Studies on the antidiabetic activities of Momordica charantia fruit juice in streptozotocin-induced diabetic rats

Context: Momordica charantia Linn (Cucurbitaceae) (MC) is used in folk medicine to treat various diseases including diabetes mellitus.

Objective: This study investigates the antidiabetic activities of Momordica charantia (bitter gourd) on streptozotocin-induced type 2 diabetes mellitus in rats.

Materials and methods: Male Wister rats were randomly assigned to 4 groups. Group I, Normal control; Group II, STZ diabetic; Group III and IV, Momordica charantia fruit juice was orally administered to diabetic rats (10?mL/kg/day either as prophylaxis for 14 days before induction of diabetes then 21 days treatment, or as treatment given for 21 days after induction of diabetes). The effects of MC juice were studied both in vivo and in vitro by studying the glucose uptake of isolated rat diaphragm muscles in the presence and absence of insulin. Histopathological examination of pancreas was also performed.

Results: This study showed that MC caused a significant reduction of serum glucose (135.99?±?6.27 and 149.79?±?1.90 vs. 253.40*?±?8.18) for prophylaxis and treatment respectively, fructosamine (0.99?±?0.01 and 1.01?±?0.04 vs. 3.04?±?0.07), total cholesterol, triglycerides levels, insulin resistance index (1.13?±?0.08 and 1.19?±?0.05 vs. 1.48?±?1.47) and pancreatic malondialdehyde content (p?p?p?Conclusions: Momordica charantia presents excellent antidiabetic and antioxidant activities and thus has great potential as a new source for diabetes treatment whether it is used for prophylaxis or treatment.     

Traumatic aortic pseudoaneurysm

A case report of a 5 years old male child, with a history of crash injury--(blunt trauma)--on the chest. Computed tomography (CT) scan, magnetic resonance imaging (MRI) of the chest revealed an aneurysm involving the arch of the aorta. An aortogram showed its exact extension. Chest X-Ray showed collapsed left lung (due to pressure of aneurysm on left main bronchus). Surgery was done o aortic arch: Resection of the aneurysm, and patch repair of aorta, under profound hypothermic circulatory arrest (PHCA) and CPB. Left bronchial tear was also closed. Post operatively the patient was ventilated for about 36 hours to allow for lung expansion. The patient had a smooth postoperative course. Intensive chest physiotherapy and repeated bronchoscopies helped in recovering the left lung function.     

Hypernatraemic dehydration and acute gastro-enteritis in children

A prospective study was conducted over a 2-year period to detect the effect of feeding practice, in particular the role of artificial milk formulae, in children admitted with hypernatraemic dehydration (serum sodium > or = 150 mmol/L) caused by acute gastro-enteritis, and to record morbidity and mortality in these patients. A control group was selected from infants and children admitted with gastro-enteritis but normal sodium levels. Sixty-seven children aged 18 days to 18 months (mean 6.9 months) were studied and represented 4.6% of all children admitted during the study with acute gastro-enteritis. Their mean serum sodium level was 161 mmol/L, the highest being 194 mmol/L. Twenty-four infants (36%) with hypernatraemic dehydration were on evaporated cow's milk powder compared with ten (15%) in the control group (p < 0.01). Five hypernatraemic infants (7.5%) were breastfed compared with 40 (60%) isonatraemic controls (p < 0.00001). Six children from the hypernatraemic group developed convulsions and two died. Hypernatraemic dehydration remains an important and serious complication in infants with gastro-enteritis in our area. Artificial milk feeding, particularly the use of evaporated cow's milk powder, is a predisposing factor for hypernatraemia in infantile gastro-enteritis. This study emphasises the importance of breast-feeding and the need to educate mothers to avoid giving evaporated cow's milk formulae to babies under 1 year of age if breast-feeding is not possible.     

