Meningo-encephalocoele of temporal lobe-management by blind SAC closure

Brain herniation into the middle ear and mastoid is rare but is a described complication of chronic ear disease. The diagnosis is mainly clinical and requires a high index of suspicion. This can be confirmed by imaging studies. Different surgical modalities have been described in managing this condition. We present a case managed by combined trans-mastoid mini-craniotomy approach and blind sac closure.     

Status and Factors of Menstrual Knowledge,Attitudes, Behaviors and Their Correlation with Psychological Stress in Adolescent Girls

Background and ObjectiveAdolescent girls perceive menstruation as a negative experience, which can affect adolescents’ physical and mental health. The aims of this study were to describe the menstrual knowledge, attitudes, and behaviors of adolescent girls in China and to examine their association with psychological stress.Design, Setting, Participants, Interventions, and Main Outcome MeasuresA cross-sectional study was conducted among 1349 adolescent girls aged 11-14 years in Changsha, China. Participants anonymously completed questionnaires that assessed sociodemographic characteristics, menstrual knowledge and attitudes, dysmenorrhea self-care behaviors, and perceived stress. One-way analysis of variance and Pearson r correlation and multiple linear regression analyses were conducted to examine the differences and associations among variables.ResultsThe mean age of menarche was 11.70 (±0.82) years. A total of 1053/1349 (78.1%) of girls had a knowledge of menstruation before menarche and their mothers were the main source 931/1349 (69.0%) of their knowledge. More than half (53.4%) of adolescent girls experienced different degrees of dysmenorrhea. The mother's education, family monthly income, family type, and the girls' age, grade, menstrual status, age at menarche, sanitary napkin change frequency, menstrual restrictions, and dysmenorrhea influenced menstrual knowledge, attitudes, and practice. Psychological stress was affected by age, grade, age at menarche, sanitary napkin change frequency, menstrual restrictions, dysmenorrhea, and menstrual knowledge, attitudes, and practices.ConclusionPsychological stress management during menstruation should be a focus of health education programs for adolescent girls. During adolescence, health care providers should not only pay attention to the physical changes of adolescence girls, but also provide stress management skills to help them cope with menstrual-related concerns.     

Ondansetron induced fatal ventricular tachycardia

Ondansetron is a serotonin receptor antagonist used widely in the prophylaxis and treatment of postoperative nausea and vomiting (PONV) and vomiting associated with cancer chemotherapy. The common side effects of ondansetron are fever, malaise, diarrhoea, constipation, and allergic reactions. Extra-pyramidal reactions are rare and cardiovascular side effects are even rarer. Even though its clinical safety has been established in a large number of studies, its adverse effects have been reported and these include cardiovascular events like acute myocardial ischemia and arrhythmias in adults.^[1] Studies of its adverse effects in children are few. We report a rare adverse effect of ondansetron in a 14-year-old girl, presenting as ventricular tachycardia.     

Urinary protein carbonyl levels and its correlation with protein misfolding in preeclampsia

Objective: To evaluate the association of protein carbonylation with preeclampsia and its correlation with urinary protein misfolding.Method: Protein carbonyl and misfolded protein levels were measured in the midstream urine sample (58 preeclamptic and 44 normotensive pregnancy) by ELISA and Congo Red Dot assay respectively.Results: Significant difference was observed in the levels of protein carbonyls (P = 0.002) and misfolded proteins (P = 0.001). Correlation between protein carbonyl and misfolded proteins levels was significant but weak (r = 0.3; P = 0.018).Conclusion: Urinary protein carbonyl level is elevated in preeclampsia but plays a minor role in proteins misfolding.     

Comparative pharmacokinetics study of two different clindamycin capsule formulations: a randomized, two-period, two-sequence, two-way crossover clinical trial in healthy volunteers

The comparative pharmacokinetic (PK) study of two brands of clindamycin hydrochloride (CAS 21462-39-5) was carried out on 32 healthy Indian subjects in an open label randomized, two way crossover, two period, two sequence, two treatment trial with a minimum washout period of 7 days. Plasma samples were collected at 10 min interval for the 1st hour, at 1 h interval for the next 6 h, at 2 h interval for next 12 h and finally at the 24th hour (pre-dose as baseline value) after drug administration. The concentrations of clindamycin in plasma were determined using high performance liquid chromatography (HPLC) technique with UV detector [lower limit of quantitation (LLOQ) 0.05 microg x mL(-1)). All PK parameters were calculated from data on clindamycin content in plasma using a non-compartmental model. Primary PK parameters were maximum plasma concentration (Cmax), area under the curve from zero to t(th) hour (AUCT) and area under the curve from zero to infinite (AUCI), whereas secondary PK parameters were elimination half-life (t half), elimination rate constant (K el) and time to reach maximum plasma concentration (Tmax). All primary PK parameters (log transformed) were subjected to ANOVA analysis and two one-sided Student's t-test (TOST) to construct the 90% confidence intervals. The result of ANOVA showed that all primary PK parameters at 90% confident intervals were within the limit of 80-125%. All the values such as 95.7-109.00% for Cmax, 99.5-117% for AUCT and 99.1% to 114% for AUCI showed pharmacokinetic equivalence and indicated that this comparative pharmacokinetic study was well designed to conclude that the test formulation and reference formulation were pharmacokinetically equivalent and hence bioequivalent with respect to rate and extent of absorption.     

An antibacterial from Hypericum acmosepalum inhibits ATP-dependent MurE ligase from Mycobacterium tuberculosis

In a project to characterise new antibacterial chemotypes from plants, hyperenone A and hypercalin B were isolated from the hexane and chloroform extracts of the aerial parts of Hypericum acmosepalum. The structures of both compounds were characterised by extensive one- and two-dimensional nuclear magnetic resonance (NMR) spectroscopy and were confirmed by mass spectrometry. Hyperenone A and hypercalin B exhibited antibacterial activity against multidrug-resistant strains of Staphylococcus aureus, with minimum inhibition concentration ranges of 2-128 mg/L and 0.5-128 mg/L, respectively. Hyperenone A also showed growth-inhibitory activity against Mycobacterium tuberculosis H37Rv and Mycobacterium bovis BCG at 75 mg/L and 100mg/L. Neither hyperenone A nor hypercalin B inhibited the growth of Escherichia coli and both were non-toxic to cultured mammalian macrophage cells. Both compounds were tested for their ability to inhibit the ATP-dependent MurE ligase of M. tuberculosis, a crucial enzyme in the cytoplasmic steps of peptidoglycan biosynthesis. Hyperenone A inhibited MurE selectively, whereas hypercalin B did not have any effect on enzyme activity.