BGR-34 is a polyherbal formulation frequently used to combat diabetes around the globe especially in Asian countries. It provides an attractive treatment option to prediabetics, diabetics, and in metabolic disorders by controlling the altered blood glucose level. The lack of phytopharmacological studies on BGR-34 prompted as to reveal the compounds responsible for the antidiabetic and free-radical scavenging activity of BGR-34. An attempt was made to assess in vitro α-amylase and α-glucosidase enzyme inhibition of BGR-34 along with its free-radical scavenging potential via DPPH scavenging activity. Further, HPTLC profiling and quantitative analysis of berberine and palmatine in BGR-34 were carried out. Thereafter, the TLC-bioautographic-MS analysis was performed to identify the compounds responsible for antidiabetic and antioxidant activities in BGR-34. The results had shown a significant and dose-dependent inhibition potential of BGR-34 against in vitro α-amylase and α-glucosidase enzymatic reactions along with significant inhibition in DPPH free-radical scavenging activity. The HPTLC profiling and quantitative validation studies showed the presence of berberine and palmatine 44.926 ± 0.2907 and 10.507 ± 0.154 μg/g, respectively. The TLC-MS bioautography revealed a total of four DPPH-active, two α-amylase-active, and nine α-glucosidase-active compounds in BGR-34. It was observed from the study that BGR-34 possesses verities of bioactive compounds, which are reasonable not only for its antidiabetic effect but also for its antioxidant activity.

Extramedullary haematopoiesis associated with thalassaemia leading to spinal cord compression is an extremely rare event in the course of the disease. The efficacy of radiation therapy is advocated in the management of such a complication. Two patients with thalassaemia, who had presented with spinal cord compression, were successfully treated by a modest dose of local radiotherapy. In one of the patients, however, radiotherapy was resorted to after an initial decompressive laminectomy and partial removal of the intraspinal haematopoietic mass proved unsuccessfil. The other patient was managed solely by radiation therapy.Extramedullary haematopoiesis (EMH) is a common manifestation of severe thalassaemia and it may involve various organs of the body such as liver, spleen, and lymph nodes.'-6 The clinical features secondary to EMH are variable and depend on the site of formation of the haematopoietic tissue. The onset of unexpected clinical signs may be the first indication that haematopoiesis is spreading to an atypical area. Spinal cord compression (SCC) as a consequence of EMH in the intraspinal epidural space is an extremely rare complication. We report two cases of thalassaemia that had presented with SCC. A review of the literature is discussed highlighting the role of radiation therapy in the management of such patients.and there was a complete loss of touch and pinprick sensation below the level ofT7.The radiograph of the skull and spine demonstrated a diffuse osteoporosis but no well defined paravertebral mass was evident. Myelogram, however, revealed a complete extradural block at the level of T9. The CSF examination proved noncontributory. His haemoglobin (Hb) was 8-7 g/dl, haematocrit 28% and white blood cell count (WBC) 7.4 x 109/L. The differential count revealed a slight shift to the left (metamyelocyte 2%, myelocyte 2%). Platelets were adequate. The peripheral smear showed anisopoikilcytosis with microcytosis and hypochromia. A few target cells were also noticed. There were three normoblasts/100 WBC. The corrected reticulocyte count was 2%. A haemoglobin electrophoresis showed 21% Hb F and 2-6% Hb A2.At laminectomy a brownish, soft, vascular extradural mass was seen extending from T5-T9. Only a partial excision of the mass could be accomplished. The histopathological examination of the excised mass confirmed it to be haematopoietic tissue. The postoperative course was uneventful. However, in view of the incomplete excision of the mass and a negligible neurological recovery, radiotherapy was started two weeks after surgery. A total dose of 30 Gy was delivered by a telecobalt unit, over a period of three weeks in 15 sessions. There was a marked neurological improvement at the end of radiation treatment and the patient continued to improve. No complication was observed during or after radiotherapy. The patient has been doing well for a period of five years.

