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Aims & Objectives: The aim of the study was to examine the biochemical, antimicrobial, antioxidant and palynological studies of different honey samples collected from different locations of Dakshina Kannada, Karnataka, India. Materials & Methods: Ten types of honey samples were collected from ten locations of Dakshina Kannada. Physical properties and biochemical constituents were determined by following standard protocols. Antimicrobial activity test was done against Klebsiella pneumoniae and Streptococcus mutans by well diffusion method. Results: The color of honey samples were differed from light to intense and pH varied from 3.48 to 6.18. The protein content was in the range of 0.13-0.62 mg/g. The honey quality varied from 4.2 to 15 Brix %. Total sugar content was in the range of 4.5- 9.8mg/g. The total phenolic content varied considerably with the highest value obtained for Processed society honey, Butterfly Park, Beluvai. The different shapes of pollen grains observed. Conclusion: The honey samples exhibited different chemical composition and pH. The local natural honeys were abundant in specific plant pollens due to wider biodiversity both cultivated and natural vegetations in the collected areas. So local honey samples can be utilized as an excellent dietary source of antioxidants as well as the antibacterial agents, and hence duly be active for both therapeutic and prophylactic application.

Introduction: Ankle Brachial Index (ABI) is one of the common non-invasive diagnostic tools available for diagnosing Peripheral Arterial Disease (PAD). However, it has been observed that for an individual diagnosed with both PAD and Type 2 Diabetes Mellitus (T2DM), ABI tends to give false diagnostic value because of the calcification of the major lower limb arteries. Therefore, the health care professionals are at times misled for the diagnosis of PAD. To overcome this another diagnostic tool Toe Brachial Index (TBI) was suggested to perform. However, there is limited literature on performing both ABI and TBI in the given population in a single study.Aim:The main focus of this study is to report the profile of ABI and TBI along with classical symptoms like claudication pain, palpation of pulse and history of T2DM for the screening and diagnosis of PAD in T2DM.Materials And Methods: In this cross-sectional observational study, a total of 121 participants diagnosed with T2DM were recruited for the study as per the inclusion criteria. Detailed demographic details of the participants were noted. Diagnostic tool including both ABI and TBI were performed for all the participants and the data was analysed.Results:Among 121 participants, only 3 participants had both ABI and TBI positive indicating positive diagnostic test for PAD and 106 participants had both ABI and TBI negative. However, in the remaining 12 participants, 10 showed TBI positive but ABI negative and 2 had ABI positive but TBI negative.Conclusions: Based on our study we have reported the profile of PAD in T2DM individuals, which is found to be 10.75.%. Therefore, it can be concluded that ABI and TBI both should be performed to rule out any complication. This will be beneficial in early screening and detection of neuro ischemic changes in foot and subsequently to prevent amputation.

Objectives: The exracts of Samadera indica used in traditional medicines for the treatment of skin diseases, rheumatism, cough and to kill head lice. The main objective of the present study was to evaluate the wound healing activity of methanolic bark extract of Samadera indica. Methods: The bark samples of were collected, allowed to shade dry for a week, then coarsely powdered and was extracted with methanol by soxhlation process. The extract was used for wound healing experiment using excision wound model. 18 healthy Wistar albino rats divided into three groups of six rats each with average body weight of 150-200 g were selected randomly for the study. ANOVA was used to compare the variation in the treatments in the result. The 1st group of animals are left as such for natural healing process as control, 2nd group of animals were treated with standard ointment betadien and 3rd group with the test drug methanolic bark ointment formulation. The methanolic extract in simple ointment base as mentioned above and betadien ointment were applied on the wound once a day for 16 days starting from the day of wounding. The percentage wound closure was observed on 4th, 8th, 12th and 16th post wounding day. Results: As for the group received methanolic bark extract for wound healing, fourth day wound mean diameter was 208.0±3.521, 8th day the wound mean diameter was 160.66±7.89, 12th day wound mean diameter was 87.5±5.8 and 16th day wound mean diameter was 22.5±5.12. Comparing to standard drug betadien the bark extract showed faster healing in terms of diameter of wound which was statistically signified. Conclusions: The results of the experiment revealed that there was marked decrease in wound diameter with every point of time the observation made indicating the effect of extract on progressive healing of wound. Samadera indica proved its wound healing potential of the plant extract which is due to the bioactive compounds and thus the study supports local folklore practitioners and tribal people for the use of plant in different ailments.

