Oxidative stress is implicated as a common pathologic mechanism contributing to the initiation and progression of hepatic damage in a variety of liver disorders. Present study attempts to evaluate the hepatoprotective activity of picroliv, curcumin and ellagic acid in comparison to silymarin using paracetamol (PCM) induced acute liver damage. Hepatotoxicity was induced by administering a single oral dose of PCM (500 mg/kg) and was assessed by quantifying the serum enzyme activities, phenobarbitone induced sleeping time and histopathological analysis of liver tissues. The antioxidant parameters, malondialdehyde (MDA), reduced glutathione (GSH) and catalase of the liver tissue were also assessed. The herbal drugs were administered for 7 days by oral route at 50 and 100 mg/kg. PCM induced hepatic damage was manifested by a significant increase in the activities of marker enzymes (alanine transaminase, aspartate transaminase and alkaline phosphatase) in serum and MDA level in liver. There was also a significant decrease in activity of GSH and catalase levels. The histopathological examination on toxic models revealed centrizonal necrosis and fatty changes. Pretreatment of mice with picroliv, curcumin and ellagic acid reversed these altered parameters towards normal values, which were compared with silymarin. The normalization of phenobarbitone induced sleeping time suggests the restoration of liver cytochrome P450 enzymes. This study supports the use of these active phytochemicals against toxic liver injury, which may act by preventing the lipid peroxidation and augmenting the antioxidant defense system or regeneration of hepatocytes. These active phytochemicals may be developed as drugs for the treatment of liver diseases.

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We have evaluated a new set of primers (TRC 4 ) in comparison with the IS6110 primers commonly used in PCR to detect tuberculous meningitis among children. The levels of concordance between the results of IS6110 PCR and TRC 4 PCR with cerebrospinal fluid specimens from patients with clinically confirmed tuberculous meningitis were 80 and 86%, respectively. Results with the two primer sets were concordant for 55 positive and 22 negative specimens (n ‫؍‬ 98). We conclude that the sensitivity of PCR can be increased by using both IS6110 and TRC 4 primers.Tuberculosis (TB) is the major cause of death worldwide and is due to a single pathogen (16). Childhood TB in general and TB meningitis in particular owe their existence to unsuspected, undiagnosed, or incompletely treated adults in the community. Among children, mortality due to TB occurs mainly due to the neural form of TB, namely, TB meningitis. About 3% of the pediatric admissions to hospitals in India are due to TB meningitis, with reported mortality ranging from 17 to 71% (2, 14). Prompt diagnosis is critical for initiating appropriate therapy and facilitating measures to prevent dissemination of this highly contagious disease. The prevalence of childhood TB meningitis remains largely underestimated because clinical manifestations are nonspecific in early stages of the disease and bacteriologic confirmation is available only for a small proportion of patients. Also, clinical diagnosis of childhood TB meningitis is difficult due to its varied clinical presentations. Further, routinely used tests employed for clinical diagnosis of TB are inadequate to detect extrapulmonary forms of TB like TB meningitis.PCR is currently the most sensitive and rapid method to detect extrapulmonary Mycobacterium tuberculosis (1,5,8,11,15). We used as a new target TRC 4 , which was cloned and characterized previously in our laboratory (10). TRC 4 is a conserved repetitive element with specificity for M. tuberculosis complex. The aim of this paper was to compare the efficiency of a PCR with a target chosen from this cloned fragment with that of a PCR with the widely used IS6110 sequence in detecting M. tuberculosis in cerebrospinal fluid (CSF) samples from children with meningitis.CSF specimens from children suffering from meningitis, aged to 12 years, were included in the study if at least four of the following seven indicators of disease were in evidence: first, the presence of clinical features, such as gradual loss of playful activity, irritability, clouding of consciousness, convulsions, neck stiffness, and cranial nerve or motor defects; second, a CSF lymphocyte count at admission greater than 10 ϫ 10 6 / liter; third, a CSF protein level at admission greater than 80 mg/dl; fourth, a CSF glucose/blood glucose ratio at admission of less than 0.5; fifth, contact with an intrafamilial adult positive for pulmonary TB; sixth, induration of 10 mm or more on tuberculin testing with 1 TU of purified protein derivative; and seventh, positive radiological features of primary complex in...

