Negotiating Death in Philip Larkin’s “Ambulances” and “Aubade”

“Ambulances” and “Aubade” are two widely read poems of Philip Larkin (1922-1985) which any serious reader of modern poems would be reminded of in these difficult times. The poems help in negotiating and coming to terms with the inevitable fact of life that is death. The imagery of a suffering patient and the way the society responds to such a spectacle is vividly documented. The ebb and flow of emotional flux emanating from the idea of death is uniquely articulated. As a Movement Poet his style in these two poems is traditional but his subject matter is derived from the observations of contemporary life. Despair is one word which haunts the mind on reading the poems. The bleak view of human existence is sharply reflected in the imagery created in the poems. The detachment of which Larkin is capable of as a poet helps in infusing artistic triumph. This artistic detachment shadows the despair forming the tone and tenor of the metaphors used. Use of alliteration in short verses leaves a jarring effect on readers. The color coding like white, red, grey, glossy, dark, is a technique enriching imagery of the poems. Personification of death and un-resting and having neared by a day creates the eerie mood required for the theme of the poems. The rich metaphors used for death bed and death itself are perhaps not very common in modern poetry in English. This paper shall lay threadbare the success of Larkin as a poet in creating a work of artistic excellence out of the most odious idea like death

Social aspects of Code-Switching: An analysis of Pakistani Television advertisements

Code switching is the shift from one language to the other or use of more than one language during conversations or writings. The present research deals with intra-sentential (within one sentence) code switching in the language of television advertisements. To facilitate the socio-linguistic analysis, 12 advertisements of beauty and health care products have been recorded and transcribed from four television channels. The linguistic analysis focuses on the social aspect (gender, geographical background, socioeconomic class, and education) of code switched language in these advertisements. From the analysis and findings, it is concluded the language of advertisements for beauty and health care products reflects a change in linguistic practices and preferences of Pakistani consumers

Pain Abdomen as a Presentation of Congenital Malrotation of Gut: A Case Series

Malrotation of the gut can present at any age but the majority of patients present in neonatal period or early infancy. Most children present with a history of recurrent colicky abdominal pain, vomiting which can be bilious and failure to thrive. Delay in diagnosis leads to increase in mortality and morbidity. Here we present a series of three patients, one girl aged 6 years, one 10 months old boy and one 10 years old boy, who got admitted at our Pediatric Department in a one month period. Patients had a history of recurrent abdominal pain and occasional vomiting, seen and managed by multiple paediatricians and GP doctors with extensive diagnostic workup but never the accurate diagnosis was made. Thorough history was taken and examination done, planned work up done for diagnosis. High index of suspicion is needed in children presenting with recurrent pain in the abdomen. Targeted work-up should be done and patients be kept on follow-up for diagnosis of late presentation of congenital malrotation of the gut

Success Rate of Probing for Congenital Nasolacrimal Duct Obstruction at Various Ages

Purpose: To determine the success rate of probing for congenital nasolacrimal duct obstruction (CNLDO) in various age groups. Methods: One hundred children (118 eyes) aged 4 to 48 months diagnosed with CNLDO were included and divided into 6 groups; group 1: infants 4-6 months of age, group 2: infants from 7 to 12 months, group 3: toddlers 13-18 months of age, group 4: older toddlers 19-24 months old, group 5: children from 25 to 36 months, and group 6: children 37-48 months of age. Probing was performed under general anesthesia in all subjects. All patients were followed at regular intervals up to 6 months postoperatively. Successful probing was documented as complete remission of symptoms 2 weeks following the procedure. Results: The success rate of probing was 100% (2 eyes) in group 1, 94% (47 eyes) in group 2, 84.4% (27 eyes) in group 3, 83.3% (15 eyes) in group 4, 61.5% (8 eyes) in group 5 and 33.3% (1 eye) in group 6; the overall success rate was 84.7% (100 eyes). The majority of eyes, 87.3% (103 eyes), had membranous obstruction while 12.7% (15 eyes) had firm obstruction. The success rate was 92.2% (95 eyes) in eyes with membranous obstruction and 33.3% (5 eyes) in those with firm obstruction. Conclusion: Probing of the nasolacrimal duct under general anesthesia is a safe and viable option as a primary treatment modality for CNLDO. The success rate decreases with increasing age; membranous obstruction resolves in the majority of cases whereas firm obstruction has a poorer outcome

Tuberculosis and diabetes mellitus: Relating immune impact of co-morbidity with challenges in disease management in high burden countries

