Background: Globally the burden of chronic kidney disease (CKD) is rising, an important cause of death and loss of disability-adjusted life years. Activation of the renin-angiotensin-aldosterone system is involved in its pathogenesis. The aim of the present study was to examine the effects of telmisartan (40 mg/day), an angiotensin receptor blocker (ARB) in Indian patients with CKD in real-life setting. Method: This was a prospective observational study. Fifty-six patients (>18 years) diagnosed with CKD were enrolled into the study. Serum creatinine, 24-h urinary protein, spot urine protein-to-creatinine ratio, glomerular filtration rate (GFR) and blood pressure (BP) were assessed along with safety. Results: A total of 55 patients (96.36% hypertensive; 63.61% diabetic) with mean age of 48.23 years completed the study. At the end of 3 months treatment with telmisartan, 24-h urinary protein, spot urine protein-to-creatinine, serum creatinine and BP significantly reduced (p < .05) by 806.78 mg, 0.95, 0.44 mg/dl and 8.9/4.7 mmHg in the overall population. GFR increased from the baseline value of 52.13 to 65.01 ml/min. Telmisartan was well tolerated and treatment was discontinued in one patient because of hyperkalemia. Conclusion: This study demonstrated that telmisartan effectively and safely reduces proteinuria in chronic kidney disease patients.

Background: Thrombolytics are recommended in high risk patients with massive pulmonary embolism (PE). However, clinical practice seems to be far different and questions related to its utility in less severely affected patients remain the subject of investigation. The objective of this observational study was to compare the efficacy and safety of tenecteplase with streptokinase and heparin. Method: A total of 103 patients (tenecteplase: 62, streptokinase: 17, heparin: 24) diagnosed with PE (massive: 33 [32.04%], submassive: 50 [48.54%], and minor: 20 [19.42%]) were included. Results: Mean age was 50.04 years and major risk factors were immobilization due to hospitalization, history of deep vein thrombosis, and diabetes. Common clinical symptoms of dyspnoea, right ventricular dysfunction, and cough were found in 94.17%, 81.55%, and 77.67% patients, respectively. Between treatment and day 7, death occurred in 4.84%, 5.88%, and 8.33% patients in the tenecteplase, streptokinase, and heparin groups, respectively. The differences among treatment groups were non-significant (p > .05). All treatments have demonstrated significant alleviation of dyspnoea and heart rate (p < .05). Significant (p < .05) increase in oxygen saturation was seen and it was markedly higher in the tenecteplase-treated patients compared with the streptokinase- and heparin-treated patients. By day 7, there was 100% resolution of right bundle branch block only in the tenecteplase group. No intracranial bleeding or fatal bleeding episodes were found in any group. Conclusion: Tenecteplase was found to be effective in patients with PE irrespective of their clinical status and no major adverse events were noted.

Aim:The present study objective is to find out the effectiveness of the two medhya (polyphyto) formulations for its learning and memory activity. Materials and Methods:There is a hypothesis is to slow down the brain degeneration caused by different pathophysiology with natural treatments and it has shown the promising effect in the treatment of memory loss. The two medhya formulation test drugs are FM01 (Habiscus rosasinensis, Oscimum sanctum, Santalum album, Phyllanthus Emblica, Convolulus pluricaulis, Bacopa monnieri), and FM02 (Convolulus pluricaulis, Abelmoschus esculentus, Terminalia Arjuna, Phyllanthus Emblica, Avena sativa) at a dose of (50 mg and 100 mg/kg p.o.) studied against standard drug Bacopa monnieri having potential effect to improving memory, evaluate it using three different animal model like Elevated plus maze (EPM), Morris water maze (MWM) and Pole Climbing apparatus (PCA) for the effect of nootropic action. Results: On administration of polyphyto formulations FM01 and FM02 showed significant (P < 0.001) reduction in transfer latency in EPM, MWM and escape latency in PCA test as compared with the control; whereas FM01 is comparatively better than FM02 and Bacopa monnieri. Conclusion: It was concluded that the nootropic polyphyto FM01 formulation composed of (Habiscus rosasinensis 30%, Oscimum sanctum 20%, Santalum album 15%, Phyllanthus Emblica 15%, Convolulus pluricaulis 10%, Bacopa monnieri 10%) having promising significant effect for enhancing learning and memory properties can be use for memory loss or dementia and prophylactically can be use to prevent neurodegeneration.

Background and objectives: The most common Gram-negative bacteria, such as enteric bacilli, Escherichia coli and Klebsiella pneumoniae, and Gram-positive bacteria, such as Streptococcus spp., are seen in patients suffering from cirrhosis and/or chronic liver diseases. The objective of this prospective observational study was to compare the efficacy and pattern of antibiotic use in patients with bacterial translocation. Methods: This 10-month study was conducted at the Gastroenterology Department of the KIMS hospital, Telangana, India. The patients were more than 18 years of age (n = 60) and diagnosed with liver cirrhosis and/ or chronic liver diseases. All data was analyzed statistically, at a significance threshold of p < 0.05. Results: Among the 60 patients, the Child-Pugh-Turcotte scores were A in 30%, B in 35% and C in 14%. White blood cell count was reduced from 12,620 ± 1,266 (before treatment) to 8,385 ± 944 (after treatment with antibiotics; p < 0.05). Serum glutamic pyruvic transaminase values were reduced from 360.1 ± 87.3 (before treatment) to 141.9 ± 37.9 (after treatment with antibiotics therapy (p < 0.001), whereas serum bilirubin values were reduced from 6.064 ± 0.91 (Before treatment) to 3.514 ± 0.44 (after treatment with antibiotics therapy; p < 0.0001). The mortality rate was 6.6 %, i.e. only 4 patients died post-treatment. It was also observed that meropenem was prescribed in the majority of cases and norfloxacin was the least prescribed of all antibiotics. Conclusions: Our study suggests that antibiotic treatment might be effective for patients suffering with cirrhosis or chronic liver diseases with improved life expectancy.

Background and Aims: The main aim of the study was to enhance the cognitive function of the brain by nootropic herbal formulations in animal models. Polyphyto herbal formulations were known to enhance the cognition and memory function by several pathways such as anti-oxidative, anti-inflammatory, and cell signaling pathways. In this study, six formulations were prepared by mixing specified plant parts and were coded as NHF1, NHF2, NHF3, NHF4, NHF5, and NHF6. Methods: The potency of the formulations was assessed by In vivo (photo actometer, rod walking test, pole climbing test, and Ellman's acetylcholinesterase test) studies. Results: NHF1 and NHF5 exhibited greater activity than the standard drug donepezil in vivo (Ellman's acetylcholinesterase test) analysis. NHF1 and NHF5 formulations containing plant parts were further investigated against several published literatures for the identification of chemical constituents and those chemical constituents were subjected to molecular docking and in silico ADME prediction studies to figure out the possible compounds responsible for the cholinesterase inhibition activity. Conclusion: In conclusion, the computational studies also reveal that presence of chemical constituents such as sarsasapogenin (13.13 nM), racemosol (16.26 nM), and beta-sitosterol (30.47 nM) having binding energy (-10.75 kcal/mol), (-10.63 kcal/mol), (-10.25 kcal/mol), might be directly responsible for the nootropic activity.