Journal of Clinical and Diagnostic Research, ISSN - 0973 - 709X

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Super Speciality Paediatric Hospital and Post Graduate Teaching Institute, Noida
On Sep 2018




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On Sep 2018




Prof. Somashekhar Nimbalkar

"Over the last few years, we have published our research regularly in Journal of Clinical and Diagnostic Research. Having published in more than 20 high impact journals over the last five years including several high impact ones and reviewing articles for even more journals across my fields of interest, we value our published work in JCDR for their high standards in publishing scientific articles. The ease of submission, the rapid reviews in under a month, the high quality of their reviewers and keen attention to the final process of proofs and publication, ensure that there are no mistakes in the final article. We have been asked clarifications on several occasions and have been happy to provide them and it exemplifies the commitment to quality of the team at JCDR."



Prof. Somashekhar Nimbalkar
Head, Department of Pediatrics, Pramukhswami Medical College, Karamsad
Chairman, Research Group, Charutar Arogya Mandal, Karamsad
National Joint Coordinator - Advanced IAP NNF NRP Program
Ex-Member, Governing Body, National Neonatology Forum, New Delhi
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Department of Pediatrics, Pramukhswami Medical College, Karamsad, Anand, Gujarat.
On Sep 2018




Dr. Kalyani R

"Journal of Clinical and Diagnostic Research is at present a well-known Indian originated scientific journal which started with a humble beginning. I have been associated with this journal since many years. I appreciate the Editor, Dr. Hemant Jain, for his constant effort in bringing up this journal to the present status right from the scratch. The journal is multidisciplinary. It encourages in publishing the scientific articles from postgraduates and also the beginners who start their career. At the same time the journal also caters for the high quality articles from specialty and super-specialty researchers. Hence it provides a platform for the scientist and researchers to publish. The other aspect of it is, the readers get the information regarding the most recent developments in science which can be used for teaching, research, treating patients and to some extent take preventive measures against certain diseases. The journal is contributing immensely to the society at national and international level."



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Sri Devaraj Urs Medical College
Sri Devaraj Urs Academy of Higher Education and Research , Kolar, Karnataka
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Professor and Head
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Lucknow
On Sep 2018




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Calcutta National Medical College & Hospital , Kolkata




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Best regards,
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On Aug 2018




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"Journal of Clinical and Diagnostic Research (JCDR) is a reputed peer reviewed journal and is constantly involved in publishing high quality research articles related to medicine. Its been a great pleasure to be associated with this esteemed journal as a reviewer and as an author for a couple of years. The editorial board consists of many dedicated and reputed experts as its members and they are doing an appreciable work in guiding budding researchers. JCDR is doing a commendable job in scientific research by promoting excellent quality research & review articles and case reports & series. The reviewers provide appropriate suggestions that improve the quality of articles. I strongly recommend my fraternity to encourage JCDR by contributing their valuable research work in this widely accepted, user friendly journal. I hope my collaboration with JCDR will continue for a long time".



Dr. Arundhathi. S
MBBS, MD (Pathology),
Sanjay Gandhi institute of trauma and orthopedics,
Bengaluru.
On Aug 2018




Dr. Mamta Gupta,
"It gives me great pleasure to be associated with JCDR, since last 2-3 years. Since then I have authored, co-authored and reviewed about 25 articles in JCDR. I thank JCDR for giving me an opportunity to improve my own skills as an author and a reviewer.
It 's a multispecialty journal, publishing high quality articles. It gives a platform to the authors to publish their research work which can be available for everyone across the globe to read. The best thing about JCDR is that the full articles of all medical specialties are available as pdf/html for reading free of cost or without institutional subscription, which is not there for other journals. For those who have problem in writing manuscript or do statistical work, JCDR comes for their rescue.
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Reviewing articles is no less a pain staking process and requires in depth perception, knowledge about the topic for review. It requires time and concentration, yet I enjoy doing it. The JCDR website especially for the reviewers is quite user friendly. My suggestions for improving the journal is, more strict review process, so that only high quality articles are published. I find a a good number of articles in Obst. Gynae, hence, a new journal for this specialty titled JCDR-OG can be started. May be a bimonthly or quarterly publication to begin with. Only selected articles should find a place in it.
An yearly reward for the best article authored can also incentivize the authors. Though the process of finding the best article will be not be very easy. I do not know how reviewing process can be improved. If an article is being reviewed by two reviewers, then opinion of one can be communicated to the other or the final opinion of the editor can be communicated to the reviewer if requested for. This will help one’s reviewing skills.
My best wishes to Dr. Hemant Jain and all the editorial staff of JCDR for their untiring efforts to bring out this journal. I strongly recommend medical fraternity to publish their valuable research work in this esteemed journal, JCDR".



