Girish Gulab Meshram

Evaluation of the Antiulcer Activity of the Leaves of Azadirachta indica: An Experimental Study

Background:Azadirachta indica, an evergreen tree, is used by several folkloric practitioners to treat peptic ulcers in India. The present study was carried out to evaluate the antiulcer activity of the aqueous extract (AE) of the leaves of A. indica in Wistar rats. Methods: Gastric ulcerations were induced by pyloric ligation, aspirin, and cold restraint stress. AE was used in doses of 150, 300, and 600 mg/kg body weight per os. Distilled water served as the control and ranitidine 20 mg/kg body weight intraperitoneal as the reference standard. The ulcer index (UI) and percentage inhibition (PI) values were determined in each model. The volume of gastric contents, free acidity, total acidity, and pH were measured in the pyloric ligation-induced ulcer model. Results: AE showed a dose-dependent and significant (p < 0.05) decrease in the UI and an increase in the PI in all models employed compared to the control group. AE caused a dose-dependent decline in the gastric content volume, free acidity, and total acidity. Conclusion: The leaves of A. indica possess significant antiulcer activity and act via multiple mechanisms.

Breast enlargement in newborns: a folkloric-medical dilemma:

A male infant was brought to hospital aged eight weeks. He was born at full term via normal vaginal home delivery without any complications. The delivery was conducted by a traditional birth attendant and Apgar scores at birth were unrecorded. One week after the birth, the parents noticed an increase in size of the baby’s breasts. In accordance with cultural practice, they massaged the breasts in order to express milk, hoping that by doing so the size of the breasts would return to normal. However, the size of the breasts increased. They also reported that milk was being discharged spontaneously through the nipples. There was no history of drug intake neither by the mother nor the baby. The infant appeared clinically well and showed no signs of irritability. On examination, bilateral breast enlargement was observed of approximate diameter 6 cm. No tenderness, purulent discharge or any sign of inflammation were observed (Figure 1). Systemic and genital examination were unremarkable. Routine blood investigations were normal. Firm advice was given not to massage the breasts of the baby.

Staphylococcal scalded skin syndrome: A pediatric dermatology case report:

Staphylococcal scalded skin syndrome is a condition which predominantly affects children and causes a spectrum of skin lesions. We present a case of a 2-month-old infant with complaints of fever and fragile blisters over the body. The mucosal areas were spared. The diagnosis of staphylococcal scalded skin syndrome was reached on clinical grounds and culture report. The patient responded well to the treatment, which included an antibiotic (cloxacillin), an analgesic (paracetamol), and hydration with intravenous fluids. He was discharged after 8 days, with almost complete resolution of his skin lesions. Having a high clinical suspicion for staphylococcal scalded skin syndrome, early diagnosis/treatment, and following robust hygiene measures are imperative for the effective management of staphylococcal scalded skin syndrome. More efforts are needed to develop novel therapies for staphylococcal scalded skin syndrome.

Unilateral Primary Congenital Lymphedema of the Upper Limb in an 11-Month-Old Infant: A Clinical and Pharmacological Perspective

BACKGROUND: Lymphedema is the accumulation of a protein-rich fluid in the interstitial space due to reduced lymph transport capacity. Congenital primary lymphedema affecting only one of the upper limbs is a rarity. CASE REPORT: We present a case of an 11-month-old infant presenting with swelling of the right upper limb, which had gradually progressed over the past five months. Lymphoscintigraphy was suggestive of lymphatic blockade in the right upper limb. All other investigations were within normal limits. A diagnosis of primary congenital lymphedema affecting the right upper limb was made. The patient was managed conservatively with complex decongestive therapy and was requested regular follow-up. The lymphedema did not increase within four months of follow-up. CONCLUSIONS: Complex decongestive therapy is the cornerstone of the management of primary congenital lymphedema. New investigational therapies such as leukotriene B4 antagonists hold a promise for patients with lymphedema.

Complete Rectal Prolapse in Children: Case Report, Review of Literature, and Latest Trends in Management

BACKGROUND: Complete rectal prolapse is the circumferential descent of all the layers of the rectum through the anus. It often leads to bleeding, obstructed defecation, incarceration or fecal incontinence. CASE REPORT: We present a rare case of a 4-year-old child with complete rectal prolapse of 12 cm in length. The prolapsed rectum was manually repositioned after reducing the oedema. The precipitating factor was identified as excessive straining while passing stools. A change in position while passing stools was advised along with a high fibre diet and a stool softener. Recurrence was not observed in the 3 month of follow-up. CONCLUSION: Most cases of pediatric rectal prolapse are managed conservatively by addressing the associated and precipitating etiological factors. Surgical intervention may be required for recurrent or persistent cases.

Cornelia De Lange Syndrome In A 4-Year-Old Child From India: Phenotype Description And Role Of Genetic Counseling

Introduction: Cornelia de Lange syndrome (CdLS) is a congenital disorder marked by distinctive facial features, severe growth restriction, cognitive disability, global developmental delay, and anomalies involving multiple body organs. Majority cases of CdLS are caused due to sporadic mutations in the NIPBL, SMC1A, SMC3, RAD21, or HDAC8 genes, which form/regulate a multiprotein complex called cohesin. Cohesin is required for the separation of sister chromatids during cell division. Case report: We present a rare case of a 4-year-old child from India depicting classical features of CdLS. The patient was managed symptomatically by a multidisciplinary team and was requested regular follow-ups. Conclusion: Phenotype description according to ethnicity may help in diagnosing CdLS. A multipronged approach by a team of physicians from various faculties is required for providing comprehensive medical care to patients with CdLS.

A case report of hypohidrotic ectodermal dysplasia: A mini-review with latest updates

Ectodermal dysplasia (ED) is a rare hereditary disorder involving two or more of the ectodermal structures, which include the skin, hair, nails, teeth, and sweat glands. The two most common forms of the disease are hypohidrotic/anhidrotic ED and hidrotic ED. They are caused by the mutations of several genes. We present a case of a 9-year-old child with hypohidrotic ED, who presented with hypodontia, dyshidrosis, hypotrichosis, and raised body temperature. We treated the raised body temperature symptomatically with cooling techniques and antipyretics. A multidisciplinary approach with physicians from several fields is required to provide comprehensive medical care to patients with ED.

Pediatric Pleomorphic Adenoma of the Parotid: Case Report, Review of Literature and Novel Therapeutic Targets

Salivary gland tumors are extremely rare and encompass a diverse group of histologies. Less than 5% of the affected population is pediatric. We present a case of 6-year-old child with pleomorphic adenoma of the parotid. The patient underwent a superficial parotidectomy. Recurrence was not observed in the six months of follow-up. Surgery is the mainstay of the management of benign salivary gland tumors. Although novel molecular agents are being explored, personalized therapy would be a challenge due to the rarity and vast genetic/histologic variations of salivary gland tumors.

Giant Congenital Melanocytic Nevi: An Update and Emerging Therapies

Giant congenital melanocytic nevi (GCMN) are a rare occurrence. Gain-of-function mutation in the NRAS gene is found to be associated with GCMN, causing abnormal proliferation of embryonic melanoblasts. The two major complications associated with GCMN are malignant melanoma and neurocutaneous melanosis. Treatment of GCMN has conventionally been surgical. However, the role of NRAS inhibitors and inactivation of nevus tissue by high hydrostatic pressure are being explored. We present a case of a 1-day-old neonate born with GCMN, along with a review of the literature.

Knowledge, Attitude and Perceptions of Indian long-distance Train Travellers Towards Medicinal Drugs, Healthcare, and Hygiene while Travelling: A Questionnaire-based Survey

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