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September-October 2021 Volume 11 | Issue 5
Page Nos. 203-256
Online since Saturday, October 30, 2021
Accessed 7,549 times.
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EDITORIAL |
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Opening schools: The road ahead |
p. 203 |
Jyotsna Varma DOI:10.4103/cmrp.cmrp_99_21 |
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ORIGINAL ARTICLES |
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Design and synthesis of pyrazole derivatives for in vitro screening to protect angiotensin-converting enzyme 2 human cells against COVID-19 |
p. 206 |
Ganesh N Yallappa, S Rajendra Prasad, Gayatri Vaidya DOI:10.4103/cmrp.cmrp_10_20
Background: ACE2 is a receptor for Corona virus. COVID-19 (coronavirus) is a deadly virus which can enter the human body through 'angiotensin-converting enzyme 2' human cells, hardly damages the respiratory system. On severe infection on these cells make the lungs weaker, results difficulty in breathing and lead to death. We took this major issue as a challenge and planned to synthesize chemical molecules (compounds), particularly pyrazole derivatives, and found good results. We prepared a convenient laboratory and planned according to our work.
Aims and Objectives: Cinnamaldehydes prepared by Claisen condensation were made to react with hydrazine hydrate and phenylhydrazine derivatives to afford pyrazoles. Nano-TiO2 was influenced the reactions without using solvents. Green chemistry was employed by microwave irradiation. Comparitive studies with conventional method were done. The synthesised compounds were characterized by Fourier transform infrared (FT-IR), Proton NMR (1H NMR) and elemental analysis. Synthesised compounds were screened against COVID-19 as antiviral agents.
Materials and Methods: We reported microwave method for the green synthesis of chemical molecules so that the reactions maintained under microwave irradiation. All the reactions were carried in microwave oven. In-vitro studies by MTT-assay method of synthesized chemical molecules exhibited good potency in inhibiting ACE2 infected human cells.
Results: Microwave assisted reactions were completed in very short time compared to Conventional method. More compounds exhibited good inhibitory potency having cytotoxicity concentration (CC50) and effective concentration (EC50) values against COVID-19. Inhibition of ACE2 human cells infected from COVID-19 was determined by MTT method. Some compounds proved as good potent molecules by acting ACE2 human cells receptors against COVID-19.
Conclusion: We afforded the Pyrazole molecules by green synthesis proved that these can act as effective drugs for ACE2 infected cells against Covid-19. Microwave method is proved to be an efficient and convenient one for the green synthesis.
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Clinical evaluation of dyslipidemia among type 2 diabetes and hypothyroidism patients |
p. 211 |
Arun Koyyada DOI:10.4103/cmrp.cmrp_86_20
Aim: To evaluate the lipid profiles among type 2 diabetes and hypothyroid patients for establishing relation between dyslipidemia, diabetes and thyroid disorders.
Background: Dyslipidaemia is the leading cause of death in cardiovascular disease (CVD) patients. Diabetes and hypothyroidism are the two main endocrine risk factors for dyslipidaemia. Diabetes is associated with altered metabolism of triglyceride (TG) levels and low-density lipoprotein (LDL) levels. Hypothyroidism leads to decreased clearance of TG and catabolism of LDL.
Materials and Methods: This was a cross-sectional with 288 subjects that include normal population, diabetic and hypothyroid patients. The plasma lipid levels, thyroid profile and glucose levels were collected from the patients. The data were subjected to an unpaired t-test for statistical analysis. The P < 0.05 is indicative of statistical significance.
Results: The study included 288 patients out of which 104 were with type 2 diabetes, 81 were hypothyroid and 103 were controls. Dyslipidaemia cases found among them were 63, 26 and 32, respectively. The mean values of lipid levels in type 2 diabetes, hypothyroidism and control population were total cholesterol (TC) (211.4 ± 4.24, 190.5 ± 3.57 mg/dl and 187.3 ± 1.91 mg/dl), LDL (134.5 ± 3.01, 120.8 ± 2.035 and 115.8 ± 1.64 mg/dl), TG (188.6 ± 4.14, 169.9 ± 0.74 and 163.2 ± 2.42 mg/dl), high-density lipoprotein (HDL) (39.64 ± 0.45, 38.78 ± 0.49 and 38.64 ± 0.12 mg/dl) and non-HDL (171.75 ± 1.52, 151.75 ± 0.99 and 148.84 ± 1.99 mg/dl), respectively. Lipid levels of type 2 diabetes and hypothyroidism patients were found to be significantly more than the control population. The mean levels of TC, LDL, TG in type 2 diabetes and LDL, TG in hypothyroidism patients were found to be more than the normal range.
