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The endocrine condition known as polycystic ovarian syndrome (PCOS) is complicated and diverse. It impacts between 4 to 20 % of women of reproductive age and is linked to a significant risk of infertility, obesity, and insulin resistance. The aetiology of PCOS remains unclear and can be multifactorial, including genetic, neuroendocrine, and metabolic causes. Recent studies in humans have shown an association between changes in the gut and vaginal microbiome and the metabolic and clinical parameters of PCOS. The aim of this review was to understand the relationship between PCOS and the microbiome, including any potential underlying mechanisms, and to look at potential therapeutic strategies to improve the therapeutic approach for patients. As a result, a hypothesis is postulated that changes in the microbiota contribute to the development of PCOS and explored the therapeutic opportunities which include probiotics, prebiotics, synbiotics, fecal microbiota transplantation and IL-22.

Background: Lateral neck radiographs are commonly used in the investigation and management of patients presenting with suspected fish bone impaction. The effectiveness of these is questioned, as many fish do not have radio-opaque bones. Objective: This study evaluated the utility of lateral neck radiographs in the management of patients presenting with fish bones retained in the upper aerodigestive tract, with the creation of a treatment algorithm to guide further management. Methods: An audit of practice was undertaken at the University Hospital of Southampton, identifying all patients admitted with potential fish bone impaction in the upper aerodigestive tract. Following analysis, a treatment algorithm was constructed for use by junior doctors. Results: In total, 34 per cent of patients with a normal radiograph were subsequently found to have a fish bone present under local or general anaesthetic assessment. The sensitivity of radiographs in the detection of fish bones was found to be 51.6 per cent. Conclusion: Lateral neck radiographs have limited value in the management of suspected fish bone impaction, and should only be used following detailed clinical examination of the upper aerodigestive tract. [ABSTRACT FROM AUTHOR]

Nelumbo nucifera Gaertn (Family: Nelumbonaceae), commonly known as lotus, is an aquatic perennial plant. The lotus leaves are used to treat fever, hematemesis, hyperlipidaemia and obesity. The leaves are rich in alkaloids such as nuciferine, roemerine, pronuciferine and N-nornuciferine. The present study describes simple, accurate, precise, robust RP-HPLC method to detect and quantitate nuciferine as a marker from lotus leaves. The marker was resolved using Hemochrom Intsil C-18 column, with mobile phase methanol:10mm phosphate buffer (85:15), pH adjusted to 4 (using orthophosphoric acid) at a flow rate of 1 mL/min. Retention time of nuciferine was 5.60±0.2 minutes at 272 nm. Linear responses were obtained in concentration range of 1 - 9 ppm for nuciferine with correlation coefficient (r2) of 0.9996. The developed method was applied for quantitation of marker from lotus leaves. This method can be used to evaluate nuciferine containing extracts, thus conforming to the need of ensuring quality and safety of herbal drugs. [ABSTRACT FROM AUTHOR]

Copyright of British Journal of Surgery is the property of Oxford University Press / USA and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Aim To describe the measurement of pain after oral surgery. Materials and methods A review of the literature describing the scales used to rate pain intensity, pain assessment by questionnaire, assessment of pain in children and older adults, the third molar pain model and factors affecting the pain experience in the context of managing pain after oral surgery. Results The most frequently used single-rating scales are the Numerical Rating Scale ( NRS), the Verbal Rating Scale ( VRS), the Visual Analogue Scale ( VAS) and the Faces Pain Scale. The surgical removal of a lower third molar with bone removal is associated with severe post-operative pain and the procedure is used as a model for investigation of analgesic efficacy. Conclusions If pain is not assessed, then it is unlikely that it will be properly treated. The scales to measure pain intensity such as the NRS that can be used readily in the hospital, clinic or over the phone when the patient has been discharged home. [ABSTRACT FROM AUTHOR]