Dr. Mamta Gupta
Consultant
(Ex HOD Obs &Gynae, Hindu Rao Hospital and associated NDMC Medical College, Delhi)
Aug 2018




Dr. Rajendra Kumar Ghritlaharey

"I wish to thank Dr. Hemant Jain, Editor-in-Chief Journal of Clinical and Diagnostic Research (JCDR), for asking me to write up few words.
Writing is the representation of language in a textual medium i e; into the words and sentences on paper. Quality medical manuscript writing in particular, demands not only a high-quality research, but also requires accurate and concise communication of findings and conclusions, with adherence to particular journal guidelines. In medical field whether working in teaching, private, or in corporate institution, everyone wants to excel in his / her own field and get recognised by making manuscripts publication.


Authors are the souls of any journal, and deserve much respect. To publish a journal manuscripts are needed from authors. Authors have a great responsibility for producing facts of their work in terms of number and results truthfully and an individual honesty is expected from authors in this regards. Both ways its true "No authors-No manuscripts-No journals" and "No journals–No manuscripts–No authors". Reviewing a manuscript is also a very responsible and important task of any peer-reviewed journal and to be taken seriously. It needs knowledge on the subject, sincerity, honesty and determination. Although the process of reviewing a manuscript is a time consuming task butit is expected to give one's best remarks within the time frame of the journal.
Salient features of the JCDR: It is a biomedical, multidisciplinary (including all medical and dental specialities), e-journal, with wide scope and extensive author support. At the same time, a free text of manuscript is available in HTML and PDF format. There is fast growing authorship and readership with JCDR as this can be judged by the number of articles published in it i e; in Feb 2007 of its first issue, it contained 5 articles only, and now in its recent volume published in April 2011, it contained 67 manuscripts. This e-journal is fulfilling the commitments and objectives sincerely, (as stated by Editor-in-chief in his preface to first edition) i e; to encourage physicians through the internet, especially from the developing countries who witness a spectrum of disease and acquire a wealth of knowledge to publish their experiences to benefit the medical community in patients care. I also feel that many of us have work of substance, newer ideas, adequate clinical materials but poor in medical writing and hesitation to submit the work and need help. JCDR provides authors help in this regards.
Timely publication of journal: Publication of manuscripts and bringing out the issue in time is one of the positive aspects of JCDR and is possible with strong support team in terms of peer reviewers, proof reading, language check, computer operators, etc. This is one of the great reasons for authors to submit their work with JCDR. Another best part of JCDR is "Online first Publications" facilities available for the authors. This facility not only provides the prompt publications of the manuscripts but at the same time also early availability of the manuscripts for the readers.
Indexation and online availability: Indexation transforms the journal in some sense from its local ownership to the worldwide professional community and to the public.JCDR is indexed with Embase & EMbiology, Google Scholar, Index Copernicus, Chemical Abstracts Service, Journal seek Database, Indian Science Abstracts, to name few of them. Manuscriptspublished in JCDR are available on major search engines ie; google, yahoo, msn.
In the era of fast growing newer technologies, and in computer and internet friendly environment the manuscripts preparation, submission, review, revision, etc and all can be done and checked with a click from all corer of the world, at any time. Of course there is always a scope for improvement in every field and none is perfect. To progress, one needs to identify the areas of one's weakness and to strengthen them.
It is well said that "happy beginning is half done" and it fits perfectly with JCDR. It has grown considerably and I feel it has already grown up from its infancy to adolescence, achieving the status of standard online e-journal form Indian continent since its inception in Feb 2007. This had been made possible due to the efforts and the hard work put in it. The way the JCDR is improving with every new volume, with good quality original manuscripts, makes it a quality journal for readers. I must thank and congratulate Dr Hemant Jain, Editor-in-Chief JCDR and his team for their sincere efforts, dedication, and determination for making JCDR a fast growing journal.
Every one of us: authors, reviewers, editors, and publisher are responsible for enhancing the stature of the journal. I wish for a great success for JCDR."



