Open Access Case Study

Escobar Syndrome: Difficulties in Anesthesia Management

Arzu Karaveli, Ülkü Kum, Deniz Yüksel, Erhan Özyurt, Bilge Karsli, Kerem Inanoğlu, Sadık Özmen

Journal of Pharmaceutical Research International, Page 1-6
DOI: 10.9734/JPRI/2018/38935

Introduction: Escobar syndrome (multiple pterygium coli) is a rare autosomal recessive disorder which characterized by various malformations. Regarding anaesthesia management, these patients should be considered due to difficult mask ventilation and intubation and risk of malignant hyperthermia by the anesthesiologist.

Case: An 11-year-old girl, with Escobar syndrome, was scheduled for orthopaedic surgery due to femur fracture. In a preoperative physical examination, the patient had revealed multiple joint flexion contractures. Neck extension of the patient was significantly limited due to the flexion contractures, and the mallampati score was 3, but the mouth opening was sufficient. Preoperative echocardiography and electrocardiogram were normal, and there was no abnormality in the complete blood count, coagulation profile and biochemical analysis.

The patient was taken to the operating theatre without premedication. Following placement of IV line and preoxygenation, anaesthesia was induced with propofol, rocuronium bromide and fentanyl. After repositioning the patient to the ‘sniffing' position and applying external tracheal pressure, the trachea was intubated by the conventional laryngoscope with the help of an intubation stylet.  Anesthesia was maintained with propofol and remifentanil infusion. The duration of anaesthesia was 210 min and no problems were encountered intraoperatively.

Discussion: Patients with Escobar syndrome are frequent in childhood and are characterized by multiple joint flexion contractures, pterygia of the neck, antecubital and popliteal areas, cleft palate, micrognathia, syndactyly, camptodactyly, decreased mouth openness, vertebral anomalies, and increased risk of malignant hyperthermia.

In the literature, it is emphasized that anaesthesia management of patients with Escobar syndrome has challenging due to difficult intubation, difficult ventilation and the risk of malignant hyperthermia.

Conclusion: In patients with Escobar syndrome, detailed physical examinations, especially cardiac and respiratory system, should be performed before the anaesthesia and necessary precautions such as difficult airway equipment should be taken in the operating theatre.

Open Access Original Research Article

Improvement of Secondary Metabolites from Phyllanthus odontadenius against Malaria by Mutagenesis

Sébastien Luyindula Ndiku, Rufin Kikakedimau Nakweti, Véronique Sinou, Florent Rouvier, Théophile Mbemba Fundu, Claudine Franche, Richard Cimanga Kanianga

Journal of Pharmaceutical Research International, Page 1-14
DOI: 10.9734/JPRI/2018/37978

Aims: Majority of deaths in children aged under 5 years are due to Plasmodium falciparum malaria. Malaria deaths in children decreased but malaria remains a major killer of children, taking the life of a child every 2 minutes. This study aims to investigate the increasing of the in vitro antiplasmodial activities by mutagenesis techniques using gamma-rays (Cs-137) or sodium azide (NaN3) as mutagens. It will allow the importance of mutagenesis use as tools for improvement of secondary metabolites against malaria parasites using chemical or physical mutagens.

Study Design: Laboratory experiment tests : identification of plant material, immersion of seeds in SA (sodium azide) solutions or irradiation by Gamma-rays (Cs-137) of P. odontadenius seeds for improvement of secondary metabolites against malaria parasites,  in vitro culture of seeds followed by the in situ culturing of plantlets for obtaining material of study, phytochemical screening of Phyllanthus odontadenius aerial parts to determine the change of compounds in comparison to controls, in vitro antiplasmodial tests for the determination of SA concentrations or those of gamma-rays doses which killing 50% of malaria parasite populations (IC50).

Place and Duration of Study: Department of Biotechnology and Molecular Biology, Department of Biochemistry: General Atomic Energy Commission, Regional Nuclear Studies Center of Kinshasa, P.O. Box. 868 Kinshasa XI, Democratic Republic of the Congo (DRC). National Institute of Biomedical Research (NIBR) at Kinshasa/Gombe (DRC). Laboratory of UMR-MD3, Aix-Marseille University, Faculty of Pharmacy/Marseille, France. The experiments were conducted from Junuary - December 2010; August and December 2011 and during May and September 2012 until July 2014.

Methodology: Aerial parts of plants M1 and M2 from Gamma-rays irradiation of P. odontadenius seeds or from immersion of P. odontadenius seeds in sodium azide solutions used as biological material for the in vitro antiplasmodial analysis. The in vitro antiplasmodial activities assays on clinical isolates of P. falciparum and on chloroquine-resistante P. falciparum strain K1 was determined using microscopic method, the isotopic micro-test method and using HRP2-based ELISA assay.

Results: Gamma-rays (Cs-137) increased (multiplied) the in vitro antiplasmodial activities from 2.48 up to 7.6 in comparison to control. Thus, the in vitro antiplasmodial activities were improved or exceeded from 147.57% up to 660% than those of control plant. SA had increased (multiplied) the in vitro antiplasmodial activities from 1.24 up to 10.15 comparing to the control plants. The antiplasmodial activities in vitro were exceeded compared to the control plants from 24.43% up to 915%.

