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   2014| January-June  | Volume 2 | Issue 1  
    Online since July 1, 2014

 
 
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ORIGINAL ARTICLES
Mixed flora in the urine of hospitalized and elderly patients: Contamination or True infection?
Trupti Bajpai, Maneesha Pandey, Meena Varma, Ganesh S Bhatambare
January-June 2014, 2(1):20-27
DOI:10.4103/2348-0149.135722  
Background: Bacteriuria in potentially complex group of patients (those including geriatric population and patients with an anatomically abnormal urinary tract or with significant medical or surgical co morbidities) needs to be managed appropriately. In such clinical settings, polymicrobial bacteriuria is frequently considered remarkable especially due to its adverse effects on the subject. Aim: The aim of the study was to report the common pathogens and to evaluate the clinical significance of polymicrobial bacteriuria (mixed flora) from urine samples of elderly and hospitalized (catheterized) patients and study the drug resistance mechanisms revealed by the isolates from mixed flora and possibly reassessing the current diagnostic standard procedure. Materials and Methods: The present study was conducted in the Department of Microbiology of a teaching tertiary care hospital located in central India, from July 2013 to December 2013. All the uropathogenic isolates were identified up to species level by conventional and automated methods. The samples with mixed flora were picked up as significant based on patient's age, clinical conditions, hospitalization status, pyuria, and significant bacteriuria. Drug resistance mechanisms were detected in all the isolates. Results and Discussion: Urine samples from 1471 male and female, inpatients and outpatients were studied. Six hundred and eight (41.3%) samples were found to be positive with 59 (9.7%) confirmed with mixed flora (two pathogens). Among the 59 samples with mixed flora, 44 patients were grouped as catheterized (18 patients were elderly and catheterized both), one was elderly but not catheterized, eight patients had urological while six had gynaecological problems. Study revealed that Escherichia coli were frequently replaced by other organisms (other Gram negative bacilli, Gram positive cocci, and Candida) in urine samples from male patients. The isolates exhibited considerable ranges of antibiotic resistance. Conclusion: The pathogens present in the urine samples with mixed flora that are frequently dismissed as contaminants may constitute important drug resistant mechanisms. As a result, the patients with the mixed flora in their urine may be left untreated or inadequately treated. Therefore, there is an urgent need to modify the guidelines for urinary tract infection (UTI) diagnosis with respect to high risk patients.
  73,477 664 3
The efficacy of interferential therapy and exercise therapy in the treatment of low back pain
OA Olawale, CM Agudzeamegah
January-June 2014, 2(1):10-14
DOI:10.4103/2348-0149.135610  
Background/Purpose: Low back pain (LBP) is an important public health problem. It is one of the most expensive conditions in musculoskeletal health care; hence the need for a safe, efficacious and cost effective management. The aim of the study was to determine the efficacy of interferential therapy and exercise therapy in the treatment of LBP. Materials and Methods: Sixty-five subjects diagnosed with low back pain participated in the study. The subjects (29 males and 36 females) were aged between 20-66 years (mean age 46.45 ± 11.90 years). Each subject was treated with interferential therapy (IFT) and some specific spinal-based therapeutic exercises thrice weekly. Assessment of pain intensity and spinal range of movements were carried out with Visual Analogue Scale (VAS) and Modified Schober Technique (MST) respectively. Measurements were carried out before and after eight weeks of treatment. Results: There was a statistically significant decrease in pain from 6.29 ± 2.16 before treatment to 2.54 ± 1.86 after treatment (P < 0.001). Spinal flexion increased from 3.44 ± 1.7 cm pretreatment to 5.22 ± 1.59 cm after 8 weeks of treatment (P < 0.01). Also, spinal extension increased from 1.2 ± 0.62 cm pretreatment to 2.29 ± 0.63 cm after 8 weeks of treatment (P < 0.001). Subjects with pain localized to the lower back and those with pain radiating to lower limbs had significant improvements from the treatment. Conclusion: The results of this study showed that interferential therapy combined with exercise therapy could help to reduce pain intensity and increase spinal range of motion in patients with low back pain.
