Mohan Babu Amberkar

Wound healing activity of aqueous extract of Crotalaria verrucosa in Wistar albino rats

Objective: To evaluate the wound healing effect of aqueous extract of Crotalaria verrucosa (C.verrucosa) in rats. Methods: Three wound models including incision, excision and dead space wmooudnedlss, wgrearneu ulasteidon i nti stshuise sdtruyd yw.e Tighhet , pbarreaamkeintegr ss tsretundgitehd a wnde rhe ybdrreoaxkyipnrgo lsintree ncgotnht einnt iinnc idseioadn swpoaucned wmouodnedls., Rpeerscuelntst:a gTew oof dwoosuensd o fc othnetr aecxttiroanc ta wndit hp earniodd w oift heopuitt hdeelixaalmizeatthioans oinne esxhcoiswieodn tsiisgsnuiefi cbauntt iitn cwraesa sheisg hine rm weiatnh hdyodsreo x8y0p0r omlign/ek,g toctoaml pparortienign wciotnht etnhte acnodn tdrroyl . wTehigeh dt eoxf agmraenthualastoinone treated group showed a significant (P<0.001) reduction in the wound breaking strength when compared to control group in incision type of wound model. Coadministration of C. verrucosa with dexamethasone significantly (P<0.001) increased the breaking strength compared to the cdoenxtarmacettiohna swoanse stirgenaiftiecda notnlyl y( Pg<r0o.u01p). iInnc reexacseisdi obny wtwoou dnods ems oodf etle,s tt heex trpaecrtc oenn taalgl eth oef dtahyes wexocuenpdt tthhee ldoewxearm deothsea swonheic hsu epxphriebsisteedd wonoluyn odn c 1o2ntthra, c1t6iothn .d Iaty ssi gonf idfircuagn ttlrye a(Ptm<e0n.0t0 a1n) dre idt uaclesdo rthevee trismede required for epithelialization and reversed the epithelialization delaying effect of dexamethasone (P<0.001). Conclusions: C. verrucosa was found to possess significant wound healing property. cTohnist rwacatsi oenv,i dseknitn bbyr edaekcirneags est rinen tghteh ,p earnidod g oraf neupliathtieolnia ltiizsastuioen d, riny cwreeaisgeh ti nc othnete rnatt.e Hofe nwcoeu nCd.

Cycloserine Induced Late Onset Psychosis and Ethambutol Induced Peripheral Neuropathy Associated with MDR-TB Treatment in an Indian Patient- A Rare Case Report

Adverse reactions and toxicity inevitably accompany all treatment courses for drug-resistant TB. Our case underscores the importance of awareness regarding neuropsychiatric adverse reactions due to MDR-TB therapy and reversible nature of it. Cycloserine induced psychosis is most life threatening complication and sometimes could be fatal. A 42-year-old male on MDR-TB therapy got admitted for his persistent psychotic complaints like hallucinations, delusions and suicidal ideations, despite being treated with quetiapine/olanzapine. Eventually patient was rehabilitated, cycloserine was stopped and psychotic events regressed slowly. Other culprit drugs like ethambutol and levofloxacin causing psychosis was ruled out because there was no relapse of psychotic events despite being continued with these drugs. He also complained of tingling, numbness, swaying, pain and weakness. On examination, he had distal motor weakness in lower limbs, tandem gait positive, altered position sense, and tenderness over toes and positive Rombergs sign with ataxia. He was diagnosed to have drug induced sensorimotor peripheral neuropathy. All these symptoms persisted after stopping cycloserine and patient continued to have neuropathy with ethambutol and ethionamide. Considering the nature of neuropathy which was mild, mixed sensorimotor and resolved completely after 2-3 weeks of stopping, it was more in favour of ethambutol. However, we could not rule out the possibility of ethionamide or (ethionamide + ethambutol) causing neuropathy or both could have accelerated the neurotoxic effects of cycloserine which remained elusive.