Conclusion: Treatment of P. odontadenius seeds by Gamma-rays or by SA give plants high in vitro antiplasmodial activities. Values of in vitro antiplasmodial activities varried from 1.24 (147.57%) to 10.15 (915%). 125, 150 and 225 Gy of Gamma-rays (Cs-137) for physical mutagenesis and 10.15 and 17.5 mM of SA solutions for the chemical mutagenesis could be used for improving in vitro antiplasmodial activities against P. falciparum (clinical isolates of P. falciparum or chloroquine-resistant P. falciparum strain K1). Thus, plants extracts from treated seeds have justified the usefulness of mutagens in plant breeding particularly in the increasing production of secondary metabolite against malaria parasite.

Open Access Original Research Article

Trace Element Composition and Anti-anaemic Effects of the Ethanol Extract of Harungana madagascariensis Lam. Ex Poiret. in Phenyl Hydrazine Induced Anaemia in Albino Rats

Olusayo A. Shorinwa, Adaobi C. Mbajiorgu, Ozadheoghene E. Afieroho

Journal of Pharmaceutical Research International, Page 1-7
DOI: 10.9734/JPRI/2018/39823

Aim: To evaluate the acute toxicity, a phytochemical constituent of the ethanol extract of the fruit of Harungana madagascariensis, as well as its trace element composition and anti-anaemic effects.

Materials and Methods: Lorke’s method was used to evaluate acute toxicity and energy dispersive x-ray fluorescence (EDXRF) spectrometer for elemental composition analysis. Thirty-six albino rats were divided into 6 groups of 6 animals each. Anaemia was induced by intraperitoneal administration of phenyl hydrazine hydrochloride (80 mg/kg) in 5 groups while the 6th group served as non-anaemic group (normal control). Administration of extract was done for 21 consecutive days orally at doses of 250, 500 and 1000 mg/kg respectively to groups I, II and III, group IV received vitamin B12 while group V served as the negative control. Haematological parameters (PCV, HB and RBC) were evaluated.

Results: Phytochemical screening revealed the presence of flavonoids, tannins, saponins and free anthraquinones. The extract contains sodium, iron and zinc in proportions of 135.09 ppm, 15.52 ppm and12.68 ppm respectively as well as copper, chromium and other elements.

 The results showed that the extract at 500 mg/kg significantly (P<0.05) increased the PCV, Hb and RBC (55.33%, 18.47 g/dl and 6.17 ×1012) more than the 1000 mg/kg dose when compared to the controls.

Conclusion: The findings showed that this extract possesses anti-anaemic activity which may be attributed to its phytochemical constituents and trace elemental composition.

Open Access Original Research Article

Glycemic Index Profiling of Quinoa (Chenopodium quinoa Willd) Variety

M. Priyanka, W. Jessie Suneetha, K. Uma Maheswari, K. B. Suneetha, B. Anila Kumari

Journal of Pharmaceutical Research International, Page 1-5
DOI: 10.9734/JPRI/2018/37915

Quinoa has proteins of high biological value, carbohydrates of low glycemic index and phytosteroids with w - 3 and 6 fatty acids that provide health benefits. The main advantage of quinoa is that along with being a protein supplement in the flour industry, it meets the increasing international demand for gluten-free products in cakes, pastries, pasta and baked goods. Studies on glycemic index (GI) profiling of newly released quinoa varieties are lacking and so the present study was taken up to assess its GI. Cooked quinoa was given to the 10 subjects, their blood glucose levels were determined every 15 min up to 60 min and again at 90 and 120 min respectively. The blood glucose levels after consumption of quinoa ranged from 78.30 to 120.20 mg/dl with an average fasting level of 96.51 mg/dl. The glycemic index of quinoa ranged from 51.28 to 78.25 with an average of 63.37 and the glycemic load was from 25.64 to 39.12 with an average of 31.68. Hence, this quinoa variety can be categorized as a medium glycemic index and high glycemic load food.

Open Access Review Article

Cytotoxic and Anticancer Activities of Indoline-2,3-dione (Isatin) and Its Derivatives

Sulayman A. Ibrahim, Tilal Elsaman

Journal of Pharmaceutical Research International, Page 1-19
DOI: 10.9734/JPRI/2018/39708

Isatin (1H-indolin-2,3-dione) is a versatile bioactive and heterocyclic scaffold with an indole nucleus. For the past decades, isatin and its derivatives have shown tremendous interest among researchers (organic and medicinal chemists). Hence, their extensive structural modification has result in different analogues of isatin depicting wide range of biological and pharmacological activities including antimicrobial, anticancer, anti-inflammatory and analgesic, anticonvulsant, anti-viral, anti HIV and antiplasmodial activity. In this present review, we focus on isatin and its derivatives possessing cytotoxic and anticancer activity against different cancer cell lines from the period 2002 to 2015.