  20,289 1,281 -
Effects of aqueous leaf extract of azadirachta indica on some haematological parameters and blood glucose level in female rats
Eghosa E Iyare, Nancy N Obaji
January-June 2014, 2(1):54-58
DOI:10.4103/2348-0149.135731  
Background: Azadirachta indica A. juss (AI; Family: Meliaceae) is one of the most useful medicinal plants containing different alkaloids that includes nimbitin, azadirachtin and salanin whose individual effects contribute to the general medicinal properties of the plant. In Nigeria, pregnant and lactating women have been observed consuming aqueous extract of AI and anecdotal reports from them suggest that they consume the extract because of the folkloric belief that it is potentially harmless, it is hematopoietic and protects them from malaria. Aim: This study was designed to investigate the effects of consumption of AI during pregnancy and lactation on some hematological parameters and blood glucose level. Materials and Methods: Sixty female rats weighing 150-200 g were used for this study. The rats were divided into three groups (non pregnant, pregnant and lactating groups) of 20 rats each. Each group was subdivided into four subgroups based on the dose of AI administered. Subgroup I served as control and received distilled water throughout the experiment while subgroups II-IV received 200 mg/kg, 400 mg/kg and 600 mg/kg body weight of the extract respectively for 21 days. On day 20 of extract administration, blood samples were withdrawn from each rat in each group after an overnight fast for the estimation of some hematological parameters and blood glucose level. Results: There were significant increases (P < 0.05 for each) in the packed cell volume (PCV), hemoglobin concentration (Hb), red blood cell (RBC), white blood cell (WBC), and platelet (PLT) and a significant dose-dependent decrease (P < 0.05) in blood glucose level in all groups. Conclusion: It is concluded that the results of the present study seem to justify the folkloric use of AI as a hematopoietic agent with the potential of ameliorating the burden of anemia and hyperglycemia in women especially during pregnancy.
  9,464 584 7
Characterization of hydantoin racemase predicted from the genome sequence of Lactobacillus pentosus KCA1
Kingsley C Anukam
January-June 2014, 2(1):1-9
DOI:10.4103/2348-0149.135605  
Background: Hydantoin racemase from Lactobacillus species of human origin has not been reported and characterized. The genome of Lactobacillus pentosus KCA1 has been sequenced and found to possess gene cassettes and open reading frames encoding the hydantoinase machinery, including a putative hydantoin racemase. Aims: To use bioinformatic tools to characterize the new hydantoin racemase predicted in the genome sequence of L. pentosus KCA1. Materials and Methods: Bioinformatic tools such as ClustalW algorithm was used to align hydantoin racemase from L. pentosus KCA1 with other hydantoin racemases extracted from the uniprot΢ database. I-TASSER was used for the prediction of secondary structure, 3-D model, similarity structure in PDB, and functional active binding site residues. Results: L. pentosus KCA1 hydantoin racemase showed significant amino acid sequence identity with hydantoin racemase from the selected bacterial organisms in the protein databank (PDB). The predicted secondary structure revealed 9 alpha-helices and 8 beta-strands. Functional prediction using enzyme partners predicted EC number 5.1.1.13 as the corresponding enzyme homolog (3eq5A) showing Cys83 and Cys187 as the potential active residues in KCA1 hydantoin racemase. The 3-D structure of KCA1 hydantoin racemase has a confidence score (C-score) of 1.2 that reflects a model of better quality, based on 3qvjA from PDB. Conclusion: The in silico data presented provides new insights into the potential activity and substrate specificity of hydantoin racemase from L. pentosus KCA1 and has proposed a mechanism for racemization of hydantoin derivatives that is consistent with the two-base process observed in other members of the Aspartate/Glutamate superfamily.
  6,411 906 -
Hematological profile of apparently healthy blood donors at a tertiary hospital in Enugu, south east Nigeria: A pilot study
Thomas Nubila, Ernest Okem Ukaejiofo, Nkoyo Imelda Nubila, Elvis Neba Shu, Chukwubuzor N Okwuosa, Mary Bassey Okofu, Benardine C Obiora, Irene L Shuneba
January-June 2014, 2(1):33-36
DOI:10.4103/2348-0149.135726  
Background: The transfusion of blood and its components is therapeutic and always associated with some level of risk, which if not well-screened, could lead to several complications. Laboratory tests such as a complete blood count are performed to find out if the patient's symptoms are likely to be relieved. Aim: To evaluate the hematological profile of screened blood donors at a tertiary hospital, Enugu (THE), South East Nigeria. Subject and Methods: Sixty subjects comprising 30 apparently healthy blood donors and 30 non-donors were recruited for the investigation of hematological profile from THE. After obtaining an informed consent, 2 ml venous blood was aseptically collected from the subjects and dispensed into tri-potassium ethylene di-amine tetra-acetic acid anticoagulant bottles and mixed by gentle inversion. Complete blood count was determined by hematology autoanalyzer-Symex-Kx-21N, while thin blood film was prepared for examination of blood cell morphology. Results: The blood picture revealed that 29 donors (96.7%) had normal blood picture while the control recorded 22 (73.3%). There were statistically significant increases in the red blood cell count (P = 0.0115), hemoglobin concentration (P = 0.0047) and packed cell volume (P = 0.0005), total white blood cell (WBC; P = 0.0483), and eosinophil (P = 0.0252) counts in the donors group when compared with the control group. In addition, the erythrocyte sedimentation rate and lymphocyte count recorded a statistically significant decrease (P < 0.001) in the donors when compared with the control group. Conclusion: The result of this present study suggests that the screening procedures for potential blood donors at THE may be regarded as effective in detecting suitable blood donors.