Thanking you
With sincere regards
Dr. Rajendra Kumar Ghritlaharey, M.S., M. Ch., FAIS
Associate Professor,
Department of Paediatric Surgery, Gandhi Medical College & Associated
Kamla Nehru & Hamidia Hospitals Bhopal, Madhya Pradesh 462 001 (India)
E-mail: drrajendrak1@rediffmail.com
On May 11,2011




Dr. Shankar P.R.

"On looking back through my Gmail archives after being requested by the journal to write a short editorial about my experiences of publishing with the Journal of Clinical and Diagnostic Research (JCDR), I came across an e-mail from Dr. Hemant Jain, Editor, in March 2007, which introduced the new electronic journal. The main features of the journal which were outlined in the e-mail were extensive author support, cash rewards, the peer review process, and other salient features of the journal.
Over a span of over four years, we (I and my colleagues) have published around 25 articles in the journal. In this editorial, I plan to briefly discuss my experiences of publishing with JCDR and the strengths of the journal and to finally address the areas for improvement.
My experiences of publishing with JCDR: Overall, my experiences of publishing withJCDR have been positive. The best point about the journal is that it responds to queries from the author. This may seem to be simple and not too much to ask for, but unfortunately, many journals in the subcontinent and from many developing countries do not respond or they respond with a long delay to the queries from the authors 1. The reasons could be many, including lack of optimal secretarial and other support. Another problem with many journals is the slowness of the review process. Editorial processing and peer review can take anywhere between a year to two years with some journals. Also, some journals do not keep the contributors informed about the progress of the review process. Due to the long review process, the articles can lose their relevance and topicality. A major benefit with JCDR is the timeliness and promptness of its response. In Dr Jain's e-mail which was sent to me in 2007, before the introduction of the Pre-publishing system, he had stated that he had received my submission and that he would get back to me within seven days and he did!
Most of the manuscripts are published within 3 to 4 months of their submission if they are found to be suitable after the review process. JCDR is published bimonthly and the accepted articles were usually published in the next issue. Recently, due to the increased volume of the submissions, the review process has become slower and it ?? Section can take from 4 to 6 months for the articles to be reviewed. The journal has an extensive author support system and it has recently introduced a paid expedited review process. The journal also mentions the average time for processing the manuscript under different submission systems - regular submission and expedited review.
Strengths of the journal: The journal has an online first facility in which the accepted manuscripts may be published on the website before being included in a regular issue of the journal. This cuts down the time between their acceptance and the publication. The journal is indexed in many databases, though not in PubMed. The editorial board should now take steps to index the journal in PubMed. The journal has a system of notifying readers through e-mail when a new issue is released. Also, the articles are available in both the HTML and the PDF formats. I especially like the new and colorful page format of the journal. Also, the access statistics of the articles are available. The prepublication and the manuscript tracking system are also helpful for the authors.
Areas for improvement: In certain cases, I felt that the peer review process of the manuscripts was not up to international standards and that it should be strengthened. Also, the number of manuscripts in an issue is high and it may be difficult for readers to go through all of them. The journal can consider tightening of the peer review process and increasing the quality standards for the acceptance of the manuscripts. I faced occasional problems with the online manuscript submission (Pre-publishing) system, which have to be addressed.
Overall, the publishing process with JCDR has been smooth, quick and relatively hassle free and I can recommend other authors to consider the journal as an outlet for their work."



