Determination of Nutritional and Energy Value of Viburnum mullaha Buch.-Ham. Ex D. Don (Indian Cranberry)

Nutritional and energy value of an underutilized wild edible Viburnum mullaha was determined. Vitamin analysis confirmed that the fruit contains high amounts of vitamin C (122.27 mg/100 g), vitamin B2 (0.14 mg/g), and vitamin E (13.47 mg/g). Macronutrient profile revealed that Viburnum mullaha is a rich source of carbohydrates (18.4 g/100 g), proteins (11.3 g/100 g), and lipids (18.4 g/100 g). It was calculated that 100 g of fruit berries can provide an average of 284.4 kcal (1185.7 kJ) energy. Analysis of magnesium, copper, iron, zinc, and manganese estimated by atomic absorption spectrophotometer confirmed that fruit berries of Viburnum mullaha can be utilized for developing various edible products. This is the first study ever on the biochemical analysis and nutritional value of this species; hence, it will provide nutritional statistics that scientific societies and the pharmaceutical and nutraceutical industries can use for their expanding investigations of the ultrasonically assisted technique described here in food and medicine.     

Modulation of P-glycoprotein-mediated multidrug resistance in K562 leukemic cells by indole-3-carbinol

Resistance to chemotherapeutic drugs is one of the major problems in the treatment of cancer. P-glycoprotein (P-gp) encoded by the mdr gene is a highly conserved protein, acts as a multidrug transporter, and has a major role in multiple drug resistance (MDR). Targeting of P-gp by naturally occurring compounds is an effective strategy to overcome MDR. Indole-3-carbinol (I3C), a glucosinolates present in cruciferous vegetables, is a promising chemopreventive agent as it is reported to possess antimutagenic, antitumorigenic, and antiestrogenic properties in experimental studies. In the present investigation, the potential of I3C to modulate P-gp expression was evaluated in vinblastine (VBL)-resistant K562 human leukemic cells. The resistant K562 cells (K562/R10) were found to be cross-resistant to vincristine (VCR), doxorubicin (DXR), and other antineoplastic agents. I3C at a nontoxic dose (10 x 10(-3) M) enhanced the cytotoxic effects of VBL time dependently in VBL-resistant human leukemia (K562/R10) cells but had no effect on parent-sensitive cells (K562/S). The Western blot analysis of K 562/R 10 cells showed that I3C downregulates the induced levels of P-gp in resistant cells near to normal levels. The quantitation of immunocytochemically stained K562/R10 cells showed 24%, 48%, and 80% decrease in the levels of P-gp by I3C for 24, 48, and 72 h of incubation. The above features thus indicate that I3C could be used as a novel modulator of P-gp-mediated multidrug resistance in vitro and may be effective as a dietary adjuvant in the treatment of MDR cancers.     

Non-invasive vaccine delivery in transfersomes, niosomes and liposomes: a comparative study

Non-invasive vaccine delivery is a top priority for public health agencies because conventional immunization practices are unsafe and associated with numerous limitations. Recently, the skin has emerged as a potential alternative route for non-invasive delivery of vaccine. Topical immunization (TI), introduction of antigen through topical application onto the intact skin, has many practical merits compared to injectable routes of administration. One of the possibilities for increasing the penetration of bioactives through the skin is the use of vesicular systems. Specially designed lipid vesicles are attracting intense attention and can be used for non-invasive antigen delivery. In the present study, elastic vesicle transfersomes, non-ionic surfactant vesicles (niosomes) and liposomes were used to study their relative potential in non-invasive delivery of tetanus toxoid (TT). Transfersomes, niosomes and liposomes were prepared and characterized for shape, size and entrapment efficiency. These vesicles were extruded through polycarbonate filter (50-nm pore size) to assess the elasticity of the vesicles. The immune stimulating activity of transfersomes, niosomes and liposomes were studied by measuring the serum anti-TT IgG titre following topical immunization. The immune response elicited by topical immunization was compared with that elicited by same dose of alum-adsorbed tetanus toxoid (AATT) given intramuscularly. The results indicate that optimal formulations of transfersomes, niosomes and liposomes could entrap 72.7+/-3.4, 42.5+/-2.4 and 41.3+/-2.2% of antigen and their elasticity values were 124.4+/-4.2, 29.3+/-2.4 and 21.7+/-1.9, respectively. In vivo study revealed that topically given TT containing transfersomes, after secondary immunization, could elicit immune response (anti-TT-IgG) that was equivalent to one that produced following intramuscularly alum-adsorbed TT-based immunization. In comparison to transfersomes, niosomes and liposomes elicited weaker immune response. Thus transfersomes hold promise for effective non-invasive topical delivery of antigen(s).     

