Radiance Research AcademyInternational Journal of Current Research and Review2231-21960975-5241123EnglishN2020February10HealthcareEffect of N-acetylcysteine in Indeterminate Acute Liver Failure English0106Tauseef NabiEnglish Sajad Ahmad DarEnglish Nadeema RafiqEnglishBackground: Acute liver failure (ALF) is a rare syndrome, characterized by acute derangement of liver function and carries high mortality. Indeterminate ALF still forms a significant number of cases in India as well in the world. A prospective case-control study was carried with the aim to determine the effect of N-Acetylcysteine (NAC) on the survival of indeterminate ALF patients. Methods: A total of 30 patients with a diagnosis of indeterminate ALF were included in the study. 14 patients received NAC infusion for 72hrs whereas 16 patients in control group received placebo. The parameters evaluated were demographic, clinical, biochemical, outcome and length of hospital stay. Results: The two groups were comparable for the various baseline characteristics (demographic, clinical, biochemical etc.). A total of 18 of 30 (60%) patients died with ALF complications; 6 (42.8%) patients belonged to NAC group and 12 (75%) patients to Control group (P = 0.077). The overall survival was not improved by NAC in indeterminate ALF. Use of NAC also did not reduce the duration of hospital stay of survived patients (P = 0.409). Conclusion: The overall survival was not improved by NAC in indeterminate ALF. NAC administration did not reduce the duration of hospital stay. EnglishAcute Liver Failure (ALF), Indeterminate ALF, Hepatic encephalopathy (HE), N-Acetylcysteine (NAC)INTRODUCTION Acute liver failure (ALF) remains a clinical challenge and still accounts for high mortality, particularly when the cause remains unclear. ALF is a syndrome characterized by the development of hepatic encephalopathy (HE) together with signs of hepatocellular insufficiency, especially jaundice and coagulation disorders, in patients without previous liver disease.[1] It is a rare disease with 2000 to 3000 reported cases in the United States per year.[2] Reports from the developed world suggest an overall incidence of 1 - 8 cases per million people every year,[3] yet it accounts for up to 7% of all liver-related deaths[2] and is responsible for 6% of liver transplants.[4] However, spontaneous recovery is observed in up to 45% of ALF patients, and specific treatments for known etiologies can be effective.[5]  The term acute liver failure is used to describe the development of coagulopathy, usually with an international normalized ratio (INR) of greater than 1.5, and any degree of mental alteration (encephalopathy) in a patient without preexisting cirrhosis and with an illness of less than 26 weeks duration.[6] Etiology of ALF is heterogeneous and shows wide geographical variation. The most important step in the management of ALF is to identify the cause which helps in the execution of targeted therapies and antidotes, when available. The main etiological factor includes: viral, drugs including herbal and traditional medications, autoimmune, toxin and indeterminate.[7] Acetaminophen overdose is the most common cause of ALF in the United States and Europe, whereas viral hepatitis is more common in Asia and Africa, but numerous other causes have been reported, including drug-induced liver injury, viral hepatitis, ischemic liver injury, Wilson’s disease, and acute presentation of autoimmune hepatitis.[8, 9] Viral hepatitis is the commonest cause of ALF world-wide and in the Indian subcontinent alone it accounts for 90% of cases.[10] Causation cannot be established in many cases; such seronegative or indeterminate liver failures happens worldwide, and are associated with especially poor survival with medical therapy alone, and frequently need emergency transplantation.[11,12] A significant minority of ALF cases, however, cannot be linked to a clear cause. 18% to 20% of ALF cases in industrialized countries have an unknown etiology.[13] They usually present with an acute or subacute ALF phenotype.[14] A proportion of these patients may have taken drugs or xenobiotics, which they do not (or cannot) recall. Others provide a history compatible with a viral phenotype, although no specific viral etiological agent can be identified.