Dr. P. Ravi Shankar
KIST Medical College, P.O. Box 14142, Kathmandu, Nepal.
E-mail: ravi.dr.shankar@gmail.com
On April 2011

Important Notice

Original article / research
Year : 2012 | Month : May | Volume : 6 | Issue : 4 | Page : 590 - 592

The Lipid Peroxidation Product as a Marker of Oxidative Stress in Epilepsy

Manmohan Krishna Pandey, Purnima Mittra, P.K. Maheshwari

1. Assistant professor of Medicine, Rohilkhand Medical College & Hospital, Bareilly (U.P.) 243001, India. 2. Assistant Professor of Pathology, Rohilkhand Medical College & Hospital, Bareilly (U.P.) 243001, India. 3. Professor and Head, Neurology Unit, P.G. Department of Medicine, S. N. Medical College, Agra (U.P.)-282003, India.

Correspondence Address :
Manmohan Krishna Pandey
Assistant professor of Medicine,
Rohilkhand Medical College & Hospital,
Bareilly (U.P.)243001, India.
Phone: 9639015013
E-mail: drmkp12@gmail.com

Abstract

Context: Free radicals have been implicated in the development of acute and chronic diseases of the brain e.g. Epilepsy, Cerebrovascular diseases, Parkinson’s disease, Alzheimer’s disease, etc. The present study was designed to assess the oxidative stress in epilepsy, since very few of such studies have been designed in human beings.

Aims: To study the level of the lipid peroxidation products i.e. malondialdehyde (MDA) as a marker of oxidative stress in epilepsy patients.

Settings and Design: This case control study had 170 samples which comprised Group I(n-90) patients of epilepsy as the cases, which were compared with Group II (n-80) which were age and sex matched controls.

Methods and Materials: The lipid peroxidation product i.e. MDA formation was estimated by assessing the levels of thio-barbituric acid reactive substances (TBARS) by using spectrophotometry.

Statistical Analysis Used: The statistical analysis was done by using the SPSS software and the results were described by using the unpaired T test and p values.

Results: In the present study, the mean MDA value in Group I (2.38 ±0.31) was significantly raised (p<0.01) than in Group II (2.15±0.36), thus suggesting that the MDA values were raised in epilepsy. The mean MDA level after 1 year of therapy was 2.25±0.25, with a p value of <0.05, thus suggesting a reduction in the oxidative stress with therapy.

Conclusions: The level of the lipid peroxidation is significantly higher in epilepsy as compared to the control and oxidative stress increases which were found with the duration of the epilepsy. The oxidative stress had no significant difference in the males and females. The oxidative stress was found to reduce on adequate antiepileptic therapy.

Keywords

Malondialdehyde (MDA), Thio- Barbituric Acid Reactive Substances (TBARS), Lipid Peroxidation Product (LPP)

Introduction
Lipids are important components of the cell membrane. Lipid peroxidation is implicated in the pathogenesis of a number of diseases and clinical conditions. These include diabetes, adult respiratory distress syndrome, premature birth disorder, aspects of shock, Parkinson’s disease, Alzheimer’s disease, pre-eclampsia and eclampsia, various chronic inflammatory conditions, ischaemia, reperfusion mediated injury to organs which include the heart, brain and the intestine, atherosclerosis, organ injury which is associated with shock and inflammation, fibrosis, cancer, inflammatory liver injury, anthracycline induced cardiotoxicity, silicosis and pneumoconiosis (1),(2),(3),(4). It has been suggested that an increase in the free radicals may cause neuronal degeneration through lipid peroxidation and a decrease in the glutathione peroxidase levels. The lipid peroxidation product, malondialdehyde (MDA) is commonly used as a measure of the oxidative stress in cells. Lipid peroxidation, being a free radical reaction, it occurs when the hydroxyl radicals, possibly oxygen, react with the unsaturated lipids of the bio-membranes, resulting in the generation of lipid peroxide radicals (ROO•), lipid hydroperoxide (ROOH) and fragmentation products such as MDA (5),(6). This aldehyde is a highly toxic molecule and it should be considered as more than just a marker of lipid peroxidation. Its interaction with the DNA and proteins has often been referred to as potentially mutagenic and atherogenic. Researchers have evaluated the role of oxidative stress in epilepsy in several animal models (Lores et al., (7); Uoda et al., (8); and its correlation in human beings was done by Rao and Rao (9), Wilson (10), and Roktya et al., (11). Our study was planned with the following aims and objectives: • To study the level of the lipid peroxidation product i.e. MDA as a marker of oxidative stress in epilepsy patients. • To compare this with the level in the controls (i.e. without epilepsy).

