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Restless legs syndrome (RLS), also known as Willis-Ekbom disease (WED), is a common movement disorder characterised by an uncontrollable urge to move because of uncomfortable, sometimes painful sensations in the legs with a diurnal variation and a release with movement. The pathophysiology is only partially known and a genetic component together with dopaminergic and brain iron dysregulation plays an important role. Secondary causes for RLS need to be excluded. Treatment depends on the severity and frequency of RLS symptoms, comprises non-pharmacological (eg lifestyle changes) and pharmacological interventions (eg dopaminergic medication, alpha-2-delta calcium channel ligands, opioids) and relieves symptoms only. Augmentation is the main complication of long-term dopaminergic treatment of RLS. This article will provide a clinically useful overview of RLS with provision of diagnostic criteria, differential diagnoses, possible investigations and different treatment strategies with their associated complications. Definition and diagnostic criteriaRestless legs syndrome (RLS), also known as Willis-Ekbom disease (WED), is a common neurological movement disorder characterised by an uncontrollable urge to move (mainly the legs).1 Diagnosis of RLS is based primarily on the patient's history and on a neurological examination to exclude differential diagnoses. The diagnosis can be made if all of the following five criteria are met (International RLS Study Group (IRLSSG) diagnostic criteria): 2 1 A need to move the legs usually accompanied or caused by uncomfortable, unpleasant sensations in the legs. 2 Symptoms are exclusively present or worsen during times of inactivity/rest. 3 Partial or total relief of symptoms by movement, such as walking or stretching, at least as long as the activity continues. 4 Symptoms are generally worse or exclusively occur in the evening or during the night. ABSTRACT Restless legs syndrome5 The occurrence of the fi rst four essential criteria must not be solely accounted for as symptoms primary to another medical or a behavioural condition.A single standard question for rapid screening of RLS has been validated by the IRLSSG, 3 which is: 'when you try to relax in the evening or sleep at night, do you ever have unpleasant, restless feelings in your legs that can be relieved by walking or movement?' This question can be used to effectively screen large patient groups as it has 100% sensitivity and 96.8% specificity for the diagnosis of RLS. However, the final diagnosis should always be confirmed by matching the patient's history and symptoms with the IRLSSG diagnostic criteria, accompanied by an exclusion of secondary conditions. Aetiology and differential diagnosesThe aetiology of RLS can be categorised as primary (idiopathic) or secondary. The majority of cases are primary Key pointsRestless legs syndrome (RLS) is a common neurological movement disorder, characterised by an uncontrollable urge to move the legs combined with an uncomfortable sensation in the legs.Diagnosis of RLS is mainly base...

BackgroundPlant derived medicines show significant contributions to mankind in treating infections of pathogenic bacteria. Recently plants are used in pharmaceutical industries for novel drug preparations because to ensure efficacy and safety as synthetic antibiotics are threatened for their multidrug resistance. The present study aimed at finding antibacterial potential of aqueous and ethanolic leaf extracts of Combretum album.MethodsAntibacterial activity was evaluated against seven bacterial strains by determining minimum inhibitory concentration (MIC) and zone of inhibition. Diameters of the zone of inhibition were compared with standard antibiotics. Preliminary phytochemical screening was done according to standard protocol. FTIR analysis was performed to identify the general phytochemical groups of compounds in the extract. All experiments were conducted in triplicate and values were expressed as the mean ± standard deviation. One-way analysis of variance (ANOVA) and Tukey tests were performed for statistical justification.ResultsMaximum zones of inhibition were found in case of ethanolic extracts in the following order Bacillus licheniformis (MTCC 530) > Pseudomonas aeruginosa (MTCC 2453) > Bacillus subtilis (MTCC 441) >, Pseudomonas fluorescens (MTCC 103) > Bacillus mycoides (MTCC 7343) > Escherichia coli (MTCC 739) > Pseudomonas putida (MTCC 1654) with zone of inhibition of 27.67 ± 0.33 mm diameter in B. licheniformis (MTCC 530). Qualitatively, the ethanol extract contains flavonoids, tannins and alkaloids. The results of FTIR analysis confirmed the presence of R-CH2-OH groups, aromatics, C-N stretching amine and NH stretching secondary amine. One way ANOVA and Tukey tests statistically justify the data (p ≤ 0.05).ConclusionsAll the tested leaf extracts showed promising antibacterial activity against both gram positive and gram negative bacteria. Phytochemical screening and FTIR analysis revealed the presence of tannins, alkaloids, R-CH2-OH groups, aromatics and flavonoids in ethanolic leaf extract qualitatively and these compounds could be responsible for antibacterial property of leaf extracts of C. album.

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