A Review on: Digitalis Purpurea

Digitalis contain cardiac glycosides and used in the treatment of congestive heart failure. Digitalis drug obtain from Digitalis Purpurea L. belongs to family scrophulariaceae. 200 years ago William Withering discover the use of digitalis in CHF treatment in 1785.In 18th century a controversy has existed about the benefits and risks of digitalis in patients with heart problems. Active component of digitalis classified as cardiac glycosides and cardiotonic steroids. The term "digitalis" or "cardiac glycosides" are used to refer to any of steroids or steroid glycosides compound which exert characteristic positively inotropic and electrophysiological effect on heart. In 20th century digitalis and its derivatives specially, digoxin is used in treatment of CHF. Cardiac glycosides are used in therapy of CHF since William Withering identify their uses. Digitalis purpurea is not only use in treatment of CHF also has wound healing, antioxidant and cytotoxic activity. In 1990 most prescribed drug is digoxin. It shows intermediate duration of action. Digoxin is use for its rate control in atrial fibrillation in the presence of marginal blood pressure. The introduction of diuretic provide an alternative more effective and safer for treatment of CHF. Keywords: CHF., Digitalis Purpurea L

Electrophysiological Effect of Acupuncture in the Carpal Tunnel Syndrome Case

Carpal tunnel syndrome (CTS) is the most common entrapment neuropathy and occurs as a result of compression of the median nerve in the carpal tunnel at the wrist. The classic symptom in patients with CTS is paresthesia (numbness, burning, tingling) and pain in the median nerve distribution area of the hand, especially at night. A 24-year-old female patient presented to GETAT polk with the diagnosis of mild carpal tunnel syndrome after examination and EMG after the complaint of numb tingling in the hand in the neurology outpatient clinic. The patient was using Parkyn (pramipexole dihydrochloride monohydrate) 25mg. Acupuncture was applied to the patient for 10 sessions. Disposable sterile acupuncture needles were applied to the PC-6, H-7, LU-9, H-7, SI-3 points (0.22x13mm, 0.22x1.5mm Hua Long). The sessions lasted 20 minutes. The sessions were done first twice a week, then once a week. The patient was prescribed Vitamin B1 + B6 supplements. After 10 sessions of acupuncture, the EMG was repeated. The EMG result of the patient was normal. Parkyn was cut by neurology, Lyrica (pregabalin) was switched to 150mg. The patient's need for medication was also reduced.

Electrophysiological effects of slim straight intracochlear electrode position

Objective The electrical current distribution of a cochlear implant electrode within the cochlea is essential for post-operative hearing performance. The slim straight electrode is designed to enable the placement of contacts in a lateral or medial direction to the modiolus. The electrophysiological effect of this different contact direction is so far unknown. The aim of this study was to determine the influence of intracochlear laterally or medially directed electrode contacts on electrophysiological behaviour. Method A slim straight electrode was inserted into the cochleae of five patients, and the neural response threshold was measured in a laterally and medially directed contact position. The cochleae in five temporal bone specimens were de-capped allowing an insertional observation of the contact position (lateral versus medial) of the electrode. Results There was no difference in neural response threshold between a lateral and a medial position of the contacts. Temporal bone study indicated no intracochlear torsion of the electrode. Conclusion Our study provides evidence that the intracochlear position of slim straight electrode contacts does not affect the neural response threshold.

Effect of CYP3A5*3 genotypes on lumefantrine plasma concentrations among malaria-HIV-infected women

Aim: We aimed to assess the effect of a functional polymorphism of CYP3A5 on lumefantrine pharmacokinetics. Patients & methods: Sixty-nine women diagnosed with malaria received standard doses of artemether–lumefantrine. Concentration–time data for lumefantrine and genotyping data were obtained for each participant. Pharmacokinetic-genotype associative relationships were assessed using linear regressions, Mann–Whitney U-test or Kruskal–Wallis statistics. Results: Average age and weight (standard deviation) of the patients were 33 (6.8) years and 59.5 (11.6) kg, respectively. CYP3A5*3 genotype associated with the log-transformed maximum concentration with the median (interquartile range) values of 8279 (6516–13,420) and 6331 (4093–8631) ng/ml (p = 0.032) among the carriers and noncarriers of CYP3A5*3, respectively. Besides, the NR1I3 c.152-1089T>C genotypes had an associative trend with the lumefantrine area under the curve (AUC0–96h) and clearance. Conclusion: CYP3A5*3 genetic variant is associated with a high maximum plasma concentration of lumefantrine. This warrants further investigations on the association between CYP3A5*3 gene variants, lumefantrine pharmacokinetics and electrophysiological effect.