Nelumbo nucifera Gaertn (Family: Nelumbonaceae), commonly known as lotus, is an aquatic perennial plant. The lotus leaves are used to treat fever, hematemesis, hyperlipidaemia and obesity. The leaves are rich in alkaloids such as nuciferine, roemerine, pronuciferine and N-nornuciferine, which are responsible for biological activity of leaf. In the present work, rapid and efficient flash chromatographic process for selective isolation of nuciferine from Nelumbo nucifera Gaertn was developed. The rate of extraction and purity of nuciferine depends upon the solvent used for extraction and optimized chromatographic conditions. Methanol was found to be best solvent for highest possible recovery of the nuciferine from Nelumbo nucifera Gaertn. Flash chromatography, also known as medium pressure chromatography, is used to speed up the flow of solvent, which decreases the time needed to purify the sample. The purified sample of nuciferine was then characterized by UV spectroscopy, HPTLC and HPLC-MS. [ABSTRACT FROM AUTHOR]

Three accurate, sensitive and reproducible methods are described for the quantitative determination of alprazolam ( ALP) and propranolol hydrochloride ( PNL) in their combined dosage form. The first method involves an RP-HPLC separation on the C column using acetonitrile-25 mM ammonium acetate buffer and 0.2% triethylamine (pH of buffer adjusted to 4 with glacial acetic acid) in the ratio of 35: 65 (v/v) as mobile phase. Symmetrical peaks with good separation, ALP at 9.3 min and PNL at 3.5 min, were achieved. Quantification was done with photo diode array detection at 255 nm over the concentration ranges of 0.5-50 and 10-250 μg/mL for ALP and PNL, respectively. The second method is based on the separation of drugs by HPTLC using chloroform-methanol-ammonia 7: 0.8: 0.1 (v/v/v) as mobile phase. Quantification was achieved using UV detection at 248 nm over the concentration range of 100-600 ng/spot and 5-30 μg/spot for ALP and PNL, respectively. The third method involves dual wavelength UV-visible spectrophotometric method. It is based on the determination of PNL at 319.4 nm using its absorptivity value and ALP at 258.2 nm after deduction of absorbance due to PNL. Quantification was achieved over the concentration range of 1-40 and 80-200 μg/mL for ALP and PNL, respectively. All methods were validated according to ICH guidelines and successively applied to marketed pharmaceutical formulation, and the results of all three methods were compared statistically as well. No interference from the tablet excipients was found. [ABSTRACT FROM AUTHOR]

Background Bleeding within the supraglottic region can be a lethal complication after CO2 laser microsurgery. Our aim was to propose endoluminal anatomical landmarks to locate the superior laryngeal vessels resulting in a safer microsurgery. Methods Endoluminal dissections were made in 22 larynges without laryngeal disease. Results The neurovascular structures were in the superior third of a triangle defined by the vocal process, the anterior commissure, and the epiglottic attachment of the aryepiglottic fold. They overlapped in 4 different ways: pattern I (70.4%): superior laryngeal vein (SLV), superior laryngeal artery (SLA), and internal laryngeal nerve (ILN); pattern II (13.6%): SLA, SLV, ILN; pattern III (4.6%): SLV, ILN, and SLA; pattern IV (4.6%): SLA, ILN, and SLV. Conclusion Microsurgery in the supraglottic region may be safer if surgeons are aware of the superior third of the above-defined triangle, 'danger area', where the vascular elements of this region are located. © 2012 Wiley Periodicals, Inc. Head Neck, 2013 [ABSTRACT FROM AUTHOR]

Any research work should have high level of Rigor and Relevance. The uses of more and more medicinal plants require the monitoring agencies to have data of standardization to compare the Sdrug with the authenticated parameters. WHO and Govt. of India have intention to include more and more number of medicinal plants into standard monograph. We at B. M. Shah College of Pharmaceutical Education and Research, Modasa have tried to work on one potential herb, A. bracteosa Wall. ex Benth., F. Labiatae. Before working for the plant we have tried to collect as much information as possible. Ajuga bracteosa belongs to family Lamiaceae (Labiatae) which is a large family comprising of 266 genera. The genus Ajuga consists of 301 species. A. bracteosa is distributed in subtropical and temperate regions from Kashmir to Bhutan, Pakistan, Afghanistan, China and Malaysia. 70% ethanol extract of Ajuga bracteosa possess significant and promising anti-inflammatory activity. Ethanolic extract of Ajuga bracteosa leaves demonstrates a dose-dependent chemosuppression during early and in established infections. The plant is astringent and used as tonic and in the treatment of agues. The leaf extract is for blood purification. The juice of the root is used in the treatment of diarrhoea and dysentery. According to Asia Pacific Medicinal Plant Database the leaves are regarded as stimulant, diuretic and tonic. The extract is used to cure swollen wounds, bites of insects, eye troubles, diseases of bladder, as well as tumors. The microscopic features of the plant are also included in the present work. [ABSTRACT FROM AUTHOR]