No abstract

Context: Nephrotoxicity is a renal dysfunction that arises from direct exposure to environmental chemicals or as a side effect of therapeutic drugs. Boerhaavia diffusa Linn. (Nyctaginaceae), Rheum emodi Wall. Ex. Meissn. (Polygonaceae), Nelumbo nucifera Gaertn. (Nelumbonaceae) and Crataeva nurvala Buch-Ham. (Capparidaceae) are well-recognized medicinal plants of Indian traditional system of medicine used for kidney disorders.Objectives: The present investigation was undertaken to develop a chromatographically characterized polyherbal combination and to evaluate its nephroprotective activity. Materials and methods: Roots of B. diffusa and R. emodi, flowers of N. nucifera and stem bark of C. nurvala were extracted by decoction using 70% ethanol. Response surface methodology (RSM) was used for the optimization of extraction parameters. Polyherbal combinations with different doses (150-300 mg/kg) were tested against methotrexate-induced nephrotoxicity in Wistar rats. Results: The optimized extract contained 27% phenols and 15% flavonoids, which showed 75% 1, 1diphenyl-2-picryl-hydrazyl (DPPH) scavenging potential. Based on the retention time of high-performance liquid chromatography (HPLC) analysis, 17 out of 122 constituents were found common in all extracts and combinations. Two combinations showed significantly higher (p 0.05) DPPH scavenging potential and xanthine oxidase inhibition. The half maximal inhibitory concentration (IC 50 ) of the best combination for DPPH scavenging and xanthine oxidase inhibition were 80 and 74 mg/mL, respectively. Treatment of methotrexate-induced nephrotoxic rats with polyherbal combination significantly (p 0.05) improved the kidney function markers, oxidative stress markers and histological parameters. Discussion and conclusion: The developed combination was found to be effective in nephrotoxicity; it can be explored further for the management of drug-induced nephrotoxicity and other chronic kidney diseases. ARTICLE HISTORY

Liver abscess is an inflammatory space-occupying lesion of the liver caused by infectious agents. Amoebic liver abscess (ALA) and pyogenic liver abscess (PLA) are its two predominant causes. Rarely, liver abscess can be caused by fungi, mycobacteria, and other atypical organisms. ALA is the predominant cause of liver abscess in India, seen in more than 60% of cases. 1 It is caused by Entamoeba histolytica with feco-oral route, the predominant mode of transmission. In this review, we describe the overview of ALA and PLA, along with its complications and management.

Visceral leishmaniasis (VL) is endemic in many parts of India. Rarely, it may be complicated by hemophagocytic lymphohistiocytosis (HLH) that has varied presentation and course. We describe two cases of VL complicated by HLH that were markedly different in clinical presentation, course and management. First case presented with Fever of unknown origin whereas second case had fever with severe bleeding manifestations. VL was diagnosed by bone marrow aspiration and serum rk39 immunodiagnostic test respectively in these cases. HLH was diagnosed by HLH 2004 diagnostic criteria. VL was treated by intravenous amphotericin B in both cases. HLH was managed by treating primary disease in the first case whereas steroid was given for management in the second case. High index of suspicion is crucial for early diagnosis of HLH to reduce morbidity and mortality.

No abstract

The aim of the present study was to develop and characterize karanjin-loaded ethosomes-based gel formulation for enhanced topical delivery and effective therapy of skin acne. Karanjin-loaded ethosomes (K-ETH) presented a nanometric size of 140.87 ± 2.35 nm, entrapment of 71.41 ± 2.74% and enhanced permeation with 1.9 times increase in the flux and 2.4 times higher skin deposition compared to the hydro-ethanolic solution of karanjin. The DSC analysis confirmed successful entrapment of the karanjin within the ethosomes. The developed ethosomes were incorporated in the carbopol gel for adequate application on the skin surface. The ethosomal gel (K-EGF) also exhibited greater penetration in the rat skin as revealed by CLSM. The optimized K-EGF formulation was non-irritant to the skin as evident by Draize score test and histopathological examination. The highest zone of inhibition, 30.0 ± 1.52 mm and 36.22 ± 0.57 mm was produced by the K-EGF against Propionibacterium acnes and Staphylococcus epidermidis, respectively, indicating substantial antibacterial properties of the K-EGF. DPPH assay indicated its potent antioxidant effects. Substantial anti-inflammatory effects in the carrageenan-induced edema in the rat paw were evident with inhibition of rat paw edema by 66.66% and 70.37% upon application of K-EGF and standard anti-inflammatory agent, respectively. Anti-acne effects were also evident with K-EGF treatment with significant decrease in number and size of sebaceous gland units in dermis. Overall, the above findings vouch for a therapeutic opportunity to improve topical delivery of karanjin in acne treatment employing ethosomal gels as the promising carrier system.