Conclusion: There was a significant relationship between type 2 diabetes, hypothyroidism and dyslipidaemia. Routine lipid profile monitoring in patients with diabetes and hypothyroid disorders is advisable for the primary prevention of dyslipidaemia and CVD.
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Enhancement of solubility of paclitaxel by applying factorial design |
p. 216 |
Pragya Baghel, Amit Roy, Shekhar Verma, Trilochan Satapathy, Sanjib Bahadur DOI:10.4103/cmrp.cmrp_51_20
Background: The poor aqueous solubility and low bioavailability of antineoplastic drugs restrict the oral route for the cancer therapy. However, specific nanotechnologies developed to address this issue. The self-micro emulsifying drug delivery system (SMEDDS) is an imperative tool in solving a lipophilic drug's low solubility and bioavailability issue. Paclitaxel (PTX) is an antineoplastic drug used to treat various kinds of cancer, especially ovarian and breast cancers. It has low aqueous solubility (0.3 μg/ml in water), resulting in poor bioavailability. This study focuses upon formulating SMEDDS incorporating PTX to increase the drug's aqueous solubility. Castor oil (Surfactant), Tween 80 (surfactant), and Transcutol (co-surfactant) were used to formulate SMEDDS. Two independent factors, concentrations of oil and surfactant, were chosen. Two dependent factors, emulsification time and in vitro drug release, were chosen. 32 factorial design analyses give a mathematical expression, which helps to study the effect of an independent factor on a dependent factor. All the nine formulations B1-B9 evaluated for globule size, zeta potential, and present drug content.
Results: The globule size found is 127–217 nm range, which indicates the formation of the transparent microemulsion; zeta potential fields between −4.29 ± 1.1 and −33.05 ± 4.5 indicate suitable stable formulation. Nearly 63%–84% drug content suggests that the drug, incorporated into prepared SMEDDS. Statistical analysis shows that an increasing amount of surfactant decreases emulsification time; this may also reduce the average droplet size of the resultant microemulsion. With the increase in the concentration of tween 80, PTX release also increased. Rapid and more extent of PTX released from formulated SMEDDS indicate that the aqueous solubility of PTX has increased. B9 formulation is the optimized formulation based on higher per cent cumulative drug release 98% at the end of 60 min, 58% of pure PTX powder solubilized in the dissolution medium.
Conclusion: In vitro drug release study proved that the prepared SMEDDS has acceptable properties of immediate release dosage forms. The enhanced solubility of PTX will increase its bioavailability.
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Aggressive pancreatic resections for Frantz tumours in a low-volume Caribbean hospital |
p. 225 |
Shamir O Cawich, Lian Sampath, Sherrise Sandy, Neil W Pearce, Vijay Naraynsingh, DOI:10.4103/cmrp.cmrp_39_21
Background: Frantz tumours are uncommon lesions worldwide and many surgeons would not encounter this lesion commonly throughout their practices.
Aims: This study sought to document the therapeutic outcomes after pancreatic resections for Frantz neoplasms in a low-volume, resource-poor setting in the Caribbean.
Materials and Methods: Data were retrospectively collected from patients who had pancreatic resections for Frantz tumours in Trinidad and Tobago between 1 June 2012 and 1 July 2017.
Results: There were 12 patients with confirmed Frantz tumours, treated by one of four surgeons at a low volume of 0.6 cases per surgeon per year. The patients were all females at a mean age of 24.83 years (standard deviation [SD] ±7.6; Range 8–35; Median 25.5). A Whipple's resection was performed in 1 patient with a pancreatic head lesion, 2 had central pancreatectomies for lesions in the body and 6 had distal pancreatectomies, 2 with splenic preservation. Histologically, clear margins were achieved in all cases and none of the nodes examined contained metastatic disease. Nine (75%) patients had poor prognostic features present on pre-operative computed tomography scans and/or histopathologic examination. The sole complication was a Grade 1 post-operative pancreatic fistula. No deaths were recorded. All patients were alive without disease recurrence after a median of 34 months (Mean 36.75; SD ± 12.8; Range 12–52).