Introduction: Nature always stands as a golden mark to exemplify the outstanding phenomenon of symbiosis. Herbal medicines are the products of therapeutic experiences, of generations of practising physicians of indigenous systems of medicine for over hundreds of years. Garcinia indica Choisy Syn Brindonia indica, commonly known as kokum and belonging to Guttiferae family, is a popular plant native to certain regions of India. The plant has long been used in traditional Ayurvedic medicine for its magical effects in curing various diseases. Objective: To present a systematic investigation of phytopharmacopoeial standards for the fruit rinds of Garcinia indica by performing pharmacognostical parameters. Material and Methods: Fresh fruit rinds sample and dried power of the fruit rinds were studied macromorphologically and cytomorphologically along with its detail physicochemical and phytochemical investigation. Other WHO recommended parameters for standardizations were also investigated. Results: Macroscopic studies showed that fruit rind shape - round, oblong or oval with pointed tips and, were crowned by the four parted stalkless stigma with reddish black colour, aromatic odour and sour taste. The detailed microscopy revealed presence of parts of pericarp, oleo resin cells etc. the other physicochemical parameters were stands within the standardized range. Conclusion: The standardization parameters provide referential information for correct identification of the plant material and will also be useful in preparation of monographs on these plants. [ABSTRACT FROM AUTHOR]

A novel series of chalcones, pyrimidines and imidazolinone is described; chalcones (4a-o) were prepared from the ead molecule 4-[2-(5-ethylpyridin-2-yl)ethoxy]benzaldehyde. Pyrimidine (5a-o) derivatives were prepared from the reaction of chalcones and guanidine nitrate in alkali media. Imidazolinones (6a-o) were synthesized from reaction of pyrimidine and oxazolone derivatives (prepared by Erlenmeyer azlactone synthesis). The structures of the synthesized compounds were assigned on the basis of elemental analysis, IR, ¹H and 13C NMR spectral data. All the products were screened against different strains of bacteria and fungi. Most of these compounds showed better inhibitory activity in comparison to the standard drugs. [ABSTRACT FROM AUTHOR]

Argyreia speciosa (Linn. f.) Sweet is a popular Indian medicinal plant, which has long been used in traditional Ayurvedic Indian medicine for various diseases. This plant is pharmacologically studied for nootropic, aphrodisiac, immunomodulatory, hepatoprotective, antioxidant, antiinflammatory, antihyperglycemic, antidiarrheal, antimicrobial, antiviral, nematicidal, antiulcer, anticonvulsant, analgesic and central nervous depressant activities. A wide range of phytochemical constituents have been isolated from this plant. A comprehensive account of the morphology, phytochemical constituents and pharmacological activities reported are included in view of the many recent findings of importance on this plant. [ABSTRACT FROM AUTHOR]

Background: Leaves of Tephrosia purpurea Linn. (sarpankh), belonging to the family Leguminaceae, are used for the treatment of jaundice and are also claimed to be effective in many other diseases. This research work was undertaken to investigate the in vitro antioxidant activity of aqueous and ethanolic extracts of the leaves. Method: The therapeutic effects of tannins and flavonoids can be largely attributed to their antioxidant properties. So, the quantitative determinations were undertaken. All the methods are based on UV-spectrophotometric determination. Result: The total phenolic content of aqueous and ethanolic extracts showed the content values of 9.44 ± 0.22% w/w and 18.44 ± 0.13% w/w, respectively, and total flavonoid estimation of aqueous and ethanolic extracts showed the content values of 0.91 ± 0.08% w/w and 1.56 ± 0.12%w/w, respectively, for quercetin and 1.85 ± 0.08% w/w and 2.54 ± 0.12% w/w, respectively, for rutin. Further investigations were carried out for in vitro antioxidant activity and radical scavenging activity by calculating its percentage inhibition by means of IC50 values, all the extracts' concentrations were adjusted to fall under the linearity range and here many reference standards like tannic acid, gallic acid, quercetin, ascorbic acid were taken for the method suitability. Conclusion: The results revealed that leaves of this plant have antioxidant potential. The results also show the ethanolic extract to be more potent than the aqueous decoction which is claimed traditionally. In conclusion, T. purpurea Linn. (Leguminosae) leaves possess the antioxidant substance which may be responsible for the treatment of jaundice and other oxidative stress-related diseases. [ABSTRACT FROM AUTHOR]