This research is an application of machine learning in medical sciences. The purpose of this research was to use machine learning through the simulated data to study the association of age, body mass index, cigarettes smoked per day, alcohol consumed per week, diastolic blood pressure, and systolic blood pressure on hypertension and coronary heart disease. The Structural Equation Modelling using Partial Least Square Method was used for the analysis of data. The results have revealed that except for age, body mass index and systolic blood pressure all the rest of the factors had a significant positive association with hypertension and coronary heart disease. The results can be of use for medical practitioners as well as researchers in machine learning, as it adds to the repository of earlier studies, which have attempted to seek relationships between these variables.

Aims: The aim of this study was to correlate serum uric acid (SUA) levels and carotid intima-media thickness (CIMT) in patients with type 2 diabetes mellitus (DM). Settings and Design: This study was a cross-sectional observational study on 103 diabetic patients conducted from September 2015 to May 2017. Subjects and Methods: We screened 103 patients with type 2 DM between the ages of 30–65 years. SUA levels and the CIMT were measured. The patients were divided into quartiles based on uric acid level. The CIMT of the quartiles is compared and analyzed. Statistical Analysis Used: Chi-squared test, Analysis of Variance, and Pearson's correlation. Results: Uric acid levels were positively associated with CIMT (P = 0.001). The association remained significant after further adjustment for potential confounders. Strong correlation was found among them as depicted by correlation coefficient (r = 0.779). Conclusions: Carotid atherosclerosis as measured by IMT is associated with SUA levels in patients with type 2 DM.

Peripheral Arterial Disease (PAD) is one of the leading complications of Type 2 Diabetes Mellitus (T2DM). According to American Heart Association, PAD is defined as, “a narrowing of peripheral arteries to the legs, stomach, arms and the head-most commonly the arteries of leg.” The global prevalence for PAD with age adjusted prevalence is approximately 12%, and it affects relatively 8 to 12 million British people. The prevalence of PAD is 2e3 times higher in person with v/s without type 2 diabetes mellitus (T2DM). Various subjective and objective methods are available to diagnose PAD, which includes questionnaires for pain and quality of life as subjective and Ankle Brachial Index (ABI), toe brachial index (TBI), arterial doppler for objective. ABI is one of the most reliable and easy to carry out method in clinical setups to diagnose PAD. The normal range for ABI is 0.9e1.29, 0.91 to 0.99 are considered as borderline, 0.41 to 0.91 are considered as mild to moderate diseased and below 0.4 is severe PAD. The objective of the study is to estimate the prevalence of peripheral arterial disease with type 2 diabetes mellitus in coastal Karnataka. Methodology: A total of 317 participants were recruited for the study based on inclusion criteria. Ethical clearance was taken from the Institutional Ethics Committee. Participants were explained about the study and informed consent was obtained from the participants. Inclusion criteria was any individual with T2DM on medication. A subjective questionnaire specific to PAD was administered to the participants. Along with this the objective measure, ABI was done on the individuals. Result: The mean age of all the participants was 57.36 ± 10.43 in years. The average Body Mass Index (BMI) was 24.62 ± 11.80 in Kg/m2. The mean duration of diabetes was found to be 9.13 ± 6.56 in years. The prevalence of peripheral arterial disease was found to be 8.52% in the study population. Conclusion: The prevalence of peripheral arterial disease was found to be 8.52% in the study population.

