Bacopa monniera protects rat heart against ischaemia–reperfusion injury: role of key apoptotic regulatory proteins and enzymes

Objectives Rat isolated hearts were perfused in a Langendorff model to study the cardioprotective effects of Bacopa monniera, a medicinal herb used in the Indian system of medicine, on cardiomyocyte apoptosis and antioxidant status following ischaemia–reperfusion (I‐R) injury. Methods Forty‐eight rats were randomly divided into four groups (12 in each group): sham group (no ischaemia–reperfusion injury), B. monniera control group (orally fed B. monniera at a dose of 75 mg/kg, for three weeks); ischaemia–reperfusion control group(subjected to ischaemia–reperfusion‐induced myocardial injury) and B. monniera‐treated group (same protocol as ischaemia–reperfusion control group except that rats also fed B. monniera). Key findings Post‐ischaemic reperfusion injury resulted in significant cardiac necrosis, apoptosis, depression of heart rate, decline in antioxidant status and elevation in lipid peroxidation. Oral administration of B. monniera per se for three weeks to healthy rats caused augmentation of myocardial antioxidants, superoxide dismutase, catalase and glutathione, along with induction of heat shock protein 72 (HSP72). Ischaemia–reperfusion‐induced biochemical and histopathological perturbations were significantly prevented by B. monniera (75 mg/kg) pre‐treatment. Interestingly, B. monniera also restored the antioxidant network of the myocardium and reduced myocardial apoptosis, caspase 3 and Bax protein expression. Conclusions Histopathological studies and myocardial creatine phosphokinase content further confirmed the cardioprotective effects of B. monniera (75 mg/kg) in the experimental model of ischaemia–reperfusion injury. The study provides scientific basis for the putative therapeutic effect of B. monniera in ischaemic heart disease.     

Objective structured clinical examination for undergraduates: Is it a feasible approach to standardized assessment in India?

Background:

There has been a growing concern among medical educators about the quality of medical graduates trained in various medical colleges in our country. Data based on the faculty and student perceptions of undergraduate curriculum indicate a need for laying more stress on practical skills during their training and assessment. The Objective Structured Clinical Examination (OSCE) is a reliable and an established and effective multistation test for the assessment of practical skills in an objective and a transparent manner. The aim of this article is to sensitize universities, examiners, organizers, faculty, and students across India to OSCE.

Materials and Methods:

We designed an assessment based on 22-station OSCE and administered it to 67 students during their final year, integrating all the domains of learning, that is higher order cognitive domain, psychomotor domain, and affective domain. Data analysis was done using SPSS version 15.

Results:

The OSCE was feasible to conduct and had high perceived construct validity. There was a significant correlation between the station score and total examination score for 19 stations. The reliability of this OSCE was 0.778. Both students and faculty members expressed a high degree of satisfaction with the format.

Conclusion:

Integrating a range of modalities into an OSCE in ophthalmology appears to represent a valid and reliable method of examination. The biggest limitation with this format was the direct expenditure of time and energy of those organizing an OSCE; therefore, sustaining the motivation of faculty might pose a challenge.     

Mandibular abnormalities in a patient with neurofibromatosis type 1

Neurofibromatosis type 1 (NF1) is an autosomal dominant disorder characterized by the presence of cutaneous neurofibromas, multiple cafd-au-lait spots and pigmented nodules of the iris known as Lisch nodules. In some cases, the diagnosis can be made at birth while in others the diagnosis is made later in life based on the appearance of additional criteria. We describe radiographic abnormalities of the mandible in a young adult male with NF1.     

Alveolar soft part sarcoma of the head and neck

Alveolar soft part sarcoma (ASPS) of the head and neck region has been a rarely reported entity. These lesions have a high propensity for distant metastasis. A retrospective study of the medical records at our institute, revealed thirty-eight cases of ASPS. Six of these were of primary head and neck origin. The article highlights the aggressive nature of the tumour and the need to arrive at a consensus on the treatment protocol.     

Cementodentinal tear: a case report with 7-year follow-up

BACKGROUND: Cemental tears are an uncommon form of root fracture that can lead to rapid localized attachment loss. Typically, the separation of the fragment occurs at the cementodentinal junction. In this report, we present a case of periodontal involvement associated with a cemental tear-like fragment that proved to be a cementodentinal tear. We also review the literature on the clinical presentation of cemental tear associated periodontal lesions. METHODS: A 52-year-old male presented with acute pain on the maxillary right second premolar. Clinically, probing depth of 7 mm and inflammation were noted on the distal aspect of tooth #4. Radiographic examination revealed separation of cervical root structure on the distal aspect of the tooth, involving two-thirds of the root length. The root fragment was removed, and the localized defect was treated by open flap debridement along with scaling and root planing. The patient was then placed on a regular periodontal maintenance schedule. RESULTS: A postoperative probing depth of 2 mm with 1 mm recession was recorded at 3 months, and maintained for 7 years. Histological examination indicated that the detached root fragment contained dentin with overlying acellular cementum and associated periodontal ligament tissue. The fragment was estimated to represent as much as 20% of the total root surface area. CONCLUSION: Moderate to severe periodontal attachment loss associated with cemental or cementodentinal tears, even ones constituting a significant portion of the root surface, can be successfully treated with conventional periodontal surgical procedures and maintained long term with a proper maintenance regimen.