A single dose, crossover bioequivalence study of two different brands of clonidine hydrochloride 25 µg tablets was conducted in 24 (+2 stand by) healthy, adult, male, Indian subjects under fasting conditions to check the implication of enterohepatic re-circulation on assessment of bioequivalence. After an overnight fasting of at least 10 h, the subjects received single oral dose of test or reference product with either of the product as per randomization schedule in each period with a washout period of 10 days. The pre-dose blood sample was collected within a period of one h before dosing. The post-dose blood samples were collected at specified time intervals up to 96 h. The plasma concentrations of clonidine were quantified by validated LCMS/MS method and pharmacokinetic parameters were computed. The 90% confidence intervals of test/reference ratios for Cmax and area under the plasma-concentration- time-curve AUC under 0-t were found to be between 0.80 and 1.25 for log-transformed data. Analysis of variance did not show significant difference to these parameters. No meaningful values of Kel and therefore AUC under 0-infinity could be calculated for significant number of subjects due to enterohepatic re-circulation. Based on the results obtained, two different brands of clonidine 25 µg tablets have comparable rate and extent of absorption after oral administration but failed to show bioequivalence as per regulatory requirement of Food and Drugs Administration-united states. [ABSTRACT FROM AUTHOR]

Abstract: Interpersonal violence is often associated with alcohol misuse. Most injuries that result from interpersonal violence affect the face, and maxillofacial surgeons are responsible for their treatment. Consequently maxillofacial surgeons are well placed to audit and help multi-agency task groups to address this social problem. An audit was undertaken of two years’ emergency referrals within the Merseyside region to assess the association of maxillofacial trauma and alcohol. The age and sex distribution were assessed together with the cause and place where the injury occurred. Results show an involvement of alcohol with interpersonal violence of 72%, which is the highest published association. We also analysed the type of injury and the place where each injury occurred, and the association with alcohol in each circumstance. In an attempt to identify alcohol misuse, an Alcohol use Disorders Identification Test questionnaire (AUDIT) was used to offer a brief intervention to educate and modify hazardous, harmful, or dependent alcoholic behaviour. [Copyright &y& Elsevier]

Factors influencing the use of chemotherapy for the initial (6 months) treatment of lung cancer in South East England were investigated. The variables explored as possibly influencing the use of chemotherapy were sex, age, the year of diagnosis, the type of lung cancer, the stage, the index of multiple deprivation and the cancer network of residence. Chi2 analysis and multivariate logistic regression models were used to examine the effect of each of the variables on the use of chemotherapy. The results showed a highly significant trend in use of chemotherapy over time; the adjusted proportion of patients receiving chemotherapy increasing from 13.6% in 1994 to 29.3% in 2003. However, age, cancer network and type of lung cancer had the strongest influence on the use of chemotherapy. This finding is important when we consider that the NHS Cancer Plan aims at improving inequalities in cancer care in the UK. [ABSTRACT FROM AUTHOR]

Pilonidal disease is a debilitating, chronic disease of the natal cleft. It mainly involves the sacrococcygeal region and the presentation varies from asymptomatic pits to painful draining abscesses. Treatment options vary from observation to wide excision. Unfortunately, surgical treatment often results in recurrence. The etiologic agent remains in question, as does the optimal treatment. Our objective was to assess the efficacy of laser epilation as an adjunctive therapy to surgical excision of the pilonidal sinus. Eighteen men and five women were treated with laser epilation in our office from 2001 to 2004. All patients had experienced recurrent folliculitis and had undergone some form of drainage procedure or prior excision. After surgical excision of the affected area, a Vasculite™ Plus laser was used for the epilation treatments. Each session involved 9 to 12 treatments and the patients underwent an average of two sessions. All 19 of the patients that remain in follow-up report no recurrence of their folliculitis or need for further surgical procedures. During treatment, six of the men and one of the women experienced a superficial wound dehiscence. All healed with local wound care and continued laser treatments. Laser epilation is an effective adjunctive therapy for the treatment of pilonidal disease. Although not curative in and of itself, the removal of hair allows better healing and decreases the chance of recurrence by removal of a significant etiology of pilonidal disease. [ABSTRACT FROM AUTHOR]

The article examines published evidence regarding chemo-fog/chemo-brain, the condition where there is a diminution in certain cognitive functions in some patients during and after adjuvant cancer chemotherapy. Subjective or objective measures of the cognitive defects that give rise to the terms include a clock-drawing test and the Functional Assessment of Cancer Therapy. Chemo-fog or chemo-brain effect is dose-related if the cause of the condition is chemo-therapeutic drugs.