  6,104 444 4
Experimental studies on immunomodulatory potential of Cissus quadrangularis Linn
Priyanka Yadav, Aditya Ganeshpurkar, Nisha Sonkar, Divya Bansal, Nazneen Dubey
January-June 2014, 2(1):49-53
DOI:10.4103/2348-0149.135730  
Introduction: In ancient times Cissus quadrangularis Linn. was used as a general chow item in China. The stout fleshy stem of C. quadrangularis is an edible plant found throughout the hotter parts of India, Malaya, West Africa, and Ceylon. The plant part contains a number of phytoconstituents like alkaloids, glycosides, polyphenols, flavonoids, sterols, etc. It has demonstrated antiulcer and cytoprotective properties. Aim: The present study was designed to evaluate immune-modulatory potential of C. quadrangularis. Materials and Methods: Plant material was powdered and extraction was done with ethanol phytochemical screening and estimations of phenolics and flavonoids were carried out. Acute toxicity studies were performed as per Organization for Economic Co-operation and Development (OECD) guidelines. The extract was further evaluated for immunomodulatory activity through carbon clearance test, effect on serum immunoglobulins, determination of delayed-type hypersensitivity (DTH) and phagocytosis of killed Candida albicans tests were done to determine immunoprophylactic potential. Result: Results of phytochemical and phytoanalytical tests demonstrated that C. quadrangularis is rich in polyphenolic and flavonoid content. C. quadrangularis also showed promising immunomodulatory potential on various models like DTH, carbon clearance test and effect on serum immunoglobulins. Discussion and Conclusion: These studies conclude that C. quadrangularis possess immunomodulatory activity which might be due to presence of phytochemicals like flavonoids and phenolic compounds.
  5,048 421 2
CASE REPORT
Dens evaginatus in association with supernumerary teeth: Report of a case
Santanu Mukhopadhyay, Chiranjit Ghosh, Pinaki Roy, Tapas Paul
January-June 2014, 2(1):64-66
DOI:10.4103/2348-0149.135733  
Dens evaginatus is an uncommon developmental anomaly that appears as a tubercle or an accessory cusp projecting from the occlusal surface of the affected tooth. The anomaly most commonly affects the premolars, and the mandibular premolars are five times more frequently affected than the maxillary premolars. Dens evaginatus occurs almost exclusively in people of mongoloid origin. Isolated cases of dens evaginatus have also been documented in the Caucasian population. This article describes a case of dens evaginatus on the maxillary left first premolar affecting a Bengali boy. The child also exhibited two mesiodens and shovel-shaped maxillary incisors. Both dens evaginatus and supernumerary teeth are clinically significant anomalies. Early diagnosis of dental anomalies helps in selecting the correct treatment plan and minimizes further complications.
  4,892 333 -
ORIGINAL ARTICLES
Anti-arthritic activity of ethanolic extract from the leaves of Commiphora caudata (Linn.) in complete Freund's adjuvant-induced arthritic rats
Girija Pashikanti, Umasankar Kulundaivelu, Venkateshwar Rao Jupalli, Sharvana Bhava Bandaru Sheshagiri, Venkateshwarlu Eggadi
January-June 2014, 2(1):42-48
DOI:10.4103/2348-0149.135729  
Objective: Rheumatoid arthritis is a chronic multi-system disease of unknown cause. It affects people in their prime of life, predominantly between the ages of 20 and 50 years with an unpredictable course. The present study was to evaluate the anti-arthritic activity of ethanolic extract of Commiphora caudata leaves in complete Freund's adjuvant (CFA)-induced arthritic rats. Materials and Methods: Arthritis was induced by sub-cutaneous injection of 0.1 ml of CFA in rats. Arthritic arts were divided into different groups and ethanolic extract of C. caudata leaves (EECCL) was administered at doses of 200 and 400 mg/kg, p.o for 28 days. The control group received Tween 20 for 28 days. Dexamethasone (1 mg/kg, i.p) was used as a standard drug. Paw volumes were recorded on 7, 14, 21 and 28 day using a plethysmometer. Blood samples were collected at the end of the experiment from all the groups to analyze the serological rheumatic factors: C-reactive protein (CRP), serum rheumatic factor (SRF) and hematological parameters. EECCL was also tested for protein denaturation and membrane stabilization activities. Statistical Analysis: All data were expressed as mean ± SEM. One-way ANOVA followed by Dunnett's test was used to compare the mean values of test groups and control. Results: The EECCL (200 and 400 mg/kg, p.o) showed significant (P < 0.01, P < 0.001) reduction in paw volume, change in body weight in CFA rats at 28 day when compared with arthritic control rats. In addition, EECCL with dose 400 mg/kg, p.o significantly (P < 0.05, P < 0.001) increase the red blood cells, hemoglobin and above the 400 mg/kg dose significantly (P < 0.001) decrease the white blood cells, erythrocyte sedimentation rate, SRF and CRP when compared with arthritic control rats. Conclusion : The results obtained from the present study revealed the potential anti-arthritic activity of ethanolic extract from the leaves of C. caudata.
