Reversal of lipopolysaccharide‐induced thermal and behavioural hyperalgesia by quercetin

Lipopolysaccharide (LPS), a major constituent of the outer membrane of the cell wall of gram‐negative bacteria, is known to cause inflammatory pain. Quercetin, a dietary flavonoid, is claimed to have antiinflammatory activity in a few experimental studies. However, it is not known whether quercetin can reverse the hyperalgesia that is secondary to the inflammation. The aim of the present study was to evaluate the effect of quercetin on LPS‐induced alteration of pain perception in mice. Central perception of pain was assessed with the tail‐flick and hot plate methods and behavioural hyperalgesia was assessed by noting the animal's reactions such as redness, paw licking, and rearing after the intraplantar injection of LPS (10 μg/paw). Local administration of LPS induced significant hyperalgesia when measured by both central effects and behavioural reactions. Quercetin (50 and 100 mg/kg), like dexamethasone (0.5 mg/kg), attenuated central and behavioural hyperalgesia. This effect of quercetin was sensitive to reversal by naloxone (2 mg/kg). Our results thus indicate that quercetin protects against LPS‐induced hyperalgesia through modulation of the opioidergic system. Drug Dev. Res. 58:248–252, 2003. © 2003 Wiley‐Liss, Inc.     

Impact of multidrug therapy on leprosy in Baroda district (Gujarat)

Though much information is available on MDT organising, it poses a challenge to the field staff due to limited field trials conducted and varied field conditions. The MDT project was begun on 11th June, 1984 in Baroda by the Govt. of India, with active assistance of State Government, the World Health Organisation and the Swedish International Development Agency. The Drug combinations for MB cases were Rifampicin 600 mg, Clofazamine 300 mg and dapsone 100 mg daily for 14 days intensive supervised therapy followed by once a month (Pulse) supervised dose of Rifampicin 100 mg, Clof. 300 mg and dapsone 100 mg for minimum period of 2 years or more if indicated and Clof 50 mg daily with dapsone 100 mg daily unsupervised for minimum period of 2 years or more if indicated, for PB cases, dapsone 100 mg daily for 6 months along with Rifampicin 600 mg supervised (Pulse) once a month for minimum period of 6 months or more if indicated. Total number of active cases at commencement of MDT was 10706, out of these 10348 (96.37%) brought under MDT till Dec. 1987. Amongst 10348, old active cases 9112 (88.05%) are cured with MDT, (3110 MB + 6002 PB) 180 old MB cases BI is still positive inspite of completed 24 pulse. The rest 1056 (10.23%) stopped the treatment for various reasons. 790 (74.81%) cases have left the villages to earn their livelihood, 30 (2.86%) were being treated by skin specialist, 86 (7.19%) refuse to continue the treatment inspite of best efforts of field staff. New cases detected since June 1984 till Dec. 1987 are 7628, out of which 7549 (96.28%) brought under treatment. Now cases cured till Dec. 1987 are 4640 (1120 MB + 3520 PB) 17 cases relapsed after MDT (15 PB + 2 MB). 280 (1.56%) cases got complications, 250 developed reactions, 3 cases Jaundice, 15 cases Gastritis and rest 12 got moderate to severe anaemia. The prevalence rate came down from 5.81 to 1.01% per thousand population till Dec., 1987. The deformity rate came down amongst new cases from 6.15 to 1.50% till Dec. 1987. regularity of treatment among PB cases is 90.84% as compared to 90.48% for MB cases. The study showed that MDT can be implemented in tribal, rural and urban populations with high rate of compliance.     

When outside the norm is normal: interpreting lab data in the aged.

Laboratory tests that are frequently ordered in a primary care practice include complete blood count, arterial blood gases, erythrocyte sedimentation rate, creatinine clearance, and glucose tolerance. Yet, the impact of age-associated physiologic changes on interpretation of laboratory data has only recently been elucidated. With advancing age, many laboratory parameters increase or decrease, some remain unchanged, and the effect of age on still others remains unclear. Interpreting lab data in the elderly is further confounded by the multiple disease states, polypharmacy, and atypical disease presentations commonly found in this population. Additional clinical research is needed to better establish reference laboratory values in elderly patients.     

Superior mesenteric artery angioplasty with the TEGwire: usefulness and technical difficulties.

The TEGwire percutaneous transluminal angioplasty balloon on a guide wire was used successfully for dilation of a proximal superior mesenteric arterial stenosis that was not well suited to dilation by conventional angioplasty catheters. After the stenosis was dilated, however, the balloon deflated only partially due to a kink in the TEGwire as it coursed over the acute angle between the aorta and the superior mesenteric artery. Several unsuccessful attempts to correct this problem were made; finally, the partially deflated balloon and the guide catheter had to be withdrawn. Although the TEGwire was used within the guidelines and recommendations of the product, this experience supports the manufacturer's recommendation that the TEGwire system should not be used with narrow-radius vascular curves such as that formed between the superior mesenteric artery and the aorta.     

Minimally differentiated acute myeloid leukemia: a morphologic, cytochemical and ultrastructural study.

Seven of 368 cases of acute myeloid leukemia (AML) could not be subclassified by routine morphologic, cytochemical and immunologic analyses during the period January 1989 to December 1990. Further investigations including ultrastructural examination, anti-myeloperoxidase and myeloid specific antigen analysis were carried out in all these patients and they were classified as AML-MO, as per the FAB criteria. Morphologically these blasts resembled ALL-L2/AML-M1. Cytochemically they were negative for Sudan black, myeloperoxidase, periodic acid-Schiff, and non-specific esterase. On initial immunophenotypic analysis, they could not be classified into B, T or myeloid lineages. Further investigations revealed CD13 and CD33 positivity in 4 of 6 patients. Anti-myeloperoxidase was positive in 6 of 6 patients and ultrastructural examination revealed myeloperoxidase-positive blasts in 6 of 7 cases. Cytogenetic analysis done in one patient revealed 60% abnormal metaphases. Six of 7 cases were treated with aggressive chemotherapy. One patient achieved complete remission but relapsed after 6 months, whereas others were resistant to treatment. Hence we conclude that an aggressive investigative and therapeutic approach is required to identify and treat AML-MO.     

Patterns of outpatient consultation: a survey of outpatients attending a metropolitan psychiatric hospital

A survey of all outpatients (n = 1135) attending a regional psychiatric hospital during a 3-month period. Psychoses constituted 72% and non-psychotic disorders 25%. Psychoses had a greater proportion of long-term attenders while non-psychotic disorders, though frequent (43%) among recent attenders, showed a high attrition rate. Demographic characteristics, patterns of attendance, selected clinical features, level of functioning and difficulties of management of the different diagnostic groups are presented and discussed. Reasons are adduced to explain why patients who were deemed suitable for transfer to other care had not been discharged from hospital. Steps taken to reduce the patient load and increase the efficiency of the services are described.     

Nonsurgical (Spontaneous) Spleno-Renal Shunt Presenting as an Abdominal Mass: Case Report and Review of the Literature

A case of an unusually large nonsurgical (spontaneous) spleno-renal shunt presenting as an abdominal mass is described. The diagnosis was first suggested by the finding of a lobulated, serpiginous, contrast-enhancing mass in the left upper quadrant of the abdomen by body CT scanning, and then confirmed by selective abdominal angiography. This represents the first report of the use of body CT scanning with contrast enhancement in the diagnosis of nonsurgical (spontaneous) spleno-renal shunts.