Pharmacological evaluation of the efficacy of <Emphasis Type="Italic">Dysoxylum binectariferum</Emphasis> stem bark and its active constituent rohitukine in regulation of dyslipidemia in rats

The antidyslipidemic effect of the ethanolic extract of Dysoxylum binectariferum stem bark and its major active constituent rohitukine was evaluated in a high fat diet (HFD)-fed dyslipidemic rat model. Chronic feeding of ethanolic extract (200 mg/kg) in HFD-fed rats showed significant lipid lowering activity. The bioassay guided fractionation of ethanolic extract resulted in the identification of known alkaloid rohitukine as major active constituent. Rohitukine (50 mg/kg) significantly decreased the plasma levels of total cholesterol (24 %), phospholipids (25 %), triglycerides (27 %), very low density lipoprotein (27 %) and low density lipoprotein (32 %) accompanied with an increase in high density lipoprotein (21 %). The present study demonstrated that ethanolic extract of Dysoxylum binectariferum stem bark and its major constituent rohitukine both have antidyslipidemic as well as antioxidant potentials. The antidyslipidemic activity of rohitukine can be correlated to its effect on enzymes involved in lipid metabolism.     

Experience of 100 solid organ transplants over a five‐yr period from the first successful pediatric multi‐organ transplant program in India

To analyze the clinical profile and outcome of pediatric patients who had undergone a liver and/or RT at our center over a five yr period, case records of all the patients who had undergone a liver or RT were analyzed retrospectively. One hundred solid organ transplants were performed at our center between January 2007 and January 2012. These included 50 liver, 44 renal, one sequential liver and renal, and two CLKT. BA was the most common indication for an LT (38%). At a median follow‐up of two yr three months, the patient survival was 88%. The most common indication for an RT was chronic glomerulonephritis (54.5%). At a median follow‐up of three yr, the survival was 91%. The CLKT were performed for hyperoxaluria. Two yr post LT, a sequential RT was performed for ESRD resulting from transplant associated microangiopathy. All patients received a living related graft. The common post‐operative complications were infections, vascular complications, and graft dysfunction. Survival rates for liver and RT at our center are comparable to those in the established centers in the West.     

Kyasanur Forest Disease Outbreak and Vaccination Strategy,Shimoga District,India, 2013–2014

We investigated a Kyasanur Forest disease outbreak in Karnataka, India during December 2013–April 2014. Surveillance and retrospective study indicated low vaccine coverage, low vaccine effectiveness, and spread of disease to areas beyond those selected for vaccination and to age groups not targeted for vaccination. To control disease, vaccination strategies need to be reviewed.     

Impact of two different models on influenza and pneumococcal vaccination in hospitalized patients

OBJECTIVE: The Centers for Disease Control (CDC) recommends trivalent influenza (TIV) and pneumococcal (PPV) vaccination for eligible hospitalized patients. We conducted a retrospective study comparing two different methods of assessment and its impact on TIV and PPV vaccination in hospitalized patients. DESIGN: Two sequential models were compared in a community hospital for assessing patients' vaccination status and eligibility for TIV and PPV in an inpatient setting. In the first model (Model I), physicians were responsible for assessing eligibility and ordering TIV and/or PPV. In the second model (Model II), nurses were responsible for assessment and vaccination of eligible patients. Charts of hospitalized patients were randomly analyzed for completion rates of the assessment form, rate of vaccination, and documentation of the reason for not vaccinating eligible patients. RESULTS: A total of 138 charts were analyzed for Model I and 168 charts were analyzed for Model II. A significantly higher completion rate for assessment was noted for Model II compared with Model I (79.16% versus 34.78%, P < 0.001 for TIV; 72.02% versus 33.33%, P < 0.001 for PPV). Hospital vaccination rates were not significantly different between the two models for TIV (P = 0.625) and PPV (P = 0.689). A significant percentage of patients refused PPV in Model II [8.03% versus Model I at 3.2% (P = 0.04)]. CONCLUSION: A standing order protocol for assessing hospitalized patients' vaccination status by nursing staff and allowing them to vaccinate eligible patients without depending upon a physician order significantly improved the assessment compliance rate, but not the vaccination rates. Our findings suggest that a system-based method with nursing assessing the need for vaccination and a physician ordering the vaccination would probably have a higher potential for success.     

Acyanotic and Cyanotic Congenital Heart Diseases

There has been tremendous progress in treatment of heart disease in children. Device therapy is increasingly being used in acyanotic congenital heart disease, while surgical results have improved significantly to give smile to many cyanotic heart disease children and their parents. This article makes an attempt to increase awareness of general pediatricians about common congenital heart diseases.