Plant-derived compounds have been used clinically to treat type 2 diabetes for many years as they also exert additional beneficial effects on various other disorders. PI3K pathway is the major pathway activated by insulin receptor (IR). It induces glucose uptake, glycogen synthesis, protein synthesis, cell growth and differentiation. Hence metabolic assay was employed to assess glucose uptake based on the property of 3T3-L 1 cells to differentiate into adipocytes which can take up the glucose in medium due to the effect of insulin or insulin like molecules. The results of the current study showed that plants extract probably exerts its anti-diabetic properties by stimulating glucose uptake in adipocytes with significant inhibition of adipogenesis demonstrating reliable relative potency in comparision to the commercial insulin. The ability of existing therapies to target various aspects of the insulin resistance syndrome induces other metabolic abnormalities, chiefly those involved in lipid metabolism. In this preliminary in-vitro study Costusspeciosus plant extract demonstrated to have significant relative potency in comparison to commercial Insulin which can be exploited to treat diabetes using natural herbal extracts Current study leads researchers to elucidate the chemical structures, isolate active ingrediatents in the crude extract for such biological activities in reference to commercial and recombinant insulins.

Background: Type 2 Diabetes Mellitus (T2DM) is usually accompanied by various micro and macro vascular complications. Peripheral Arterial Disease (PAD) is one of the major complications of diabetes which is accountable for morbidity and mortality throughout the world. The first line of treatment in these individuals is life style modification and exercise. There is a dearth of literature on effect of supervised exercise program in PAD with T2DM on quality of life, walking impairment, change in Ankle Brachial Index (ABI) values. So, we conducted a systematic review to explore the available literature on supervised exercise program in PAD with T2DM. Methods: We conducted a systematic review (PubMed, Web of Science, CINAHL and Cochrane) to summarise the evidence on a supervised exercise program in PAD with T2DM. Randomised and nonrandomised studies were included in the review. Results: Three studies met the inclusion criteria. The outcomes taken into accounts by the studies were the quality of life, walking impairment questionnaire, Ankle brachial index. Neither of the studies matched in their supervised exercise program nor in their outcome. Conclusion: In conclusion, the data evaluating the supervised exercise program in PAD with T2DM is inadequate to determine its effect on this population. Future large-scale studies can be conducted on both subjective and objective outcomes of PAD with T2DM to have a better understanding of the condition and for a universally acceptable exercise program for these individuals which the healthcare practitioners can use in their practice.

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Colonization factor antigen I (CFA/I) is the prominent colonization factor present in one-third of enterotoxigenic Escherichia coli (ETEC) isolates. The effect of egg-yolk derived CFA/I specific immunoglobulin Y (IgY) antibodies on growth and adhesion parameters of human ETEC expressing CFA/I was studied. Native CFA/I was purified from ETEC strain and used for production of CFA/I specific IgY antibodies by immunizing chicken. CFA/I specific IgY antibodies significantly reduced growth of ETEC in the culture conditions. The adherence phenomenon of ETEC to HT-29 cell monolayer, a colon adenocarcinoma cell line, was assessed by incubating bacteria in the presence of CFA/I specific IgY antibodies and control (non immunized) antibodies. Bacteria adhered to cell monolayers were quantitatively assessed and expressed as colony forming units. Data presented in the present article on the bacterial growth and adherence to intestinal epithelial cells in the presence of CFA/I specific IgY antibodies suggests that it significantly reduced ETEC adherence to HT-29 cells. These results highlight the therapeutic importance of CFA/I and IgY antibodies as a means of passive immunization against ETEC infection. Data generated using IgY antibodies strengthens the efforts on developing an alternative therapy to antibiotics in controlling and preventing ETEC infections.

In this study, the influence of geometrical parameters on the curve veering phenomenon in a tor-sional system with stepped shaft is investigated. Three approximate solutions including finite el-ement, Rayleigh-Ritz and discretization methods, along with an exact solution are employed to obtain the natural frequencies of the structure. The study reveals that, under specific circumstances, the results obtained by approximate methods are very close to the exact solution. The curve veering behavior is manifested irrespective of the method employed. It is concluded that for the structure studied the curve veering behavior is not because of the approximate techniques used to compute the natural frequencies, and is an inherent behavior of the structure.