[15] Some subsequently present with immune-mediated features, suggesting that the original disease may have been autoimmune in nature. In some of these groups, as well as in those of a known etiology, the potential for paracetamol-induced co-toxicity may be raised by the presence of paracetamol adducts.[16] Equally, studies have suggested that some cases of presumed seronegative etiologies may have HEV infection, and appropriate tests regarding sensitivity and specificity should always be undertaken.[17] Mortality related to ALF can be attributed to three complications in particular: cerebral edema, multiorgan dysfunction syndrome, and sepsis. Liver has the unique ability to regenerate after acute, self-limiting injury. The overall management strategy starts with the identification of cause and an initial assessment of prognosis. Although many people recover with supportive treatment; Orthotropic liver transplantation (OLT) remains the only definitive therapy for patients who are unable to achieve sufficient hepatocyte regeneration on supportive treatment. OLT has made a significant impact on the survival of patients with ALF.[18, 19] Therefore better cost-effective alternatives are needed in locations where facility is not available. N- Acetylcysteine (NAC) has a well-established role in paracetamol-induced ALF[20] although it is now also recommended in selected cases of non-paracetamol ALF[21-23] because of its multiple mechanisms of action. NAC is a thiol-containing agent that scavenges free oxygen radicals and replenishes cellular mitochondrial and cytosolic glutathione.[24, 25] Its anti-inflammatory, antioxidant, inotropic, and vasodilating effect has been proved from various trials.[26, 27] NAC may benefit patients either by improving systemic hemodynamics and tissue oxygen delivery [28] or via other mechanisms.[29] Role of NAC in indeterminate ALF has not been studied in controlled trials. In this prospective study, we aimed to determine the role of NAC on mortality in indeterminate ALF and also to evaluate the safety and efficacy of NAC and its impact on the duration of hospital stay at a tertiary care centre in Kashmir (North India). MATERIALS AND METHODS It was a single centre prospective study of adult patients with indeterminate ALF. This study was carried out in the Department of Gastroenterology of Sher-i-Kashmir Institute of Medical Science (SKIMS), Soura, J&K. The study was approved by the institutional ethical committee (SKIMS). Informed consent was obtained from all the recruited subjects. Study subjects Total of 30 patients with diagnoses of indeterminate ALF who fulfilled eligibility criteria were recruited in the study. This study was conducted over a period of three years from April 2011 to April 2014. Information regarding various demographic characteristics was taken through well-structured questionnaires from all subjects. Besides a detailed history, physical examination and biochemical workup which included baseline investigations, liver function test (LFT), coagulogram of subjects were carried out. Eligibility criteria: Inclusion criteria include patients having age >18years and ALF was defined as biochemical evidence of acute liver injury with INR ≥1.5 and any degree of encephalopathy caused by the illness of duration 30 and bilirubin > 20mg/dl were the independent prognostic factors determining mortality. DISCUSSION Acute liver failure (ALF) is a dynamic clinical condition manifested by an abrupt onset of a liver-based coagulopathy and biochemical evidence of hepatocellular injury resulting from rapid deterioration in liver cell function.[31] The correct determination of etiology in ALF is vital for both therapeutic and prognostic considerations and the use of antidotes depends on the identification of the causative process. OLT has now become an established treatment option in patients with ALF. Due to a lack of OLT facility, NAC has emerged as a beneficial treatment for non-paracetamol ALF.