Prolonged toxicokinetics and toxicodynamics of paraquat in mouse brain

BACKGROUND: Paraquat (PQ) has been implicated as a risk factor for the Parkinson disease phenotype (PDP) in humans and mice using epidemiologic or experimental approaches. The toxicokinetics (TK) and toxicodynamics (TD) of PQ in the brain are not well understood. OBJECTIVES: The TK and TD of PQ in brain were measured after single or repeated doses. METHODS: Brain regions were analyzed for PQ levels, amount of lipid peroxidation, and functional activity of the 20S proteasome. RESULTS: Paraquat (10 mg/kg, ip) was found to be persistent in mouse ventral midbrain (VM) with an apparent half-life of approximately 28 days and was cumulative with a linear pattern between one and five doses. PQ was also absorbed orally with a concentration in brain rising linearly after single doses between 10 and 50 mg/kg. The level of tissue lipid peroxides (LPO) was differentially elevated in three regions, being highest in VM, lower in striatum (STR), and least in frontal cortex (FCtx), with the earliest significant elevation detected at 1 day. An elevated level of LPO was still present in VM after 28 days. Despite the cumulative tissue levels of PQ after one, three, and five doses, the level of LPO was not further increased. The activity of the 20S proteasome in the striatum was altered after a single dose and reduced after five doses. CONCLUSIONS: These data have implications for PQ as a risk factor in humans and in rodent models of the PDP.     

Rofecoxib-beta-cyclodextrin inclusion complex for solubility enhancement

Complex formation of rofecoxib and beta-cyclodextrin in aqueous solution and in solid state and the possibility of improving the solubility and dissolution rate of rofecoxib via complexation with cyclodextrin were investigated. Phase solubility studies indicated the formation of an 1:1 complex in solution and the value of apparent stability constant was 769 M(-1). Solid inclusion complexes of rofecoxib and cyclodextrin were prepared by the kneading method in different molar ratios. Differential scanning calorimetry studies indicated the formation of solid inclusion complexes of rofecoxib and cyclodextrin at different molar ratios and the solid complexes exhibited a higher rate of dissolution than the physical mixture and the pure drug.     

Addressing tobacco in managed care: a survey of dentists' knowledge,attitudes, and behaviors

OBJECTIVES: This study assessed the tobacco cessation knowledge, attitudes, and behaviors of dentists participating in a large managed care dental plan. METHODS: Participating dentists in 4 states were surveyed via mail. RESULTS: Dentists' perceived success in helping patients quit using tobacco was highly correlated with discussion of specific strategies for quitting, advice about the use of nicotine gum, and time spent counseling patients. Dentists who were confident about their smoking cessation knowledge frequently advised patients to quit and spent more time counseling patients about tobacco cessation. CONCLUSIONS: Tobacco cessation is not a routine part of dental practice. Knowledge, time spent counseling patients, and specific strategies for quitting were associated with dentists' perceptions of success.     

A 10-year (2000-2010) systematic review of interventions to improve quality of care in hospitals