Adipocyte dysfunction plays an important role in the obesity development. People with a body weight ~ 45% heavier than the average body weight are at risk of death two times greater than the average body weight. The use of anti-obesity drugs have many side effects, so it is necessary to find the anti-obesity drug with low toxicity. Many microbial secondary metabolites and chemically synthesized anti-obesity drugs are available in the market with progressive side effects upon long term use of these medicines and drugs. Plant source antiobesity drugs are potentially sustained safe source of treatment. This ex vivo study was conducted to determine the activity of Costus speciosus plant extract in inhibiting triglycerides and cholesterol synthesis in HepG2 cells. Anti-obesity activity includes reduced formation of lipid droplet in HepG2 cells. The triglyceride levels and lipolytic activity by measuring cholesterol levels was performed based on commercially available kits. This study suggested that the extract of C.speciosus inhibited triglycerides and cholesterol synthesis in HepG2 cell lines with inhibition of 89.25% and 52.01% respectively at the highest concentrations tested. The study also confirmed the anti-adipogenesis activity of plant extract and its potential in inhibiting the synthesis of triglycerides and cholesterol in HepG2 cell.

Plant-derived compounds have been used clinically to treat type 2 diabetes for many years as they also exert additional beneficial effects on various other disorders. PI3K pathway is the major pathway activated by insulin receptor (IR). It induces glucose uptake, glycogen synthesis, protein synthesis, cell growth and differentiation. Hence metabolic assay was employed to assess glucose uptake based on the property of 3T3-L1 cells to differentiate into adipocytes which can take up the glucose in medium due to the effect of insulin or insulin like molecules. The results of the current research showed that plants extract probably exerts its anti-diabetic properties by stimulating glucose uptake in adipocytes with significant inhibition of adipogenesis demonstrating reliable relative potency in comparision to the commercial insulin. In this preliminary in-vitro study we report Costus speciosus plant extract to have significant relative potency in reference to commercial Insulin which can be exploited to treat type II diabetes. This plant source could to be a potential, sustainable, natural anti diabetic product after structured preclinical and clinical studies. Current study leads researchers to elucidate the chemical structure, isolate active ingrediatents in the crude extract for such biological activities.

Patients living with HIV are commonly diagnosed with anaemia which can have various aetiologies. However, one of the rare causes of anaemia in such patients is Auto Immune Haemolytic Anaemia (AIHA), which is difficult to diagnose due to the absence of reticulocytosis in HIV patients. Such patients can be treated with corticosteroids which can gradually be tapered off over a period of time. The following is a case of a 52-year-old male living with HIV who was diagnosed to have AIHA and was successfully treated with steroids.

Molar pregnancy is one of the components of a broader spectrum of diseases known as Gestational Trophoblastic Disease (GTD), presenting with amenorrhoea and irregular bleeding which may be rarely associated with passage of vesicles per vagina. However, it can rarely be associated with hyperthyroidism, which may be associated with clinical features of hyperthyroidism. The following is a report of a 20-year-old woman who presented with amenorrhea followed by irregular bleeding per vagina, thyromegaly and abnormal levels of thyroid hormones. Transvaginal ultrasound revealed features consistent with molar pregnancy. A suction evacuation was done following which serum levels of β-hCG reduced and the levels of thyroid hormones also reduced. On follow up, six weeks later, β-hCG and thyroid hormones were within normal limits. The case and relevant literature are presented here.

Typhoid fever is a very common illness in developing countries. Patients most often present with a history of fever, vomiting, anorexia, abdominal pain, etc. Rarely there is hepatic involvement due to the disease process. This is a case report of a 26-year-old male who had presented with fever, jaundice and ascites. The widal titres were found to be within normal limits (1:80) however the patient was found to have Salmonella typhi on ascitic fluid culture. The patient was treated with the appropriate antibiotics and was later discharged.