[21-23] Role of NAC in Viral-ALF has not been studied in controlled trials. So the prospective study was carried out to determine the role of NAC on mortality in indeterminate ALF and also to evaluate the safety and efficacy of NAC and its impact on the duration of hospital stay at a tertiary care centre in Kashmir (North India). In our study there were 30 patients of indeterminate ALF, which constituted around 35% of cases of 84 ALF patients, an endemic zone for HEV.[32] Similar percentage of indeterminate cause of ALF was shown by Khuroo MS, et al [33] while western studies reported less percentage7 and other studies even reported a higher percentage.[34] There were 14 patients in the NAC group and 16 patients in Control group. In this prospective case-control trial, more patients (57.2%) survived in NAC group than in the Control group (25%) but no significant improvement in the survival of patients who were treated with NAC was seen (P = 0.077). Furthermore, the use of NAC was not associated with a shorter length of hospital stay in survived patients (P = 0.409). The previous study by us showed that NAC improved the overall survival in non-acetaminophen induced ALF with a more favourable effect on drug-induced ALF.[21] Other studies also reported NAC improved transplant-free survival in early stage non-acetaminophen ALF(both in adults and childrens).[22,23] The non favourable effect of NAC in indeterminate ALF could be because indeterminate ALF had an advanced grade of encephalopathy (Gr III & IV) and subacute presentation which are related to poor prognosis. In this study age >50 years, III-IV grade of encephalopathy, renal impairment, MELD score > 30 and bilirubin > 20mg/dl were the independent prognostic factors determining mortality. To the best of our knowledge, the role of NAC in indeterminate ALF has not been studied in prospective controlled trials. The major strengths of this study include prospective cases and controls. Some of the limitations of our study include small sample size, single centre study and the duration of follow up was short (hospital stay till discharge or death in the hospital). To conclude the overall survival was not improved by NAC in indeterminate ALF. NAC administration did not reduce the duration of hospital stay. ACKNOWLEDGEMENTS: The authors thanks the Department of Gastroenterology of SKIMS. Authors acknowledge the immense help received from the scholars whose articles are cited and included in references of this manuscript. The authors are also grateful to authors/editors/publishers of all those articles, journals and books from where the literature for this article has been reviewed and discussed CONFLICT OF INTEREST: There are no conflicts of interest to be declared. FINANCIAL SUPPORT: Nil. Englishhttp://ijcrr.com/abstract.php?article_id=2651http://ijcrr.com/article_html.php?did=2651 Trey C, Davidson CS. The management of fulminant hepatic failure. Prog Liver Dis 1970; 3: 282-98. Hoofnagle JH, Carithers RL Jr, Shapiro C, Ascher N. Fulminant hepatic failure: summary of a workshop. Hepatology 1995; 21(1): 240–52. Bower WA, Johns M, Margolis HS, Williams IT, Bell BP. Population-based surveillance for acute liver failure. Am J Gastroenterol 2007; 102: 2459-63. Rockville. Health Resources and Services Administration, Healthcare Systems Bureau, Division of Transplantation; 2007. Lee WM, Squires Jr RH, Nyberg SL, Doo E, Hoofnagle JH. Acute liver failure: summary of a workshop. Hepatology. 2008; 47(4): 1401-15. Bernal W, Wendon J. Acute liver failure. N Engl J Med 2013; 369: 2525–34. Ostapowicz G, Fontana R J, Schiodt F V. Results of a prospective study of acute liver failure at 17 tertiary care centers in the United States. Ann Intern Med 2002; 137: 947–54. Lee WM. Etiologies of acute liver failure. Semin Liver Dis 2008; 28(2): 142-52. Sugawara K, Nakayama N, Mochida S. Acute liver failure in Japan: definition, classification, and prediction of the outcome. J Gastroenterol. 