Conclusion: Surgeons practicing in the Caribbean treat patients with pancreatic Frantz tumours at minimal volumes, performing aggressive resections with good outcomes. We advocate aggressive surgical resections for pancreatic solid pseudopapillary neoplasms, considering that outcomes are good and 75% of patients have unfavourable radiologic and/or histopathologic features present at the time of diagnosis.
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REVIEW ARTICLE |
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The medical diagnostic laboratory: Bio-safety precautions for handling and processing of specimens during COVID-19 pandemic |
p. 230 |
Seema Bhargava, Anjali Manocha, Mamta Kankra, Parul Singla, Anisha Sharma, Manushri Sharma DOI:10.4103/cmrp.cmrp_35_21
The coronaviruses are single-stranded RNA viruses, one of which is responsible for the current outbreak of coronavirus disease-19. COVID-19 has affected health-care workers including laboratory personnel worldwide in an alarming and unprecedented manner. In India too, the huge number of infected health-care staff has further weighed down our already over-burdened health-care system. While their protection is of paramount importance, it is also essential that these personnel adhere to the specific bio-safety practices to minimize their exposure to this disease. In this article, our objective is to provide guidelines for laboratories while working with COVID-19 samples to reduce the human and economic burden in the current pandemic. A risk assessment of all policies must be done and standard operating procedures on all 'Safe Laboratory Practices and Procedures' must be readily available for the staff. Dividing the laboratory functions into three broad phases, namely pre-examination, examination and post-examination, the precautions outlined for each stage must be followed stringently with the frequency defined as per the workload of the laboratory. The safety measures must cover all the laboratory processes including sample disposal. Decontamination too plays a major role and must be performed as per the standard national and international guidelines. Hence, following special precautions in the laboratory while working through the COVID-19 pandemic will not only minimize the risk of infection to the laboratory staff and but also help reduce the mortality and morbidity associated with this disease.
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CASE REPORTS |
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Wernicke's encephalopathy in a child with abdominal tuberculosis |
p. 237 |
RK Sabharwal, Praveen Kumar, Seema Sud, Krishna Janakbhai Kasawala DOI:10.4103/cmrp.cmrp_57_21
Wernicke's encephalopathy (WE) is an acute neurological disorder, potentially fatal if untreated, caused by thiamine deficiency. A 15-year-old female patient with choledocholithiasis, cholecystitis and abdominal tuberculosis on antitubercular therapy presented with poor oral intake, bilious vomiting and encephalopathy. A prompt diagnosis of WE was made and confirmed by brain magnetic resonance imaging. The patient recovered completely after the administration of thiamine.
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A rare case of postmenopausal inguinal endometriosis |
p. 241 |
Jayabal Pandiaraja, Arumugam Shalini, Subramaniam Vidhya DOI:10.4103/cmrp.cmrp_45_21
Endometriosis is a condition in which endometrial cells are located outside the uterine cavity, mostly in the abdominal cavity and the peritoneum. It is commonly located in the ovaries, bowel, and pelvic cavity. Sometimes, it can be located in the extrapelvic region also. Inguinal endometriosis is a rare form of extrapelvic endometriosis. Most of the inguinal endometriosis present around 30–40 years of age with a prior history of gynecological or abdominal wall surgery. Our patient presented with inguinal endometriosis in the postmenopausal period without a history of prior surgery. Moreover, she did not present with classical symptoms of abdominal wall endometriosis. Inguinal endometriosis can be considered as one of the differential diagnoses in postmenopausal women even without classical symptoms of endometriosis.
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SHORT COMMUNICATION |
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Heparin-induced thrombocytopenia |
p. 245 |
Prakash Shastri, Shubhlesh Kumar DOI:10.4103/cmrp.cmrp_77_21 |
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CLINICAL IMAGES |
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Radiological manifestations of thalassaemia |
p. 248 |
KK Saxena, Shelly Sharma DOI:10.4103/cmrp.cmrp_93_21 |
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LETTERS TO EDITOR |
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COVID in children: The generation that was changed by the pandemic |
p. 250 |
Kanika Chandra DOI:10.4103/cmrp.cmrp_92_21 |
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Why schools should reopen? |
p. 253 |
Anika Gogia DOI:10.4103/cmrp.cmrp_98_21 |
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Reopening schools during Covid-19 pandemic |
p. 255 |
Nitya Arora DOI:10.4103/cmrp.cmrp_101_21 |
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