Material and Methods

Subjects and Methods
This cross-sectional study was conducted at a tertiary care hospital in north India. An informed consent was obtained from all the participants (from parents if participant was minor) and the institutional ethics committee approved the study. Each case of epilepsy was asked to give a detailed clinical history or the attendants of the patients or witnesses were asked to give it. Study Cases The cases were divided in two groups: Group-1: Epileptic cases (n-90) Group-II: Control group (n-80) Inclusion Criteria 1. Age between 10 to 60 years, thus ensuring a representative sample of the epileptics, which was comparable with the stand-ardization samples of the questionnaire which was used.

2. The diagnosis of epilepsy was corroborated on the basis of the clinical history or a definitely abnormal electroencephalogram (EEG). 3. A minimum period with epilepsy for one year, during which five or more epileptic attacks had occurred. 4. Both new and follow-up patients were taken for the study. 5. No clinical evidence of a drug overdose and a postictal effect at the time of the assessment.

Exclusion Criteria 1. Patients who were more than 60 years and less than 10 years of age. 2. Patients who were suffering from any other chronic serious physical illness or an organic brain syndrome due to some cause other than epilepsy.

The control groups were persons who visited the hospital during the same period, who were not suffering from epilepsy and were age and sex matched. Methods Estimation of MDA : MDA was estimated by assessing the levels of Thio- Barbituric Acid Reactive Substances (TBARS). The TBARS assay was performed by using MDA equivalents which were derived from tetra-ethoxy-propane. MDA was identified as a product of lipid peroxidation which reacted with TBA to give a pink coloured species that gave an absorbance at 532 nm. The method involved heating of the separated platelets of the patients with the TBA reagent which contained Tri-chloro Acetic acid (TCA), Thio-Barbituric Acid (TBA) and Hydrochloric Acid (HCl). After cooling the solution, it was centrifuged at 2000 rpm and the precipitate which was obtained was removed .The absorbance of the supernatant was determined at 532 nm against a blank that contained all the reagents minus the platelets. The MDA equivalents of the sample were calculated by using an extinction of 1.56 × 105M-1cm-1 (12). The level of MDA was read as nmoles MDA per 109 platelets.

44 patients (30 males and 14 females) were given carbamazepine 600 to 1200 mg per day as per the weight of the case and their MDA levels were measured after one year.

Results

The total number of cases which were included in this study were 170, out of which 105 (61.76%) were males and 65(38.23%) were females. The male to female ratio in this study was 1.6:1. The mean value of MDA in Group I was 2.38 ± 0.31 and in Group II, it was 2.15 ± 0.36 (p<0.01), thus suggesting the occurrence of oxidative stress in epilepsy (Table/Fig 1). A maximum of 29 patients (32.22%) in Group I fell in the age group of 21 to 30 years, followed by 25 in the age group of 15 to 20 years. The mean age of the patients in Group I was 29.72 ± 10.53 and that in Group II was 29.72 ± 10.53, thus suggesting that epilepsy was a disease of the young population (Table/Fig 2). The duration of the epilepsy was compared with the oxidative stress marker in Group-I. Patients with a longer history of epilepsy had higher levels of MDA (Table/Fig 3). 44 patients of Group I were followed up after 1 year of antiepileptic (carbamazepine) treatment according to the weight of the patients. These patients had no seizure for one year. The mean MDA level after one year of therapy was 2.25 ± 0.25 (p value<0.05), thus suggesting a significant difference which showed reduction in the oxidative stress with therapy (Table/Fig 4). It had been already seen in previous studies that carbamazepine itself had an antioxidant effect (13). The most common seizure type in the present studywas partial seizures (44.44%), followed by the generalized type of seizures (35.56%) (Table/Fig 5).

