Dengue fever treatment with Carica papaya leaves extracts

The main objective of the current study is to investigate the potential of Carica papaya leaves extracts against Dengue fever in 45 year old patient bitten by carrier mosquitoes. For the treatment of Dengue fever the extract was prepared in water. 25 mL of aqueous extract of C. papaya leaves was administered to patient infected with Dengue fever twice daily i.e. morning and evening for five consecutive days. Before the extract administration the blood samples from patient were analyzed. Platelets count (PLT), White Blood Cells (WBC) and Neutrophils (NEUT) decreased from 176×10³/µL, 8.10×10³/µL, 84.0% to 55×10³/µL, 3.7×10³/µL and 46.0%. Subsequently, the blood samples were rechecked after the administration of leaves extract. It was observed that the PLT count increased from 55×10³/µL to 168×10³/µL, WBC from 3.7×10³/µL to 7.7×10³/µL and NEUT from 46.0% to 78.3%. From the patient feelings and blood reports it showed that Carica papaya leaves aqueous extract exhibited potential activity against Dengue fever. Furthermore, the different parts of this valuable specie can be further used as a strong natural candidate against viral diseases.     

Antioxidant and urease inhibitory C-glycosylflavonoids from Celtis africana

Two new C-glycosylflavonoids celtisides A (1) and B (2) have been isolated from n-butanol-soluble fraction of Celtis africana, along with five known C-glycosylflavonoids vitexin (3), orientin (4), isoswertiajaponin (5), isoswertisin (6), and 2″-O-rhamnosyl vitexin (7) reported for the first time from this species. Their structures were assigned from 1D and 2D NMR spectra. These compounds were investigated for biological activities and showed significant antioxidant and urease inhibitory activities.     

Co-treatment with pegylated interferon alfa-2a and entecavir for hepatitis D: a randomized trial

AIM: To investigate the efficacy of pegylated interferon alfa(PEG-IFNα) therapy with and without entecavir in patients with chronic hepatitis D. METHODS: Forty hepatitis D virus(HDV) RNA positive patients were randomized to receive either PEG-IFNα-2a 180 μg weekly in combination with entecavir 0.5 mg daily(n = 21) or PEG-IFNα alone(n =19). Patients who failed to show 2 log reduction in HDV RNA level at 24 wk of treatment, or had detectable HDV RNA at 48 wk of therapy were considered as treatment failure. Treatment was continued for 72 wk in the rest of the patients. All the patients were followed for 24 wk post treatment. Intention to treat analysis was performed.RESULTS: The mean age of the patients was 26.7 ± 6.8 years, 31 were male. Two log reduction in HDV RNA levels at 24 wk of therapy was achieved in 9(43%) patients receiving combination therapy and 12(63%) patients receiving PEG-IFNα alone(P = 0.199). Decline in hepatitis B surface antigen(HBs Ag) levels was insignificant. At the end of treatment, HDV RNA was negative in 8 patients(38%) receiving combination therapy and 10 patients(53%) receiving PEG-IFNα-2a alone. Virological response persisted in 7(33%) and 8(42%) patients, respectively at the end of the 24 wk follow-up period. One responder patient in the combination arm lost HBs Ag and became hepatitis B surface antibody positive. Six out of 14 baseline hepatitis B e antigen reactive patients seroconverted and four of these seroconverted patients had persistent HDV RNA clearance.CONCLUSION: Administration of PEG-IFNα-2a with or without entecavir, resulted in persistent HDV RNA clearance in 37% of patients. The addition of entecavir did not improve the overall response.     

Predictors of chronic disease at midlife and beyond - the health risks of obesity

A burgeoning pandemic of obesity is well characterized. 41% of U.S. adults are projected to be obese by 2015 and obesity, a potentially modifiable risk, is emerging as a leading predictor of lifetime health. The wide spectrum of morbidities related to excess body mass includes risks for diabetes, hypertension, coronary artery disease, dyslipidemia, malignancy, venous thrombosis, degenerative joint disease, pulmonary compromise, sleep apnea, cholelithiasis, depression and overall reduced quality of life. Beyond the myriad major and minor morbidities linked to obesity, increased all-cause mortality and cardiovascular mortality is recognized in the obese. Bariatric surgery literature suggests that, in the morbidly obese, increase in the lifespan is achievable with reversal of obesity, reinforcing the realization that sequelae therein are by no means inevitable. Aggressive efforts must be targeted towards population-based strategies to educate and sensitize all generations on contributors to and sequelae of excess body mass as obesity represents one of the few modifiable factors that impact on the quantity and quality of lifespan.     