2012; 47(8): 849-61. Acharya SK, Dasarathy S, Kumer TL, Sushma S, Prasanna KS, Tandon A et al. Fulminant hepatitis in tropical population: clinical course, cause, and early predictors of outcome. Hepatology 1996; 23: 1448-55. Bernal W. Changing patterns of causation and the use of transplantation in the United Kingdom. Semin Liver Dis 2003; 23: 227–37. Wei G, Kalaitzakis E, Bergquist A, Bjornsson E. Long-term follow up of patients with acute liver failure of indeterminate etiology. Scand J Gastroenterol 2008; 43: 984–91. Bernal W, Wendon J. Acute liver failure. N Engl J Med 2013; 369: 2525–34. Bernal W, Auzinger G, Dhawan A, Wendon J. Acute liver failure. Lancet 2010; 376: 190–201. Bernal W, Ma Y, Smith HM, Portmann B, Wendon J, Vergani D. The significance of autoantibodies and immunoglobulins in acute liver failure: a cohort study. J Hepatol 2007; 47: 664–70. James LP, Letzig L, Simpson PM, Capparelli E, Roberts DW, Hinson JA, et al. Pharmacokinetics of acetaminophen-protein adducts in adults with acetaminophen overdose and acute liver failure. Drug Metab Dispos 2009; 37: 1779–84. Manka P, Bechmann LP, Coombes JD, Thodou V, Schlattjan M, Kahraman A, et al. Hepatitis E virus infection as a possible cause of acute liver failure in europe. Clin Gastroenterol Hepatol 2015; 13: 1836–42. Lee WM. Acute liver failure in the United States. Semin Liver Dis 2003; 23: 217–26. Schiodt FV, Atillasoy E, Shakil AO, Schiff ER, Caldwell C, Kowdley KV. Etiology and outcome for 295 patients with acute liver failure in the United States. Liver Transpl Surg 1999; 5 (1): 29-34. Polson J, Lee WM. American Association for the Study of Liver Disease. AASLD position paper: the management of acute liver failure. Hepatology 2005; 41: 1179–97. Nabi T, Nabi S, Rafiq N, Shah A. Role of N-acetylcysteine treatment in non-acetaminophen-induced acute liver failure: A prospective study. Saudi J Gastroenterol 2017; 23(3): 169–75. Lee WM, Hynan LS, Rossaro L Fontana RJ, Stravitz RT, Larson AM, et al. Intravenous N-acetylcysteine improves transplant-free survival in early stage non-acetaminophen acute liver failure. Gastroenterology 2009; 137: 856–64. Darweesh SK, Ibrahim MF, El-Tahawy MA. Effect of N-Acetylcysteine on mortality and liver transplantation rate in non-acetaminophen-induced acute liver failure: a multicenter study. Clin Drug Investig. 2017; 37(5): 473-82. Cotgreave IA. N-acetylcysteine pharmacological considerations and experimental and clinical applications. Adv Pharmacol 1997; 38: 205-27. Kharazmi A, Nielsen H, Schiotz PO. N-acetylcysteine inhibits human neutrophil and monocyte chemotaxis and oxidative metabolism. Int J Immunopharmacol 1988; 10: 39-46. Harrison P, Wendon J, Williams R. Evidence of increased guanylate cyclase activation by acetylcysteine in fulminant hepatic failure. Hepatology 1996; 23 (5): 1067–72. Harrison PM, Wendon JA, Gimson AE, Alexander GJ, Williams R. Improvement by acetylcysteine of hemodynamics and oxygen transport in fulminant hepatic failure. N Engl J Med 1991; 324 (26): 1852–7. Rank N, Michel C, Haertel C. N-acetylcysteine increases liver blood flow and improves liver function in septic shock patients: results of a prospective, randomized, double-blind study. Crit Care Med 2000; 28: 3799–807. Bémeur C, Vaquero J, Desjardins P, Butterworth RF. N-Acetylcysteine attenuates cerebral complications of non-acetaminophen-induced acute liver failure in mice: antioxidant and anti-inflammatory mechanisms. Metab Brain Dis 2010; 25(2): 241-9. Lee WM, Larson AM, Stravitz RT. AASLD Position Paper: The Management of Acute Liver Failure: Update 2011. http://www. aasld.org/practiceguidelines/ Documents/AcuteLiverFailureUpdate2011. pdf. Accessed Jan 2019. Squires JE, McKiernan P, Squires RH. Acute liver failure: an update. Clinics in liver disease. 2018; 22(4): 773-805. Nabi T, Rafiq N, Jamil I. Comparative study of Etiological Profile and Outcome in Acute liver failure. Int J Sci Rep 2019; 5(4): 96-102. Khuroo MS, Kamili S. Aetiology and prognostic factors in acute liver failure in India. J Viral Hepat 2003; 10: 224–31. European Association for the Study of the Liver. EASL Clinical Practical Guidelines on the management of acute (fulminant) liver failure. J Hepatol. 2017; 66(5):1047-81.

