A rating scale for drug-induced akathisia has been derived that incorporates diagnostic criteria for pseudoakathisia, and mild, moderate, and severe akathisia. It comprises items for rating the observable, restless movements which characterise the condition, the subjective awareness of restlessness, and any distress associated with the akathisia. In addition, there is an item for rating global severity. A standard examination procedure is recommended. The inter-rater reliability for the scale items (Cohen's kappa) ranged from 0.738 to 0.955. Akathisia was found in eight of 42 schizophrenic in-patients, and nine had pseudoakathisia, where the typical sense of inner restlessness was not reported.

A rating scale for drug-induced akathisia

The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation and Treatment of High Blood Pressure

The therapeutic value of Aegle marmelos Correa (Rutaceae), commonly known as ''Bael," has been recognized as a component of traditional medication for the treatment of various human ailments. The plant, though, being highly explored, still lacks sufficient evidences for the best variety possessing the highest degree of medicinal values. The present study is focused on phytochemical screening of aqueous and methanolic leaf extracts of 18 varieties/accessions of A. marmelos. The crude extracts of A. marmelos revealed the presence of several biologically active phytochemicals with the highest quantity of alkaloids, flavonoids, and phenols in Pant Aparna variety. The antibacterial efficacy was investigated against pathogenic bacterial strains and the highest inhibitory activity of aqueous extract was obtained against S. epidermidis, whereas methanolic extract was found to be most potent against S. aureus at 40 mg/mL concentration. However, in aqueous : ethanol, the best results were observed against E. aerogenes followed by K. pneumonia and S. epidermidis. The MIC of aqueous and methanol extract of Aegle marmelos ranged from 10 mg/mL to 40 mg/mL whereas in aqueous : ethanol it ranged between 40 mg/mL and 160 mg/mL. The GC-MS analysis revealed the presence of many bioactive compounds such as flavonoids, alcohols, aldehydes, aromatic compounds, fatty acid methyl esters, terpenoids, phenolics, and steroids that can be postulated for antibacterial activity.

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Phytochemical evaluation, antimicrobial activity, and determination of bioactive components from leaves of Aegle marmelos.

Rationale
An increasing number of herbal products has been introduced to treat anxiety and depression. Gelsemium elegans Benth (G. elegans) is a well-known herbal plant in Asia. Four major alkaloids (gelsemine, koumine, gelsevirine, and gelsenicine) have been isolated from G. elegans. Recently, interest has arisen to investigate the pharmaceutical potential of G. elegans alkaloids in the context of neuropsychopharmacology.

The active alkaloids of Gelsemium elegans Benth. are potent anxiolytics

The second generation antipsychotic drug (SGA) olanzapine has an efficacy to treat schizophrenia, but can cause obesity and type II diabetes mellitus. Cholinergic muscarinic M3 receptors (M3R) are expressed on pancreatic β-cells and in the brain where they influence insulin secretion and may regulate other metabolic hormones via vagal innervation of the gastrointestinal tract. Olanzapine's M3R antagonism is an important risk factor for its diabetogenic liability. However, the effects of olanzapine on central M3Rs are unknown. Rats were treated with 0.25, 0.5, 1.0 or 2.0 mg olanzapine/kg or vehicle (3×/day, 14-days). M3R binding densities in the hypothalamic arcuate (Arc) and ventromedial nuclei (VMH), and dorsal vagal complex (DVC) of the brainstem were investigated using [3H]4-DAMP plus pirenzepine and AF-DX116. M3R binding correlations to body weight, food intake, insulin, ghrelin and cholecystokinin (CCK) were analyzed. Olanzapine increased M3R binding density in the Arc, VMH and DVC, body weight, food intake, circulating plasma ghrelin and CCK levels, and decreased plasma insulin and glucose. M3R negatively correlated to insulin, and positively correlated to ghrelin, CCK, food intake and body weight. Increased M3R density is a compensatory up-regulation in response to olanzapine's M3R antagonism. Olanzapine acts on M3R in regions of the brain that control food intake and insulin secretion. Olanzapine's M3R blockade in the brain may inhibit the acetylcholine pathway for insulin secretion. These findings support a role for M3Rs in the modulation of insulin, ghrelin and CCK via the vagus nerve and provide a mechanism for olanzapine's diabetogenic and weight gain liability.

Effects of olanzapine on muscarinic M3 receptor binding density in the brain relates to weight gain, plasma insulin and metabolic hormone levels

Medication error is a major cause of morbidity and mortality in medical profession, and anaesthesia and critical care are no exception to it. Man, medicine, machine and modus operandi are the main contributory factors to it. In this review, incidence, types, risk factors and preventive measures of the medication errors are discussed in detail.

Medication error in anaesthesia and critical care: A cause for concern.

