Finasteride to evaluate the efficacy of dutasteride in the management of patients with lower urinary tract symptoms and enlarged prostate

Patients with lower urinary tract symptoms and enlarged prostate were randomized to receive, in a double blind fashion, either Finasteride 5 mg/day or Dutasteride 0.5 mg/day for a period of 12 weeks. IPSS score, Qmax, and Quality of Life were assessed at the end of 0 and 12 week periods. Dutasteride significantly improved Qmax, reduced IPSS score, and improved Quality of Life as compared to Finasteride at the end of the 12-week period. Dutasteride with its inhibitory effects on type 1 and 2 5alpha-reductase, produces significantly better results than Finasteride.     

Immunogenicity and safety study of Indirab: A Vero cell based chromatographically purified human rabies vaccine

A chromatographically purified Vero cell rabies vaccine, Indirab manufactured by Bharat Biotech International Limited, Hyderabad, India was subjected to safety and immunogenicity studies by both intramuscular and intradermal routes of administration in parallel with a reference vaccine, Verorab. A Pre-exposure study was undertaken in 239 subjects by intramuscular (IM) route (Study I), Post-exposure study in 188 patients by intramuscular route (Study II) and Simulated post-exposure study in 134 subjects by intradermal (ID) route (Study III). All subjects in these studies were administered with either the test or the reference vaccine as per WHO approved intramuscular and intradermal regimens. The blood samples were collected on days 0, 14 and 35 in case of Study 1, and days 0, 14, 28 and 90 in case of studies II and III. In all studies both vaccine groups had adequate antibody titers (>0.5 IU/mL) on all days tested post-vaccination and there was no significant difference in the titers observed (p > 0.05). Some side effects like pain, induration, itching and fever were noted in both vaccine groups in all studies. Both vaccines were well tolerated. Hence it can be concluded that Indirab is as safe and immunogenic as Verorab when administered by both intramuscular and intradermal routes.     

Ureteroscopic stone management in prepubertal children

Ureteroscopy for treating ureteric stones in prepubertal children has become more common with the advent of smaller endoscopes. We retrospectively reviewed our experience with ureteroscopy for ureteric stone in this cohort of patients. During the period Jan 2001 and June 2005, we performed 22 ureteroscopic procedures in 20 children. Ureteroscopy was done in a manner similar to that in adults. Ureteral dilatation was done in all cases. A stent was placed postoperatively if there was significant stone burden, ureteral trauma, impaction and edema of ureteric orifice. Of the 20 children, 18 were male and 2 were females. Average age was 5.2 years (range 3–9). Stones were 4–14 mm in size (average 6 mm). Overall 90% of the children were rendered stone free after one procedure and 100% after two procedures. Ureteroscopy for ureteric stones in prepubertal children is safe and effective first line treatment in whom conservative therapy fails. Routine ureteral stent placement postoperatively is not always necessary.     

Curcumin as inhibitor of mammalian Cathepsin B,Cathepsin H,acid phosphatase and alkaline phosphatase: a correlation with pharmacological activities

Curcumin, a polyphenol, an important constituent of turmeric is used as dietary spice and herbal remedy. In the present work, we aim to assess the effect of curcumin on some physiologically significant enzymes such as lysosomal cysteine proteases—Cathepsin B, Cathepsin H and Phosphatases—acid and alkaline phosphatases. Elevated levels of these enzymes have been reported in various diseased conditions. The in vitro enzyme inhibition studies emphasizes on the pharmacological basis of various therapeutic uses of turmeric. The enzymes were first purified using the techniques of acetone powder preparation, homogenisation, (NH₄)₂SO₄ fractionation, molecular sieve chromatography and cation exchange chromatography. Thereafter, the inhibitory effect of curcumin was evaluated on Cathepsin B [3.4.22.1], Cathepsin H [3.4.22.16], acid phosphatase [3.4.3.2] and alkaline phosphatase [3.4.3.1] using well characterized substrates for particular enzymes. The study showed that curcumin effectively inhibited these enzymes. In addition, the results were correlated with the in silico docking studies.     

Integrative studies to design and validate wearable footwear among neuropathic patients

Uncontrolled high blood sugar levels leads to diabetic neuropathy, which is usually develops slowly. Damaged nerves stop sending messages or may send message slowly at the wrong times. The propsed model is an insole for individuals with peripheral neuropathy conditions, where the peak plantar pressure value is measured at specified locations of the foot by means of a pressure sensor, which can be accessed via a mobile applications; Simultaneously, a stimulation is given at acupressure points of the foot to relieve pain at definite intervals of time, based on the signals from the controller. A controller is being used to perform these operations which will be transmitted to the mobile application via Bluetooth terminal.     

Spontaneous perforation of choledochal cyst and hyperemesis gravidarum.

A 28-year-old primigravida at seven weeks gestation presented to the Accident & Emergency Department complaining of vomiting for five days. She was admitted and managed as a case of hyperemesis gravidarum. Two days later she developed abdominal distension. Ultrasound scan revealed ascites and common bile duct dilatation. The ascitic fluid was bile stained. At emergency laparotomy spontaneous perforation of the supraduodenal part of the common bile duct was seen. This was closed around a T-tube. She then underwent medical termination of pregnancy. The post-operative T-tube cholangiogram was suggestive of a type I choledochal cyst. Three months later this was excised and biliary enteric continuity restored by performing a hepaticojejunostomy. To the best of our knowledge, spontaneous rupture of a choledochal cyst in a patient of hyperemesis gravidarum has not been reported before. In this article, we discuss treatment options for choledochal cyst during pregnancy.     

Inferior mesenteric artery aneurysm: case report and literature review.

A 70 year old man presented with retrosternal and epigastric pain. He was in shock. The diagnosis on admission was acute myocardial infarction. CT scan of the abdomen showed coeliac and superior mesenteric artery (SMA) occlusion. In addition there appeared to be large collateral from the inferior mesenteric artery (IMA) with a retroperitoneal collection. He underwent emergency laparotomy and a ruptured IMA aneurysm was detected. The aneurysm was excised and the IMA was ligated. He developed progressive multi-system organ failure post operatively. We discuss the aetiology, presentation, diagnosis and treatment of IMA aneurysms.