Radiance Research AcademyInternational Journal of Current Research and Review2231-21960975-5241123EnglishN2020February10Life SciencesLong Term Studies on the Role of Parasitic Nematode Hexamermis Sp. in Controlling Brown Planthopper in Farmer’s Rice Field of West Bengal, India English0711Pinaki AcharjeeEnglish Chitta Ranjan SatpathiEnglish Malay Kanti ModakEnglishOn farm, trials were carried out at rainfed rice growing areas of West Bengal, India during Kharif(rainy) season 2003-04 and an average population of parasitic nematode Hexamermis sp. counted from the same field during 2003-04 to 2018-19 in Birbhum. A similar set of experiment was conducted during boro(summer) season 2008-09 in Bankura and average population of Hexamermis sp. was also calculated from the same field during 2008-09 to 2018-19. Each trial comprised three treatments viz (i) Natural Biological Control (NBC) with no pesticide application throughout the crop season (ii)Need based protection (NBP)- judged by periodic monitoring of brown planthopper population and (iii) Schedule treatment (ST)- involving application of insecticides following usual package of practices. The study revealed that NBC resulted in maintaining highest level of parasitism of Brown Plant hopper by this parasite Nematode as compared to NBP and ST. Identical results were also obtained from 15 years and 10 years average data from Birbhum and Bankura during kharif (rainy) and boro(summer) season rice respectively.. EnglishBrown planthopper, Hexamermis sp., Natural Biological Control, Need Based protection, Scheduled treatment, Parasite, PestIndia is the second largest producer of rice in the  world. Rice being the principal crop occupied 66% of the gross cropped area of eastern India particularly in West Bengal. Brown plant hopper  Nilaparavata lugens Stål has been recognized  as the major biotic stress responsible for significant reduction in yield of rice in west Bengal (Satpathi et al. 2005, Katti et al. 2006) and  about 30% of the natural control of brown plant hopper in eastern India are due to parasitic nematode (Satpathi et al. 2008). Farmers of eastern India have been relying mostly on chemical pesticides for the management of brown plant hopper, however their indiscriminate use  has led to the destruction of the natural  parasites. Hence on farm trials were conducted by National Agricultural Technology Project (NATP) and National Agricultural Innovative project (NAIP) during kharif 2003 & 04 and Boro 2008 & 09 to generate the information on the effect of  different treatment on Hexamermis sp population(Fig-1) in rain fed rice of west Bengal .   Fig 1 Hexamermis sp. emerged out from adult brown planthopper in Birbhum Materials and Methods: Field trials were conducted in 2 villages spread across Birbhum and Bankura districts of West Bengal during kharif (rainy)season of 2003 & 04 and boro (summer) seasons of 2008 & 09. In each village, 3 hectare field was selected in farmer’s field  , where there were three treatment blocks viz  (i) Natural Biological Control (NBC)  with no pesticide application throughout  the crop season  (ii)Need based protection  (NBP)- judged  by periodic monitoring  of brown planthopper population and  (iii) Schedule treatment (ST)- involving application of insecticides where  all the other agronomic Practices are common to three treatments and followed as per recommended package of practices. The population of brown planthoppers were recorded randomly from 50 hills in each sub plot at weekly interval. For estimation of parasitism the mummified adult and nymphs were collected at regular interval and released on potted plant for laboratory study. The infected hopper pests  were split horizontally and kept in containers with small quantity of water and was collected and retained for examination. Maintaining the identical treatment procedure, the data were collected from  one acre area at the same locality for last 15 years from 2004-2005 to  2018 -19 during Kharif (rainy) and 10 years from 2009-10 to 2018-19 during rabi (summer ) seasons to  estimate  the population level of  Hexamermis sp. in farmer’s field of rain fed rice growing areas of West Bengal. The treatments are applied in each plot is given in Table-1. Result and Discussions   The fifteen years  average(2004-18) data presented in Table-2 showed that at Birbhum district  the percent of parasitisation was low 0.8 to 5.7 during the Kharif season 2008 at 60 DAT and the significant differences were there  among the treatments. However the percentage of parasitism was recorded up to 32.60% in NBC treatment showed significantly higher in the range of 18.60-32.60% compared to 1.44 to 4.66% in schedule treatment (ST) and 4.00 to 13.57% in Need Based Protection (NBP) during 70 to 130 DAT. The data confirmed the results of  Satpathi et al. 2011 as given in Table-2. Although the percentage of parasitism of last 15 years (2005-19) was low at 60 DAT during kharif season in another study but the higher parasitism in the range of 16.00 to 34.00%, 2.00to5.50%,4.20 to 14.00 % were  recorded in NBC, ST and NBP during 70 to130 DAT respectively.  