The in vitro antimicrobial activity of serial petroleum ether, chloroform and methanol extracts from leaves of Aegle mawmelos were investigated against bacterial and fungal species. All the extracts exhibited broad spectrum antimicrobial activity with zones of inhibition ranging from 10 to 22 mm against bacteria: Staphylococcus aureus, beta Streptococcus haemolyticus group A, Proteus mimrabilis, Klebsiella pneumoniae, Pseudomonas aenrginosa, Escherichia coli, Salmonella typhi, fungi: Candida albicans, Candida tropicalis and Aspergillusflavus. The minimal inhibitory concentrations (MIC) and the minimal microbicidal concentrations (MMC) of the extracts ranged from 1.25 to 10 mg/mL and 2.5 to 20 mg/mL respectively. Assessment of antibacterial efficacy of different extract revealed that Staphylococcus aureus, beta Streptococcus haemolyticus group A, Pseudomonas aeruginosa and Escherichia coli showed high susceptibility to petroleum ether extract. Proteus mimrabilis, Klebsiella pneumoniae showed high susceptibility to chloroform extract and Salmonella typhi showed high susceptibility to methanol extract. Petroleum ether extract exhibited the highest antifungal efficacy against all tested fungal species. Phytochemical screening revealed the presence of phenols, sterols in petroleum ether and chloroform extracts, whereas tannins, flavonoids, coumarins, saponins and triterpenoids in methanol extract. The ability of the leaf extracts of Aegle manmelos to inhibit growth of bacteria and fungi is an indication of its broad spectrum antimicrobial activity which could be a potential source for development of novel bioactive antimicrobial agents.

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Antimicrobial activity and phytochemical screening of serial extracts from leaves of Aegle marmelos (Linn.).

The objective of the present study was to evaluate the anxiolytic and antidepressant activities of methanol extract of Aegle marmelos (AM) leaves as well as its interaction with conventional anxiolytic and antidepressant drugs using elevated plus maze and tail suspension test in mice. Albino mice were treated with AM (75, 150 and 300 mg/kg, po), imipramine (20 mg/kg, po), fluoxetine (20 mg/kg, po), and combination of sub-effective dose of AM with imipramine or fluoxetine. Effects were observed on (a) time spent on (b) number of entries into (c) number of stretch attend postures (d) number of head dips in arms of elevated plus maze and on duration of immobility in tail suspension test. Effects of pretreatment with prazosin (0.062 mg/kg, po), haloperidol (0.1 mg/kg, po) and baclofen (10 mg/kg, po) were also studied on AM induced decrease in duration of immobility. Effects of AM (75, 150 and 300 mg/kg po) were observed on locomotor activity using photoactometer. Results showed that AM significantly (P 0.05) effect on locomotor activity of mice. It is concluded that AM possess potential anxiolytic and antidepressant activities and it enhances the anxiolytic and antidepressant activities of imipramine and fluoxetine.

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Anxiolytic and antidepressant activities of methanol extract of aegle marmelos leaves in mice

Present study was aimed to elucidate hypolipidemic effect of fresh Triticum aestivum (common wheat) grass juice (GJ) in experimentally induced hypercholesterolemia in rats and to investigate its role in cholesterol excretion. Hypercholesterolemia was induced experimentally in rats by including 0.75 g% cholesterol and 1.5 g% bile salts in normal diet for 14 days. Hypercholesterolemic rats were administered fresh Triticum aestivum GJ at the dose of 5 mL/kg and 10 mL/kg and the standard drug atorvastatin 0.02% w/v in 2% gum acacia suspension at the dose of 1 mg/kg for 14 days by gavage. Blood samples were collected after 24 h of last administration and used for estimation of lipid profile. Fecal cholesterol levels were estimated using standard methods. Fresh GJ administration at 5 mL/kg and 10 mL/kg resulted in dose dependent significant decline in total cholesterol (TC), triglycerides (TG), low density lipoprotein-cholesterol (LDL-C) and very low density lipoprotein-cholesterol (VLDL-C) levels in hypercholesterolemic rats. Further, in comparison to atorvastatin, GJ administration at the dose of 10 mL/kg resulted in comparable decrease of TC, LDL-C, TG and VLDL-C levels (p > 0.05). Fecal cholesterol excretion was significantly (p < 0.05) enhanced by Triticum aestivum GJ administration. Phytochemical analysis revealed the presence of flavonoids, triterpenoids, anthraquinol, alkaloids, tannins, saponins and sterols in fresh wheat grass juice. The results of present study revealed hypolipidemic effect of Triticum aestivum GJ in hypercholesterolemic rats by increasing fecal cholesterol excretion. Fresh GJ could have potentially beneficial effect in atherosclerosis associated with hyperlipidemia.

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Hypolipidemic effect of fresh Triticum aestivum (wheat) grass juice in hypercholesterolemic rats.

Objective: To study the hypolipidemic activity of fresh grass juice of Triticum aestivum in normal rats. Materials and Methods: Freshly prepared Triticum aestivum grass juice was administered to normal rats at the dose of 5 ml/kg and 10 ml/kg orally once daily for 21 days. Blood samples were collected after 24 hours of last administration and used for estimation of lipid profile. Fresh grass juice was also subjected to preliminary phytochemical screening. Results: Fresh grass juice administration produced dose related significant (P Conclusion: The results of the present study lndicate hypolipidemic activity of fresh Triticum aestivum grass juice.

Saroj Kothari

Papers

Medication error in anaesthesia and critical care: A cause for concern.

Antimicrobial activity and phytochemical screening of serial extracts from leaves of Aegle marmelos (Linn.).

Anxiolytic and antidepressant activities of methanol extract of aegle marmelos leaves in mice

Hypolipidemic effect of fresh Triticum aestivum (wheat) grass juice in hypercholesterolemic rats.

Effect of fresh Triticum aestivum grass juice on lipid profile of normal rats