Discussion

Membrane lipids which contain unsaturated fatty acids are particularly sensitive to oxidative stress, and peroxidation of the membrane lipids leads to a disturbance of the membrane integrity (14),(15). The normally damaged membranes are repaired and one important repair mechanism is reacylation of the phospholipids in the membrane. There are reports that lipid peroxidation inhibits this reacylation process (14). The nervous system is more susceptible to the damaging effect of oxidative stress, due to the high content of polyunsaturated fatty acids that are susceptible to lipid peroxidation (16). It receives a large percentage of oxygen and is relatively deficient in antioxidant enzymes. It has been suggested that an increase in the free radicals may cause neuronal degeneration through per-oxidation and decrease in the glutathione peroxidise levels. These free radicals have been implicated in the development of many acute and chronic diseases of the brain, like epilepsy, cerebrovascular disease, Alzheimer’s disease, etc. In the human brain, there is a distinct regional distribution of thio-barbituric-acid (TBA) positive materials in the endogenous pool, with higher levels in the cerebellar vermis and lower levels in the thalamus, cortical regions, substantia nigra, caudate nucleus, pallidum, putamen, thalamus and the pineal gland (17). Oxidative stress exacerbates the aetiology of epilepsy (18). The present study signified the higher levels of oxidative stress in epilepsy than in the age and sex matched controls. This oxidative stress was decreased in patients who took regular antiepileptic medication for one year. The present study was supported by evidences which were provided by the past studies.

References

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Lores Amaiz S, Travackr M, Llesuy S, Rodriguez de Lorez Amaiz G. Regional vulnerability to oxidative stress in a model of experimental epilepsy. Neurochemical Research 1998;23(12): 1477-83.
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Uoda Y, Yokoyama H, Ohya- Nishiguchi H, Kamada H. ESR spectroscopy for the analysis of the hippocampal elimination of a nitroxide radical during Kainic acid-induced seizures in rats. Magnetic Resonance in Medicine 1998 ;40(3): 491-93.
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Wilson J X. Antioxidant defenses of the brain: the role of astrocytes. Can J Physiol Pharmacol 1997; 75 (10-11), 1149-63.
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Rokyta R, Racek J, Holecek V. Free radicals in the nervous system. Cesk Fysiol. 1996 ;45(1):4-12.
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Wojciech S, Elzbieta S, Wojciech K. Evaluation of the influence of the antiepileptic therapy on the antioxidant enzyme activity and the lipid peroxidation in the erythrocytes of children with epilepsy. J Child Neurol 2006; 21:558-62.
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Zaleska MM, Wilson DF. Lipid hydroxyperoxides inhibit the reacylation of phospholipids in the neuronal membranes. J. Neurochem. 1989; 52:255-260.
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Kaneko M, Panagia V, Paolillo G, Majumder S, Ou C, et al. Inhibition of cardiac phosphatidyl ethanolamine- N-methylation by oxygen free radicals. Biochim. Biophys. Acta 1989;1021: 33-38.
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Coyle JT, Puttfarcken. Oxidative stress, glutamate and neurodegenerative disorder. Science 1993;262: 689-93.
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Boehme DH, Kosecki R, Carson S. Lipid peroxidation in human and rat tissue. Brain Research 1977;136:11-21.
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Oliver CN, Starke-Reed PE, Stadtman ER, Lin GJ, Correy JM, Floyd RA. Oxidative damage to the brain proteins, loss of the glutamine synthetase activity and production of free radicals during ischaemia/ reperfusion induced injury to the gerbil brain. Proc Natl Acad Sci USA 1990; 87:5144–47.

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