The Effects of Abscisic Acid on Angiogenesis in Both ex vivo and in vivo Assays

Background: Angiogenesis is a complex biological process wherein novel capillary blood vessels mature from pre-existing vasculature for delivering tissues with oxygen and nutrients. Natural molecules that have anti-angiogenic activity and toxicity can raise the focus on using plant sources as essential therapeutic agent. Objective: The current research was intended to estimate the probable anti-angiogenic activity of abscisic acid alone and in combination with prednisolone, a well-known angiostatic glucocorticoid. Methods: two months old albino rats were used in this study. ABA and prednisolone stock solutions were prepared and added after embedding aortic rings in growth media. The ex vivo rat aorta ring assay (RAR) was applied to explore the anti-angiogenic effect of ABA. The in vivo chorioallantoic membrane assay (CAM) was applied to quantify the blood vessels inhibition zone by ABA effect. That zone was calculated as the mean inhibition region on eggs in mm ± SD. Results: Abscisic acid screened byex vivo and in vivo assays, revealed a significant dose-dependent blood vessels inhibition in comparison to the negative control with IC50= 7.5µg/ml and a synergism effect when combined with prednisolone. Conclusion: The synergism activity of ABA with prednisolone can significantly inhibit blood vessels growth in RAR and CAM assays. These results shed the light on the potential clinic values of ABA, and prednisolone combination in angiogenesis-dependent tumors.     

Clinical presentation and outcomes of acute coronary syndromes in the gulf registry of acute coronary events (Gulf RACE)

OBJECTIVE: To identify the characteristics, treatments and hospital outcomes for patients diagnosed with acute coronary syndromes (ACS) in the Gulf area. METHODS: Prospective, multinational, multicentre, observational survey of consecutive ACS patients who were admitted to 65 hospitals during May 2006. RESULTS: A total of 1484 ACS patients were recruited. The mean age was 55 years, and 76% were men. The final discharge diagnosis was ST-segment elevation myocardial infarction (STEMI) in 37%, non-ST-segment elevation myocardial infarction (NSTEMI) in 32%, left bundle branch block myocardial infarction (LBBB MI) in 2%, and unstable angina in 29%. Among patients with STEMI and LBBB MI, the reperfusion rate was 65%, with use of primary percutaneous coronary intervention in 7% and thrombolytic therapy in 93%. When thrombolytic therapy was used, the median door to needle time was 45 minutes, with 37% receiving it within 30 minutes of hospital presentation. During the first day of hospitalization, aspirin was administered to 94%, clopidogrel to 51%, and beta blockers to 65%. Angiotensin converting enzyme inhibitors/Angiotensin receptor blockers and statins were used in 62% and 82%, respectively. Coronary angiography during hospitalization was performed in 21%. In-hospital mortality was 3%. CONCLUSION: We were able to determine the characteristics, treatments and in-hospital outcomes of patients hospitalized with ACS in our region. There is room for improvement in using medications, reducing needle to door time and utilizing more cardiac catheterization services.     

New modalities to deliver surfactant in premature infants: a systematic review and meta-analysis

Context: Surfactant is the principle treatment of respiratory distress syndrome, but the ideal method of its administration remains controversial. The intubation, surfactant administration and extubation (InSurE) method is proven to work but is invasive. The objective of this systematic review is to evaluate the efficacy and safety of the modalities of surfactant administration.

Methods: We searched MEDLINE, EMBASE and CENTRAL (inception to December 2015) for randomized trials comparing new modalities with InSurE method. The primary outcome was mortality and development of bronchopulmonary dysplasia (BPD).

Results: We screened 1837 citations and identified five unique trials were included; all were of unclear risk of bias. Four trials (400 infants) compared endotracheal catheters with InSurE, and one trial (70 infants) compared laryngeal masks (LMA) with InSurE. There was no significant difference between using endotracheal catheters compared with InSurE regarding infant mortality (risk ratio 1.05, 95% CI 0.57–1.94, 4 trials, 400 patients, p 0.87, I² 0%) or BPD (risk ratio 0.73, 95% CI 0.43–1.21, 4 trials, 400 patients, p 0.22, I² 0%). Adverse events were under-reported.

Conclusion: The use of endotracheal catheters may provide comparable results to the InSurE method. There is limited evidence on the comparative efficacy of LMA.