Midwifery students' enrolment reasons and evaluations of the first Bachelor of Midwifery programme in Jordan

OBJECTIVE: to explore reasons for enrolment in the first bachelor of midwifery programme in Jordan, and to describe midwifery students' evaluations of the programme. DESIGN: a cross-sectional survey design. SETTING: The Faculty of Nursing at Jordan University of Science and Technology, Irbid, Jordan. PARTICIPANTS: 16 diploma-prepared midwifery students enrolled in the 2-year bachelor-completion programme. MEASUREMENTS AND FINDINGS: an open-ended question explored students' reasons for enrolling in the midwifery programme. For programme evaluation, a 13-item Midwifery Programme Evaluation Questionnaire (MPEQ) was developed and used. Total score ranged from 39-61, with a mean of 51.2 (SD=6.7). CONCLUSION: midwifery students reported five reasons for enrolling in the midwifery programme, which was favourably evaluated. IMPLICATIONS FOR PRACTICE: encouragement and sustainability of student enrolment in the JUST Bachelor of Midwifery programme are recommended to improve midwifery education and enhance midwifery as a profession.     

Specificity and prognostic validation of a polyclonal antibody to detect Six1 homeoprotein in ovarian cancer

Objective

The presence of Six1 mRNA gene portends a poor prognosis in ovarian cancer. We describe validation of a Six1 specific antibody and evaluate its association with tumorigenicity and prognosis in ovarian cancer.

Methods

A Six1 antibody (Six1cTerm) was raised to residues downstream of the Six1 homeodomain, representing its unique C-terminus as compared to other Six family members. Cells were transfected with Six1-Six6 and Western blot was performed to demonstrate Six1 specificity. Ovarian cancer cell lines were analyzed for Six1 mRNA and Six1cTerm and tumorigenicity was evaluated. Ovarian cancer tissue microarrays (OTMA) were analyzed for Six1cTerm by immunohistochemistry and scored by two blinded observers. The metastatic tumors of 15 stage IIIC high grade serous ovarian cancers were analyzed with Six1 mRNA and Six1cTerm and expression was compared to clinical factors and survival.

Results

The Six1cTerm antibody is specific for Six1. Cell line tumorigenicity in SCID mice correlates with Six1 levels both by mRNA(p = 0.001, Mann-Whitney U test) and by protein (presence vs. absence, p = 0.05 Fischer's Exact test). Six1 protein was present in up to 54% of OTMA specimens. Six1 protein expression in omental/peritoneal metastases correlated with worsened survival in a sample (n = 15) of high grade serous stage IIIC ovarian cancers (p = 0.001).

Conclusions

The Six1cTerm antibody is specific and able to detect Six1 in cell lines and tumor tissue. Six1 protein detection is common in ovarian cancer and is associated with tumorigenicity and poor prognosis in this group of patient samples. Six1cTerm antibody should be further validated as prognostic tool.     

Cervical and prolapsed submucosal leiomyomas complicating pregnancy

Cervical and prolapsed submucosal leiomyomas are rarely seen in pregnancy. Depending on the size threshold used to diagnose a leiomyoma, the prevalence of uterine leiomyomas in pregnancy is approximately 3% to 10%. The prevalence of clinically evident cervical leiomyomas in pregnancy is less than 1%. Contrary to prior thought, the majority of uterine leiomyomas in pregnancy do not usually lead to complications. Indications for surgical intervention in pregnancy for cervical leiomyomas include bleeding, infection, degeneration, pain, and urinary stasis. Preoperative imaging with ultrasound and magnetic resonance imaging may help to delineate the location and nature (e.g., pedunculated) of the cervical leiomyoma when clinical examination is inconclusive. We reviewed the current literature in regard to cervical leiomyomas in pregnancy and summarize the major findings. After completing this CME activity, readers should be better able to evaluate the prevalence and natural history of uterine and cervical leiomyomas in pregnancy, assess indications for surgical intervention in pregnant patients, manage surgical complications, and select imaging modalities that may determine their origin. Target Audience: Obstetricians & Gynecologists, Family Physicians Learning Objectives: After completion of this educational activity, the reader should be better able to evaluate the prevalence and natural history of uterine leiomyomas in pregnancy; assess indications for surgical intervention in pregnant patients; manage surgical complications; and select imaging modalities that may determine their origin.