Identical results were also obtained in the same field in 2003 which indicated that the parasitic nematode   population drastically reduced due to the indiscriminate use of pesticides as given inTable-3. At Bankura the ten years average data (2009-10 to 2018-19) on percentage of parasitism was very low in the range of 1.80 to 3.2 % in NBC treatment during boro(summer) season significantly higher as compare 0.32 to 0.35 % in ST and 0.5 to 1.00 in NBP during 90 to 110 DAT.    The observation on average population on Hexamermis sp. also confirmed the result of 2003 in the same field where the nematode population appeared for short period as given in Table-4. The result corroborated the study of previous workers from  most  of the rice growing areas round   the world. Mention may be made of the natural incidence of parasitism by  Hexamermis sp on BPH was first reported in south India by Manjunath (1978) and in eastern india by Satpathi  (1999). In addition to this  Grewal et al.  (2006) recorded it in Asia and Pena & Shepared (1985) recorded 50% parasitisation of BHP by Hexamermis sp. in Phillippines. Heong (1983) also reported that an entomopathogenic nematode Amphimermis  unka K&I  caused high mortality  of hoppers pest in China. Ramani, (2003) also reported that mermathrid  Hexamermis sp. was most important  nymphal /adult parasitoid from India . Satpathi et al. (2008) studied in detail about the factor affecting abundance of parasitic nematode Hexamermis sp. in eastern India where the nematode started to build up its population in the month of September starting with very low number of 3 to4 per 100  brown plathopper and two distinct population  peaks were observed with population level of 18.52 and 35.00 per 100 BPH. During first and last week of October respectively. From behavioral study with respect to the ecological niche of the host and parasite a relationship was drawn between Hexamermis sp . and Nilaparvata lugens Stål  in rice crop in Eastern India where it was recorded that peak population of this parasitic nematode was usually found a week after peak appearance of BPH in rice field but the temperature range of 25 to30ºC and relative humidity of 60 to80% were conducive for population build up of both this host as well as parasite in the rice field ( Satpathi 2009) .The quantification of role of Hexamermis sp in controlling brown planthopper was first initiated  with respect to the different plant protection measured was fist initiated in West Bengal during 2003 to 2009 (Satpathi et al.2011)  and this long term data may also taken as consideration for one of the component of biological control in most of the rice growing areas of West Bengal. Conclusion:                                     From the intensive study of last fifteen years during kharif(rainy) season and ten years during boro(summer) season in rainfed rice growing areas of West Bengal, it is to be concluded that Natural Biological control (NBC) had shown the optimum result by exhibiting higher parasitism as compare with that of Schedule Treatment (ST) and Need Based Protection (NBP) due to the considerable reduction the number of application  of insecticide.  Both the Need Based Protection  (NBP) and scheduled protection (ST)resulted in optimum build up of Hexamermis sp population akin to that natural biological control (NBC) making it more environment  friendly. Acknowledgement The  authors are thankful to the Director of Research, Bidhan Chandra Krshi Viswavidyalaya, Kalayani, Nadia, West Bengal for providing the facilities to carry out the experiment.  We gratefully acknowledge the financial support received from ICAR under the World Bank aided National Agricultural Technology Project (NATP)and National Agricultural Innovative  Project(NAIP) during the course of study. Englishhttp://ijcrr.com/abstract.php?article_id=2652http://ijcrr.com/article_html.php?did=2652Gururaj Katti, Pasalu I.C, Varma N.R.G, Dhandapani N (2001) Quantification of natural biological control in rice ecosystem for possible exploitation in rice  IPM.  