  4,700 492 2
Evaluation of the protective effects of naproxen and celecoxib on naphthalene-induced cataract in albino rats
Dick BS Brashier, Anjan Khadka, Prashant Mishra, Ashok Kumar Sharma, Navdeep Dahiya, Ajay K Gupta
January-June 2014, 2(1):28-32
DOI:10.4103/2348-0149.135723  
Background: Cataract is an age-related disorder. The role of non-steroidal anti-inflammatory drugs (NSAIDs) in cataract formation is still unclear. Previous data have indicated a cataractogenic as well as a potential protective effect of NSAIDs against cataract formation. Anti-cataract efficacy of NSAIDs has been studied extensively in different experimental settings. Use of aspirin in the prevention of cataract came from its use in elderly patients with osteoarthritis, rheumatoid arthritis, cardiovascular diseases and diabetes. Subsequently, a number of NSAIDs with diverse chemical structures like paracetamol, Ibuprofen, naproxen were reported to have anti-cataract potential as they delayed the onset and progression of cataract development. In view of this, naproxen is used as standard and celecoxib, a (cyclooxygenase II) COX II inhibitor, is used as drug for comparison to evaluate the protective effects on naphthalene-induced cataract in albino rats. Objective: The objective of the present study was to evaluate the effects of naproxen and celecoxib on naphthalene-induced cataract in albino rats. Materials and Methods: Thirty-six adult albino rats were divided into six groups containing six animals each. Group I (control) received normal saline orally. Group II (control) received normal saline eye drops. Group III received naproxen (4 mg/kg) orally. Group IV received naproxen eye drops (2%). Group V received celecoxib (3 mg/kg) orally. Group VI received celecoxib eye drops (2%). Oral dose and eye drops were given daily for 10 days prior to induction of cataract. Cataract was induced by oral administration of naphthalene 1 gm/kg in albino rats. Rats were examined daily for the appearance of lenticular capacity by indirect illumination, direct ophthalmoscopy, slit lamp examination, and observed for any mortality for period of 30 days. Results: Oral naproxen significantly retarded the appearance and progression of cataract, whereas less significant improvement was seen with oral celecoxib. Although, naproxen eye drops were just marginally effective, celecoxib eye drops was not at all effective in preventing cataract. Conclusion: Oral naproxen being a nonselective COX inhibitor was more efficacious than celecoxib, a COX II selective inhibitor, in retarding the progress of cataract induced by naphthalene. Similarly, naproxen eye drops also showed a marginal effect in prevention of progression of cataract, whereas celecoxib eye drops had no effect at all.
  4,667 363 -
Hepatoprotective activity of ethanolic extract of Leea indica (Burm.f.) Merr. (Leeaceae) stem bark against paracetamol induced liver toxicity in rats
Garima Mishra, RL Khosa, Pradeep Singh, KK Jha
January-June 2014, 2(1):59-63
DOI:10.4103/2348-0149.135732  
Background: Liver diseases have become one of the major causes of morbidity and mortality all over the world. Among them, synthetic drug-induced liver injury is one of the most common causative factor that poses a major clinical and regulatory challenge. The herbal medicinal plants have pivotal role in management of various diseases including liver disorders. Therefore, it is inevitable to discover novel hepatoprotective agents from natural sources. Objective: To evaluate the hepatoprotective activity of ethanolic extract of Leea indica stem bark against paracetamol (PCM) induced hepatotoxicity in rats. Materials and Methods: Hepatotoxicity was induced by PCM (2 g/kg b.w., p.o.) and biochemical parameters such as serum glutamic pyruvic transaminase (SGPT), serum glutamic oxaloacetic transaminase (SGOT), serum alkaline phosphatase (SALP), serum bilirubin (total and direct), and triglyceride level were estimated. Silymarin (100 mg/kg b.w.) was employed as standard hepatoprotective agent. Histopathological changes in liver were also studied. Results: The ethanolic extract (200 mg/kg and 400 mg/kg b.w.) treatment exhibited significant decrease in elevated level of serum marker enzymes, bilirubin (total and direct), and triglycerides when compared to positive control group. The ethanolic extract at dose of 400 mg/kg b.w. was found to be more potent than 200 mg/kg. Conclusion: The ethanolic extract of Leea indica bark seems to justify the promising hepatoprotective effect on PCM induced liver damage in rats.