Introduction: Paraquat is a commonly ingested poison especially in Southern India. There is no antidote for paraquat poison and consumption is often fatal. The usual cause of death is either acute lung injury or multi-organ failure. Aim: To evaluate the role of early haemoperfusion as a therapy in paraquat poisoned patients. Materials and Methods: This study was a retrospective analysis of patients admitted to a Tertiary Medical College Hospital between January 2012 and December 2015 with history of paraquat consumption, comparing outcomes in those who received only gastric lavage and symptomatic treatment with those who received haemoperfusion as a therapy. The role of early haemoperfusion (≤ 6 hours) vs late haemoperfusion (> 6 hours) in paraquat poisoned patients was also compared. The data of these patients was extracted and analysed with respect to age, sex, mode of treatment, the outcome in patients who received early and late haemoperfusion. Results: A total of 101 patients were studied out of which 62 died. Deaths were more in those patients who received only gastric lavage with symptomatic treatment as therapy compared to those who received haemoperfusion i.e., 92.1% vs 42.9% respectively. We also found that, the survival rate was better in patients who received early haemoperfusion. Conclusion: Early haemoperfusion was helpful in the management of severe paraquat poisoning and improved the survival rate in these patients.

In the present study total polyphenols, antioxidants and antimicrobial activities of the bark powder extracts of Pajanelia longifolia in water, ethanol, methanol and ethyl acetate were estimated and analysed. Soxhlet method was employed for preparation of bark extracts in different solvents. FRAP assay was used to determine the total antioxidant activity and phenols were estimated by FC assay. Antibacterial and antifungal activity studied by well diffusion method. Water and methanolic extract had the highest amount of polyphenols (28.51 and 25.62 mg pyrocatechol equivalent/g raw material respectively) followed by ethanol and ethyl acetate extracts. Among the four extracts, 70% methanol extract showed the maximum antioxidant activity while ethyl acetate extract exhibited the minimum. Antibacterial activity of the extracts was tested against 7 bacterial species such as Staphylococcus aureus, Vibrio parahaemolyticus, Escherichia coli, Bacillus subtilis, Proteus mirabilis, Lactobacillus casei and L. fermentum. Vibrio parahaemolyticus and Bacillus subtilis were found to be susceptible to the ethanolic extracts at a concentration of 5 mg/ml. Other bacterial species including E. coli was found to be the most resistant organism and was not inhibited by any of the extracts. The present study showed that Pajanelia longifolia has significant levels of antioxidant and antimicrobial activity against a V. parahaemolyticus and Bacillus subtilis. The present study is the first scientific report in the literature to show the presence of antioxidant and antimicrobial activity of the said plant. Therefore the result strengthens the existing traditional usage of the plant for the therapeutic use.

Background H1N1 (hemagglutinin-H-neuroaminidase-N) influenza infection is associated with high morbidity and mortality because of associated complications and related factors. Predictors of mortality in H1N1 patients are studied with very few without seasonal/pandemic declaration. This study was carried out to describe the clinical features, complications and different risk factors that affect the outcome in the patients with confirmed H1N1influenza infection. Methods A retrospective study was done in Kasturba Medical College Hospital, Manipal, India by analyzing the medical records of 141 patients admitted from January, 2011 to June, 2015. Results Of the 141 patients in the study, 51.1% of the patients were female with a mean age of 32±16.2 years. Fever with headache was observed in 92.9% patients while cough in 78.7% patients and breathlessness in 54.6% patients. On the basis of disease severity, 53.2% of the patients were put on mechanical ventilation. For all the patients, treatment for influenza management began with oseltemivir. Diuretics, antianxiety and corticosteroids were given as supportive and symptomatic care which contributed to high mortality in hospitalized patients. Mean hospitalization period was 8.5 days. During the hospitalization, patients developed different complications i.e. 31.20% patients developed respiratory tract infections, while 17.7% patients developed ARDS and 14.4% patients developed sepsis. The mortality rate of this study population was found to be 29.1 %. Conclusion It was observed that low oxygen saturation during admission, high blood urea level, use of diuretics, corticosteroids, anti-anxiety drugs and complications like ARDS, sepsis influence the mortality rate of patients with H1N1 infection.

Pulmonary tuberculosis is a common infection associated with immunocompromised state. It usually presents with fibrosis or fibrocavitary lesions in the lung. We report a case of bilateral tuberculous pneumonia of acute presentation in a young lady who was being treated for systemic lupus erythematosus.

This article discusses the historical background, epidemiology, and pathophysiology of meconium-stained amniotic fluid and provides current concepts in delivery room management of meconium-stained neonate including the current Neonatal Resuscitation Program guidelines.