GC-MS analysis of Cocus nucifera flower extract and its effects on heterogeneous symptoms of polycystic ovarian disease in female Wistar rats

AIM： To evaluate the effect of Cocus nucifera L. flowers in reducing the major multiple symptoms of letrozole-induced polycystic ovarian disease（PCOD） in female rats. METHOD： Female, virgin Wistar rats were treated with letrozole（1 mg/kg body wt） to induce PCOD, and after 21 days of induction rats were administered orally with 100 and 200 mg·kg-1 of Cocus nucifera flower aqueous extract, respectively. Estrus cycle and blood sugar were monitored once a week throughout the study. After scarification, various biochemical parameters, such as antioxidant status（superoxide dismutase（SOD） and glutathione reductase（GSH）） of the uterus homogenate, lipid profile（total cholesterol（TC）, high density lipoprotein（HDL）, low density lipoprotein（LDL）, and triglycerides（TG）） of the serum were determined. Weights of the uterus and ovaries were separately monitored. The characteristics of changes in the ovary were evaluated by histopathological studies. RESULTS： GC-MS analysis of the aqueous extract showed the presence of volatile and pharmacologically active phytoconstituents. C. nucifera flower extract-treated groups showed estrus cyclicity and increased uterus weight which indicates the estrogenic effect. The improved blood sugar level, ideal lipid profile, good antioxidant status, and histopathology results revealed the recovery from poly cystic ovaries. CONCLUSION： The results indicate that C. nucifera flower is a potential medicine for the treatment of PCOD and this study supports the traditional uses of C. nucifera flower.     

Subcutaneous Zygomycosis: A Report of One Case Responding Excellently to Potassium Iodide

Subcutaneous Zygomycosis is a rare opportunistic fungal infection caused by Basidiobolus ranarum. Though this entity is endemic in South India, limited numbers of cases have been reported from this part of the country. We report a case of subcutaneous zygomycosis in a 25 year old lady who presented with a nontender, firm to hard swelling over the upper-left arm. Finger was easily inserted below the indurated edge. Histopathology revealed suppurative granuloma with aseptate hyphae. Patient responded excellently to saturated solution of potassium iodide in subsequent visits.     

Patient and Caregiver Perspectives on Ethical Issues in Mental Health Care: an Exploratory Study from India

Ethical viewpoints about the correct course of action in a clinical situation can vary across individuals. The views of patients and their caregivers are also important considerations while exploring solutions to ethical dilemmas. This study aimed to ascertain the perspectives of patients and caregivers on ethical issues in mental health care. This vignette-based study included patients with psychiatric disorders and their caregivers. Patients were included if they were in clinical remission determined by psychiatric rating scales. Caregivers were included if they resided with the patient for the last 1 year. Both patients and caregivers were in the adult age group. The vignettes pertained to confidentiality and coercive care and elicited a yes or no type of responses. Ten short vignettes were presented to the patient caregiver dyad. The types of responses and agreement between the patients and their caregivers were assessed. Responses were available from 160 dyads of patients and their caregivers. The mean age of the patients was 35.6 years while that of the caregivers was 40.5 years. A slight majority of the patients and caregivers were males and were educated above high school. There was considerable variation in the views about correct course in a particular clinical situation. The responses from patients and caregivers endorsing disclosure of confidential information or coercive treatment varied from about 50% to more than 90% depending upon the clinical situation. The responses of patients generally had a fair agreement with responses of the caregivers (kappa values largely between 0.21 and 0.40). Viewpoints of patients and their caregivers provide an important stakeholder insight in approach to resolving ethical dilemmas. In the present cultural context, patients and caregivers were amenable to disclosure of confidential information in for a variety of clinical situations.     

Unusual complication of Mycoplasma pneumonia in a five-year-old child

Mycoplasma pneumoniae is common agent causing community acquired pneumonia in children. However, the course of illness is usually benign and is rarely associated with pulmonary complications. We report a five-year-old child with massive pleural effusion and empyema secondary to Mycoplasma pneumonia infection. This potential yet rare source of infection should be considered in young patients where resolution of symptoms from pneumonia is delayed.     

A Clinico-pathological study of Reinke’S oedema

An analysis of 92 eases of Reinke’s oedema was done in this study. It wen most often seen in middle-aged persons. A Male predilection (57%) was found. In 68 (74%) cases, the lesions were unilateral and in 24 (26%) teses, the lesions were bilateral. Smoking (83%), vocal alms or misuse (80%) and chromnic respiratory tract infection (43%) were the main aetiological factors. No significant relationship of reinke’s oedema with hypotkyroidsm was found. There were no dysplastic changes in the epithelium The treatment of reinke’s oedema is a combination of surgery and vocal rehabilitation. Conventional microlaryngeal surgery is ideal for the treatment of Reinke’s oedema. Acquired laryngeal web involving the anterior part of the vocal cords may develop if stripping of the both vocal cords is performed carelessly. Operating measures do not prevent recurrences of Reinke’s oedema. Voice therapy and cessation of smoking in the postoperative period play important roles in the long term treatment results of Reinke’s oedema.