Indian Journal of Entomology 63(4)  : 439-444 Gururaj K., Pasalu I.C., Dani R.C., Bora D.K ., Singh, M.P., Satpathi C.R., Reddy P.S., Venkateswariu ,B (2006) Integrated pest Management  in rainfed rice production system of india a farmers partipatory study Oryza (43)4 pp 296-304. Satpathi C.R., Mukhopadhyay A.K., Katti, G., Pasalu I.C, Venkateswarlu, B. (2005) Quantitication of the role of natural biological control in farmer s ricefield in west Bengal . Indian journal of Entomology 67(3) :211-213 Satpathi C.R., Sarkar, A., Acharjee, P. (2008) Factors affecting abundance of Hexamermis sp in rice plant in Eastern India, International Journal of Nematology 18 (1) :75-78. Satpathi C.R. 2009 Relationship between parasitic nematode, Hexamermis sp.and brown planthopper, Nilaparvata lugens Stål in rice crop in Eastern India. International Journal of Nematology 19 (1) :120 Satpathi Chitta Ranjan, Acharjee,Pinaki , Katti, Gururaj, and Prasad, Yenumula Gerard(2011) Quantification of the role of parasitic nematode Hexamermis sp. in controlling brown planthopper in farmers’ rice fieild in Eastern India witnh special reference to West Bengal. Pub in National congress of Parasitology on Oct.30Nov 2011 at the Department of Zoology, University of Kalyani , WB, India Grewal P.S., Ehlers,R. and Shapiro, D.I. (2006) Nematodes as bio control agents  Wollingford, UK. CBA international  pp 480 Manjunath T.M. (1978)  Two nematode parasites of rice brown planthopper in India. International Rice Research Newsletter 3,11. Satpathi C.R.(1999) Record of Nematode (Hexamermis sp) on brown planthopper  in West Bengal . Insect Environment  5:89 Pena N.P & B.M. Shepard, 1985. Parasitism of nematode of three species of hopper pests of rice in Laguna, Philippines;  International Rice Research Newsletter(10)19-20      Heong K.L (1983) Studies on natural enemies of rice insect Pest Acta Phytophlacica Sinica, 10:224 Ramani S. (2003) Biological control of rice insect pests, Biological control of crop pests in India, Kalyani Publisher. pp 349.

Radiance Research AcademyInternational Journal of Current Research and Review2231-21960975-5241123EnglishN2020February10HealthcareDesign and Development of Polyherbal Formulation for Arthritis English1218Mishra SaurabhEnglishFrom long back herbal drugs are used for treatment of arthritis and other joint disorders which require potent analgesic and anti-inflammatory action together with pharmacological activities which can induce the remission by modifying the course of the disease. Our ancient text of Ayurveda like Charak Samhita, Charak Sutrasthan, Sushrut Sutrasthan, Bhavprakash, Rajnighantu prescribe the use of different Herbo-mineral agents in such diseased conditions, which gives a vision to different researcher to investigate the plant component and their pharmacological action for their therapeutic use. The present work is focused on the development of new polyherbal anti-arthritic formulation by carefully selecting few herbs for treatment of arthritis, which may full fill the criteria of Herbal combination therapy i.e. provide synergistic action without any interaction so that less dose may be required and different organ or system affected by the disease can be targeted with focus on joint inflammation and pain. To achieve this objective four drugs were selected, which were already reported for their potent anti-rheumatic and anti-inflammatory activity i.e. Guggal, Sunth, Arand, Giloe and two diuretic drugs i.e. Gokhru and Punarnava are added in the formulations, which helps in treatment of associated disorders. The combination suitability was derived from the Ancient literature consulting Ayruvedic physicians. Finally the tablet dosage form was prepared from a developed Polyherbal formulation. Four different batches are prepared by changing the binder in tablet formulation and evaluated for standard quality parameters for the tablet. EnglishMishra Saurabh, Department of Pharmacy, M.J.P. Rohilkhand University, Bareilly-243006, (Uttar Pradesh), India.http://ijcrr.com/abstract.php?article_id=4361http://ijcrr.com/article_html.php?did=4361