Pharmacotherapy of Opportunistic Infections in HIV Patients: A Review -

With the introduction of antiretroviral therapy, there has been a dramatic decrease in the morbidity and mortality of human immunodeficiency virus (HIV) infected individuals. Due to varying degree of immunosuppression, these patients are prone to various number of infections in their lifetime. Respiratory system, central nervous system, gastrointestinal tract and the skin are the most susceptible for the organisms to be infected in opportunistic infections. Timely management of these microbial infections followed chemoprophylaxis is an important part of guidelines set for management of opportunistic infections in HIV. The development of drug toxicities and drug resistance in managing patients with HIV has always remained a clinical challenge. Consideration is given to the numerous known pharmacokinetic interactions between drugs used to treat and prevent opportunistic infections and antiretroviral drugs, and development of complications like immune reconstitution inflammatory syndrome. Clinicians must be knowledgeable about optimal strategies for diagnosis, prevention and treatment of opportunistic infections in order to improve health and to provide high quality of care for the patients.

A Retrospective Study of the Treatment Outcome of Drug Therapies used in Heart Failure Patients with Associated Co-morbidities in a Tertiary Care Hospital.

INTRODUCTION Heart failure is one of the most common heart problems seen in the Indian population. There are various drugs used to prevent further progression of the disease. In India, there are few studies in relation to treatment outcome in a tertiary care hospital. AIM To study the treatment outcome of drug therapies used in heart failure patients with associated co-morbidities in a tertiary care hospital. MATERIALS AND METHODS This was an observational study conducted on 250 patients with heart failure. Details collected using the proforma were demography (age, gender); medical history; medication history for heart failure patients on admission and discharge; ejection fraction; median length of stay in hospital; number of readmissions & in-hospital mortality. RESULTS One hundred and twenty eight patients categorized into LVSD group (ejection fraction <40%) and 122 patients in PSF group (ejection fraction > 40%). Medical history of coronary artery disease (54%) was significantly higher in LVSD group (p<0.05) and anaemia (19%) was significantly higher in PSF group (p<0.05). On admission, inotropes (30%), digoxin (59%) and statins (54%) were prescribed more in LVSD patients (p<0.05) while calcium channel blockers (20%) were prescribed more in PSF group (p<0.05). At discharge, patients with LVSD were receiving ACE inhibitors (51%), beta blockers (30%), digoxin (67%) and statins (59%) (p<0.05) while calcium channel blockers (20%) was prescribed more in PSF group. The median length of stay was slightly higher in patients with PSF (7 days) as compared to LVSD (6 days). In-hospital mortality was lower in patients with PSF (6%) than patients with LVSD (20%). The percentage of readmissions within one month was slightly higher in patients with PSF (15%) compared to LVSD (14%). CONCLUSION Length of stay in hospital was 6-7 days in heart failure patients. In hospital mortality in LVSD patients (20%) was higher compared to PSF patients (6%). A 15% heart failure patient were readmitted within 1month of discharge.

Acebrophylline-induced angioedema

A 53-year-old woman visited her physician complaining of acute breathlessness and productive cough. Her medications included budesonide and formoterol for asthma, fixed-dose combination aspirin 150 mg + clopidogrel 75 mg + atorvastatin 20 mg for ischemic heart disease. History revealed that she had allergic rhinitis and was hypersensitive to penicillins. The patient was prescribed acebrophylline (ABP). Six hours after ABP therapy she presented with generalized urticarial lesions, swelling of hands, feet, lips and face, suggestive of angioedema. ABP was stopped immediately, and the patient was treated symptomatically. This case was categorized as probable as per standard causality assessment scale.

Risperidone Induced Granulomatous Mastitis Secondary to Hyperprolactinemia in a Non-Pregnant Woman-A Rare Case Report in a Bipolar Disorder

Idiopathic granulomatous lesion is a rare entity of the breast seen in young-middle aged women. Diagnosis and management of granulomatous lesions with known aetiology does not impose major clinical problems. However, most often these lesions are undetected or unnoticed due to lack of timely diagnosis and inappropriate management, as primarily it is idiopathic. Hyperprolactinemia have been proposed as one of the mechanisms underlying the development of granulomatous lesions of the breast. We report a case of hyperprolactinemia due to risperidone therapy for bipolar mood disorder in a woman who eventually developed granulomatous mastitis. Histologically, the diagnosis was confirmed by the presence of granulomatous lesion and by ruling out other potential causes. In this case, raised prolactin was possibly an important factor which was secondary to risperidone therapy. However, idiopathic granulomatous mastitis could not be completely ruled out.