The use of herbal drugs for the treatment of liver diseases has a long tradition in many eastern countries. The easy accessibility without the need for laborious pharmaceutical synthesis has drawn increased attention towards herbal medicines. Few herbal preparations exist as standardized extracts with major known ingredients or even as pure compounds. Some of the herbals, which show promising activity, are ellagic acid for antifibrotic treatment, phyllanthin for treating chronic hepatitis B, glycyrrhizin to treat chronic viral hepatitis and picroliv for liver regeneration. These compounds, which have proven antioxidant, antiviral or anticarcinogenic properties, can serve as primary compounds for further development as hepatoprotective drugs. This review provides the chemistry, pharmacology and future aspects of picroliv, ellagic acid and curcumin with focus on hepatoprotective properties. These phytochemicals may prove to be very useful in the treatment of hepatotoxicity induced by viral agents, toxic drugs and plant poisons. The high safety profile may be an added advantage. However, poor bioavailability and temperature and light sensitivity can reduce the efficacy of drugs like curcumin. In future, the derivatives or new combinations of these drugs may prove to be useful.

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Plant drugs are known to play a major role in the management of liver diseases. There are many plants and their extracts that have been shown to possess hepatoprotective activities. There are more than 300 preparations in Indian system of medicine for the treatment of jaundice and chronic liver diseases. About 600 commercial herbal formulations with claimed hepatoprotective activity are being sold all over the globe. The active phytochemical fraction that imparts hepatoprotective activity has been identified in many plants. These phytochemicals can be isolated and developed as single-ingredient drugs, with quality and standards of modern medicine. The major problem faced with herbal products is their standardization and their quality assurance. There can be batch-to-batch variations in their efficacies as a result of natural and genetic alterations, seasonal changes, differences in soil and climatic conditions, and nutritional status of the medicinal plant. Pharmacological validation of each hepatoprotective plant should include efficacy evaluation against liver diseases induced by various agents. The most effective drugs for each kind of liver disease have to be selected by separate efficacy evaluations. To treat liver disease of known, unknown, or multiple causes, a combination of different herbs with active fractions (or purified compounds) has to be developed. They may prove to be useful in the treatment of infective, toxic, and degenerative diseases of the liver.

Background:Surgical endodontic therapy comprises of exposure of the involved root apex, resection of the apical end of the root, preparation of a class I cavity, and insertion of a root end filling material. Mineral trioxide aggregate (MTA) is now the gold standard among all root end filling materials. MTA is however difficult to handle, expensive and has a very slow setting reaction.Aim:(1) To compare the sealing ability of MTA, polymethylmethacrylate (PMMA) bone cement and CHITRA Calcium phosphate cement (CPC) when used as root end filling material using Rhodamine B dye evaluated under a confocal laser scanning microscope. (2) To compare the seal of root ends prepared using an ultrasonic retroprep tip and an Er: YAG laser using three different root end filling materials.Statistical Analysis:Statistical analysis was performed using a one-way ANOVA and a two-way ANOVA, independent samples t-test and Scheffe's post hoc test using SPSS Version 16 for Windows.Results:All the three materials, namely MTA, PMMA BONE CEMENT and CHITRA CPC, showed microleakage. Comparison of microleakage showed maximum peak value of 0.86 mm for MTA, 0.24 mm for PMMA bone cement and 1.37 mm for CHITRA CPC. The amount of dye penetration was found to be lesser in root ends prepared using Er: YAG laser when compared with ultrasonics, but the difference was found to be not statistically significant.Conclusion:PMMA bone cement is a better material as root end filling material to prevent apical microleakage. MTA still continues to be a gold standard root end filling material showing minimum microleakage. Er: YAG laser is a better alternative to ultrasonics for root end preparations.

Correspondence to: Dr. Girish C, E-mail: gcnx@rediffmail.com AbstractThe episodes of nausea and vomiting which follow each cycle of chemotherapy are the most troublesome side effect experienced by cancer patients. Introduction of ondansetron was a definite therapeutic advance in treating chemotherapy induced nausea and vomiting (CINV) with more effectiveness with corticosteroids. However, the protection remained largely limited to acute phase of CINV with little or no effect over delayed phase. Aprepitant, a drug that antagonizes the effect of substance P on neurokinin type 1 receptor showed promising results in controlling both phases of CINV. This drug is well absorbed orally with a t max of about four hours. The addition of aprepitant to ondansetron and dexamethasone was found to be superior to ondansetron and dexamethasone alone in clinical trials with patients taking high and moderate emetogenic chemotherapy. This drug also showed a good safety