Abstract : Urolithiasis plagues are common urinary disease in worldwide. Siddha medicine is one of the traditional systems of medicines practiced in the southern India. Amurthathi Chooranam is a classical Siddha Poly herbal formulation which was analyzed by molecular docking for Urolithiasis. The present study is aimed to accomplish the In Silico computational binding of phytocomponents of Amurthathi Chooranam with the core amino acids (CYS 527, PRO 528, HIS 529, GLY 534, ARG 583, THR 585, ARG 586) of the target protein Tamm–Horsfall protein (PDB) - 4WRN which is involved in calcium oxalate crystallization for management of urolithiasis. Docking calculations were carried out for retrieved phytocomponents against target protein Tamm–Horsfall protein. Essential hydrogen atoms, Kollman united atom type charges, and solvation parameters were added with the aid of AutoDock tools. Docking simulations were performed using the Lamarckian genetic algorithm (LGA) and the Solis & Wets local search method. Initial position, orientation and torsions of the ligand molecules were set randomly.Total 9 bioactive lead compounds were retrieved from the herbs present in Amurthathi Chooranam such as Alpha-phellandrene, Elemene, Elemicin, Tinosporide, Nerolidol, Eugenol, Quercetin, Syringic Acid and Morphine possess maximum of 3-4 interactions with the core active amino acid residues present on the target protein Tamm–Horsfall protein. Based on the results it was concluded that the above mentioned compounds exerts anti-urolithiasis activity by preventing calcium oxalate crystallization which inhibit the target Tamm–Horsfall protein for management of urolithiasis. Keywords: Molecular Docking, Amurthathi Chooranam, Antiurolithiatic activity, Tamm–Horsfall protein

Keyword : Molecular Docking, Amurthathi Chooranam, Antiurolithiatic activity, Tamm–Horsfall protein

Abstract : Background: Oropharyngeal colonization by pathogenic organisms especially in the initial crucial days of ICU admission, is the main cause of predisposition to nosocomial infections. Hence, identifying bacterial flora, in respect to hospitalization will help in further management to prevent morbidity and mortality of these patients. Objective: Determining changes in bacterial flora in oropharynx of patients with nasogastric tube, admitted in ICU. Methods: One year prospective observational study including 40 patients between 18 and 70 years, Group A 20 cases- with nasogastric tube in situ, Group B 20 controls including those without tube. Oropharyngeal swab taken on Day 0 and 7 of ICU admission respectively. Results: There was nearly equal distribution of gender, with 19 females and 21 males, majority in the age group of 35-74 years. Most of patients had no growth on day 0 (35% cases) but as the day of ICU admission progressed, there was increased growth of Gram negative bacteria like Pseudomonas aeruginosa (20%), Klebsiella pneumonia (25%) especially in cases group. Conclusion: The progressive increase of pathogenic organism and the variation to gram negative bacteria further confirmed predispositions to pathogen carriage at these sites and the subsequent risk of infection within the crucial 48 hours. Hence, need for consistent oral cleansing procedures, maintaining good oral hygiene in these prolonged tube-fed patients will help prevention of nosocomial infections.

Keyword : Nasogastric tube, Oropharyngeal flora, ICU, bacteria, growth

Abstract : This study was carried out to compare the efficacy and safety of epoetin alfa vs desidustat (prolyl hydroxylase inhibitor) for treatment of anemia in chronic kidney disease(ckd) patients on maintenance hemodialysis. Sixty patients of ckd stage 5 were included in the study undergoing maintenance hemodialysis. These patients were divided randomly into two groups. Group A consists of 30 patients who received epoetin alfa during each dialysis (3 times/week). Group B consisting of 30 patients received desidustat tablet 3 times/week. The change in the haemoglobin level was taken as the main evaluation parameter between epoetin alfa and desidustat groups and measured after three months. The change in haemoglobin level from baseline to 3 months was 1.37 g/dl in epoetin alfa group and 1.53 g/dl in desidustat group. The safety profile of both the drugs was comparable. There were no increased risks seen with desidustat as compared to epoetin alfa. In this study desidustat is found to be more efficacious with equal side effects as compared to epoetin alfa in ckd patients on maintenance hemodialysis.

Keyword : Epoetin alfa , desidustat , ckd , hemodialysis.