ABSTRACT: BACKGROUND: Against a backdrop of rising healthcare costs, variability in care provision and an increased emphasis on patient satisfaction, the need for effective interventions to improve quality of care has come to the fore. This is the first ten year (2000--2010) systematic review of interventions which sought to improve quality of care in a hospital setting. This review moves beyond a broad assessment of outcome significance levels and makes recommendations for future effective and accessible interventions. METHODS: Two researchers independently screened a total of 13,195 English language articles from the databases PsychInfo, Medline, PubMed, EmBase and CinNahl. There were 120 potentially relevant full text articles examined and 20 of those articles met the inclusion criteria. RESULTS: Included studies were heterogeneous in terms of approach and scientific rigour and varied in scope from small scale improvements for specific patient groups to large scale quality improvement programmes across multiple settings. Interventions were broadly categorised as either technical (n = 11) or interpersonal (n = 9). Technical interventions were in the main implemented by physicians and concentrated on improving care for patients with heart disease or pneumonia. Interpersonal interventions focused on patient satisfaction and tended to be implemented by nursing staff. Technical interventions had a tendency to achieve more substantial improvements in quality of care. CONCLUSIONS: The rigorous application of inclusion criteria to studies established that despite the very large volume of literature on quality of care improvements, there is a paucity of hospital interventions with a theoretically based design or implementation. The screening process established that intervention studies to date have largely failed to identify their position along the quality of care spectrum. It is suggested that this lack of theoretical grounding may partly explain the minimal transfer of health research to date into policy. It is recommended that future interventions are established within a theoretical framework and that selected quality of care outcomes are assessed using this framework. Future interventions to improve quality of care will be most effective when they use a collaborative approach, involve multidisciplinary teams, utilise available resources, involve physicians and recognise the unique requirements of each patient group.     

Altered gallbladder contractility after extracorporeal shock-wave cholecystolithotripsy

Change in gallbladder contractility after biliary extracorporeal shock-wave lithotripsy (ESWL) may significantly influence the clearance of fragments after successful gallstone fragmentation. We assessed changes in gallbladder contractility in response to an oral fatty meal in 50 patients 1 month after biliary ESWL (all fragments were smaller than 3 mm) and also in a separate group of 10 patients 3 months after complete clearance of fragments. The prevalence of persistent lumen-obliterating contraction of the gallbladder after biliary ESWL also was analyzed in 325 patients. Gallbladder contractility remained unchanged in 30, increased in nine, and decreased in 11 of the 50 patients. The average reduction in the fasting gallbladder volume after lithotripsy was 28% (p less than .001). Gallbladder contractility remained unchanged 3 months after complete clearance of fragments in six of 10 patients studied separately. A decrease (n = 2) or increase (n = 2) in contractility was seen in the remaining patients. No significant difference occurred in the average ejection fraction of the gallbladder before lithotripsy and after complete clearance of the fragments. Thirty-four of the 325 patients who have so far undergone biliary ESWL had a completely contracted gallbladder with no lumen visible on sonography. The gallbladder returned to a relaxed state in half of these patients within 1-9 months. Thus, biliary ESWL did not significantly alter gallbladder contractility in 60% of patients. A significant reduction in the volume of the fasting gallbladder occurred after lithotripsy. Successful clearance of fragments did not improve the contractility of stonebearing gallbladders in the majority of patients.     

Giant schwannoma of upper esophagus requiring esophagectomy

Esophageal schwannoma is rare and it is difficult preoperatively to confirm a diagnosis, even using current imaging techniques. We present a 30-year-old woman with progressive dysphagia for six months. Chest imaging showed an upper mediastinal mass (right paratracheal region). Computed Tomography (CT) showed a soft tissue mass in tracheoesophageal groove with compression of esophageal lumen. Peroperatively, esophageal mass became evident. Esophagectomy was necessitated because of large size of the tumor, mucosal involvement (endoscopic finding) and lack of definitive preoperative diagnosis. Subsequently a colonic bypass was done. The patient had no postoperative complications.     

The effectiveness of pencil pushups treatment for convergence insufficiency: a pilot study.

PURPOSE: To study the effectiveness of pencil pushups treatment (PPT) for the treatment of convergence insufficiency in a clinical situation. METHODS: PPT was prescribed for use at home for 6 weeks for 25 subjects with convergence insufficiency. RESULTS: Twelve of the subjects returned for follow-up. Seven of 12 (58%) subjects showed a clinically significant improvement in nearpoint of convergence and positive fusional vergence, and 11 of 12 reported improvement in symptoms. Only one subject became asymptomatic. CONCLUSIONS: PPT resulted in some improvement in both objective findings and symptoms for some subjects. Compliance with the recommended home therapy protocol was poor.