Several animal models have been developed to investigate osteoarthritis and potential disease-modifying therapeutics. However, early disease data from these models are limited by the resolution of current imaging modalities. In this in-vitro study, an optical coherence tomography (OCT) system with an axial resolution of 15 µm was used to track sequential changes in osteoarthritic rat knees. Osteoarthritis was induced via transection of the medial collateral ligament and an artificial full thickness meniscal tear. Imaging occurred at one, two, and three weeks after surgery. OCT successfully detected early signs of osteoarthritic change, including alteration of the cartilage surface and disruption of the bone–cartilage interface. This study demonstrates that OCT, along with the induction of mechanical injury, provides an excellent model for monitoring the sequential changes of osteoarthritis. [ABSTRACT FROM AUTHOR]

Rectourethral fistula (RUF) is a relatively rare complication of radical prostatectomy, but is extremely difficult to treat. Multiple surgical approaches have been described for definitive treatment, but to date none of them have been determined to be the gold standard, either due to a high recurrence rate of the condition or due to the morbidity associated with the procedure. In this case report, we describe a successful repair of iatrogenic RUF through a multidisciplinary approach consisting of cystoscopy, urethral stent placement, colonoscopy, and TEM-assisted rectal advancement flap. [ABSTRACT FROM AUTHOR]

Editorial. Offers observation on prostaglandins. Historical background on the word prostaglandin; Description on isotopically labeled prostaglandins; Relationship between the concentration of total prostaglandins in human seminal fluid and the degree of fertility.

A 60-year-old male with chronic lymphatic leukemia (CLL) after 6 months of fludarabine therapy was admitted with status epilepticus and developed left hemiplegia. His magnetic resonance imaging revealed multiple T2 hyperintense lesions in the right frontal and left parieto-occipital lesion, simulating progressive multifocal leucoencephalopathy (PML). Cerebrospinal fluid Polymerase Chain Reaction (PCR) for JC virus was negative. We suggest the possible role of fludarabine in producing PML-like lesions in patients with Chronic Lymphocytic Leukemia (CLL). INSET: 14. [ABSTRACT FROM AUTHOR]

Introduction The incidence of secondary nonresponders is of key concern to physicians treating cervical dystonia with botulinum toxins. The presence of impurities and aggregation of therapeutic proteins are two well-known phenomena that can enhance the immune response. The purity and integrity of Elan's botulinum toxin type B solution (NeuroBloc™) were assessed. Methods Biochemical evaluation of several lots of the type B toxin complex were designed to assess key product attributes, including: (1) specific activity: ratio of potency (mouse IP LD[sub 50] assay) to protein concentration; (2) complex consistency: size exclusion chromatography (SEC), sodium dodecylsulfate polyacrylamide gel electrophoresis (SDS-PAGE), and N-terminal sequencing; and (3) percent nicking: (endoproteolytic activation). Results Specific activity, a sensitive measurement of the purity and activity of the neurotoxin complex, was elevated and consistent (100 U/ng) across all batches. An intact, non-aggregated, non-dissociated toxin complex was demonstrated by size exclusion chromatography with an estimated molecular weight of approximately 700 kilodaltons (kDa). SDS-PAGE analyses confirmed the relative composition and purity of the polypeptides forming the neurotoxin complex. Protein sequencing confirmed the amino acid identity of the eight polypeptides that compose the neurotoxin complex and the site of nicking (between residues 440 and 441). In addition, the percent nicking was highly reproducible (approximately 75% nicked product). Conclusion Elan's botulinum toxin type B (NeuroBloc™) has excellent and reproducible complex integrity and purity profile. It is therefore anticipated that therapeutic use of NeuroBloc™ will minimize the development of neutralizing antibodies and the incidence of secondary non-responders among patients. [ABSTRACT FROM AUTHOR]