formed 5% each, while branch retinal vein occlusion constituted only 1.9%. Sixty-four percent were hypertensive and 24% were diabetic. Conclusion: The prevalence of retinal abnormalities among stroke patients is quite remarkable (57.4%). Routine retinal examination in such patients cannot be overemphasized because it may help to detect potentially vision-threatening retinal disorders.
  - 2,967 108
Nutritional status assessment of school children in Mangalore city using the multicenter growth reference study WHO 2007 Z-scores
Ramachandra Kamath, Manish Kumar, Sanjay Pattanshetty, Asha Kamath
September-December 2012, 2(3):233-236
DOI:10.4103/2231-0738.99476  
Context: One of the the United Nation's Millennium Development Goals (MDGs) is the reduction of maternal and child mortality. The 'green revolution' has increased food supply in Asia, and hunger and under nutrition have been decreasing since 1981. However, instead of having to deal with surplus food grain, South Asia and India are still facing high levels of hunger. Although some south Indian cities are witnessing a technology boom, one in every 11 children die within the first 5 years of their lives either due to malnutrition or due to non availability of even simple technology and health care. Aim: To assess the nutritional status of schoolchildrenin Mangalore city. Settings and Design: A cross-sectional study. Materials and Methods: A total 1630 students from 11 schools were enrolled for the study. The sample size was calculated assuming the prevalence of undernourished in Mangalore city as 20% and a relative precision of 10%. Statistical Analysis: The BMI (body mass index), Z-scores, and World Health Organization (WHO) Multicentric Growth Reference Study (MGRS) growth chart was used for analysis. Results: Our study population of 1630 students comprised 830 (50.9%) males and 800 (49.1%) females. On analysis, 82 children (5.03%) were found to be undernourished, 37 (2.3%) were overweight, and 16 (1%) were obese. Undernourishment was more prevalent in boys (6.87%) than in girls (3.12%).Obesity was marginally higher among males (1.2%) as compared to females (0.8%) (P=0.003). A total of 15 boys (1.8%) and 22 girls (2.8%) were found to be overweight. Conclusions: The nutritional status of the students in our study is better than has been found in other studies. However, there are cases of under nourishment that need attention. At the same time, there is a need to deal with obesity and overweight in schoolchildren in order to prevent the impending epidemic of noncommunicable disease.
  - 3,823 363
A retrospective study of the metabolic adverse effects of antipsychotics, antidepressants, and mood stabilizers in the psychiatry outpatient clinic of a tertiary care hospital in south India
Kingshuk Lahon, Harsha M Shetty, Amith Paramel, Gyaneshwar Sharma
September-December 2012, 2(3):237-242
DOI:10.4103/2231-0738.99477  
Background: Persons with severe mental illness are at relatively greater risk of developing obesity, type 2 diabetes mellitus, hypertension, and dyslipidemia as compared to the normal population. Psychotropic medication such as antipsychotics, antidepressants, and mood stabilizers may further increase the risk in these patients. Hence, we wanted to study the prevalence and pattern of metabolic adverse effects of antipsychotics, antidepressants, and mood stabilizers. Materials and Methods: We conducted a 1-year retrospective study of case records in the outpatient clinic of the psychiatric unit of our hospital and assessed the causality, severity, and preventability of the documented metabolic adverse events. We calculated prevalence rates by descriptive methods and used standard scales for assessing the causality, severity, and preventability of the adverse drug reactions (ADR). Results: Out of 222 patients who received antipsychotics, antidepressants, or mood stabilizers, 20 patients developed metabolic ADRs (9.01%), which included weight gain, hyperglycemia, dyslipidemia, and galactorrhea. These ADRs were possible to probable, mild to moderately severe, and probably preventable as per the respective scales. Conclusions: The prevalence of metabolic ADR was low but the pattern was similar to that found in previous studies from the West. Weight gain was the most common metabolic ADR, and olanzapine was the psychotropic drug most commonly responsible for causing metabolic ADRs. Awareness and timely intervention on the part of treating physicians can help in prevention (by lifestyle modification) and management of such ADRs (by change of drug and/or using specific treatment for the metabolic derangement, e.g., oral hypoglycemic drugs for diabetes mellitus) and thus help decrease the morbidity and mortality among psychiatric patients.
  - 3,715 206
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