  4,341 364 1
Evaluation of sound perception and its cardiovascular implications
Kenneth Akhabue Okojie, Ahbor Dolly Awani Ighoroje
January-June 2014, 2(1):15-19
DOI:10.4103/2348-0149.135613  
Background: Sound is a vibration from a particular machine, place or material which can be heard clearly whereas noise is mixed vibrations that will come to us from all directions. A sound can be clear and heard but noise will not be clear and cannot be heard. Noise is a known stress that affects various physiological responses of individual exposed to it and its pollution is increasingly being recognized as a physical factor in the environment that is injurious to many aspects of our health. Aim: To assess the effects of environmental noise on sound perception and cardiovascular system of those exposed to noise over a period of time. Materials and Methods: The study group included 50 subjects from a noisy environment (≥80 dB). This group was further divided into group Ia (those that have developed Noise Induced Hearing Impairment) and group Ib (those without Noise Induced Hearing Impairment). The control group consists of 50 subjects from a non-noisy environment (≤60 dB). An audio-visual scale which was marked between 0 and 10 cm and calibrated for differing sound levels was used as a tool for the determination of sound perception. Heart rate and blood pressure was measured using digital sphygmomanometer at rest and after exposure to noise at 60 dB, 90 dB, and 102 dB for 5 minutes each. All data were expressed as mean ± SEM. All the results were analyzed using one-way ANOVA. P ≤ 0.05 was considered as statistically significant. Results/Discussion: Noise exposure over a period of time produced a cardio-protective mechanism against arterial blood pressure in group Ia but produced a very significantly high arterial blood pressure in sub-group Ib and control subjects. There was also a very poor sound perception among those that have developed noise-induced hearing impairment unlike in sub-group Ib and control. Conclusion: Environmental noise is a possible contributing factor in the development of high arterial blood pressure and significantly affects individual's sound perception.
  3,788 280 -
Serum aminotransferase activities and bilirubin levels in salt loaded experimental rabbits treated with aqueous and ethanol extracts of Acalypha wilkesiana
Omage Kingsley, Azeke A Marshall
January-June 2014, 2(1):37-41
DOI:10.4103/2348-0149.135728  
Background: Acalypha wilkesiana, commonly called Irish petticoat, is native to the South Pacific Islands and belongs to the family Euphorbiaceae. In traditional medicine practice, the leaves of A. wilkesiana are eaten as vegetables for the management of hypertension, being a diuretic plant. Aim: This study was conducted to evaluate the effects of extracts of A. wilkesiana leaves on activities of serum aminotransferases and bilirubin levels, which are indicators of liver function, in salt loaded rabbits. Materials and Methods: A total of 30 rabbits were randomly divided into five Groups (A to E) of six rabbits each and treated with salt loaded diet, aqueous extract (Group B) and ethanol extract (Group C) of A. wilkesiana leaves; continuous salt loading (Group A); salt loaded and nontreated (D); nonloaded (with salt) and nontreated (with extract) (E). Results: Salt loading resulted in a significantly (P < 0.05) higher serum alanine aminotransferases (ALT) and aspartate aminotransferases (AST), and a significantly (P < 0.05) lower serum direct bilirubin, when compared with the control. Treatment with A. wilkesiana leaf extracts, at a dose of 300 mg/kg body weight, resulted in a nonsignificantly (P > 0.05) lower serum total bilirubin and direct bilirubin, as compared with the control, in the salt loaded rabbits. Discussion and Conclusion: The use of A. wilkesiana leaf could be relatively safe considering its effects on serum ALT, AST, total and direct bilirubin of the experimental animals. Thus, it may be useful in the management of any possible deleterious effect of salt load to the liver.
  3,331 317 2
LETTER TO EDITOR
Prevalence of poor glycemic control among Nigerian female diabetics
Ibrahim Abdul Olayemi, Favour Osazuwa
January-June 2014, 2(1):67-68
DOI:10.4103/2348-0149.135734  
  3,325 302 -
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