Mycobacterium tuberculosis (MTB) is the causative agent of TB. TB incidence is high in many low resource settings where limited health systems make it difficult for screening of co-morbid conditions. Susceptibility to TB is increased with coincident diabetes mellitus (DM) or prediabetes. DM leads to chronic, subclinical inflammation in the host leading to compromised protective immunity against MTB, impacting TB treatment. This review focuses on the immunological impact of DM and prediabetes on TB infections, highlighting the importance of having effective diagnostic, treatment and management programs for early identification of hyperglycemia in TB patients to improve treatment outcomes. Further, it describes challenges in monitoring of TB and DM co-morbidity in a high-burden setting

Development of novel polymer haemoglobin based particles as an antioxidant, antibacterial and an oxygen carrier agents

Abstract This innovative work aims to develop highly biocompatible and degradable nanoparticles by encapsulating haemoglobin (Hb) within poly-ε-caprolactone for novel biomedical applications. We used a modified double emulsion solvent evaporation method to fabricate the particles. A Scanning electron microscope (SEM) characterized them for surface morphology. Fourier Transform Infrared Spectroscopy (FTIR) and Ultraviolet–visible spectroscopies (UV–visible) elucidated preserved chemical and biological structure of encapsulated haemoglobin. The airproof equilibrium apparatus obtained the oxygen-carrying capacity and P50 values. The DPPH assay assessed free radical scavenging potential. The antibacterial properties were observed using four different bacterial strains by disk diffusion method. The MTT assay investigates the cytotoxic effects on mouse fibroblast cultured cell lines (L-929). The MTT assay showed that nanoparticles have no toxicity over large concentrations. The well-preserved structure of Hb within particles, no toxicity, high oxygen affinity, P50 value, and IC50 values open the area of new research, which may be used as artificial oxygen carriers, antioxidant, and antibacterial agents, potential therapeutic agents as well as drug carrier particles to treat the cancerous cells. The novelty of this work is the antioxidant and antibacterial properties of developed nanoparticles are not been reported yet. Results showed that the prepared particles have strong antioxidant and antibacterial potential

Prognostic value of miliary versus non-miliary sub-staging in advanced ovarian cancer

WOS: 000404945600010PubMed ID: 28495239Objective. The presence of miliary disease during initial ovarian cancer debulking may reflect a distinct mode of peritoneal spread independent from size-based tumor staging and may explain variation in response to treatment and survival outcomes. To infer the prevalence, presentation and clinical implications of miliary disease we reviewed existing surgical records. Methods. Reports were available for 1008 primary debulking surgeries for ovarian, primary peritoneal or fallopian tube cancer between 2001 and 2015 (685 reports from 2005 to 2015). Clinical outcome data was available for 938 patients. We analyzed a high-stage sub-cohort for survival (N = 436). Results. Most records were evaluable for miliary disease (761/938); for these, the miliary phenotype was highly prevalent (249/761, 32.7%) and often accompanied by ascites (185/249, 74%). While optimal debulking rates were unaffected by miliary disease, total resection (RO) rates were poorer. Liver, stomach, spleen or bladder appeared to be sporadically involved while the omentum, mesentery, bowel, peritoneum and diaphragm were affected simultaneously (Spearman rho > 0.5). Overall, miliary disease was associated with worse progression free survival, overall survival, and time from relapse to death independent of stage. Survival effects were particularly strong for Stage IV disease where median overall survival varied by over 30 months (log-rank p = 0.002). Conclusions. Miliary disease is an identifiable surgical phenotype reflecting a distinct clinical trajectory that adds prognostic information to standard disease burden-based staging. These findings should permit further retrospective investigation in a wider cohort and prompt the consideration of prospective structured operative reporting standards and treatment strategies. (C) 2017 The Authors. Published by Elsevier Inc.National Institutes of HealthUnited States Department of Health & Human ServicesNational Institutes of Health (NIH) - USA [K01LM012100, T32CA108456, P30CA016056]; RPCI-UPCI Ovarian Cancer SPORE [P50CA159981-01A1]; Roswell Park Alliance Foundation; Roswell Park Cancer InstituteThis work was supported by the National Institutes of Health (K01LM012100, T32CA108456, P30CA016056), RPCI-UPCI Ovarian Cancer SPORE (P50CA159981-01A1) and the Roswell Park Alliance Foundation, Roswell Park Cancer Institute. The authors report no conflicts of interest

Host genes that affect progression of AIDS/HIV in India and novel gene therapeutic approaches against HIV

A multitude of host and viral factors play critical role in susceptibility to HIV-1 infection and its subsequent progression to AIDS. Various host factors involved in HIV-1 infection include the chemokine receptors CCR5, CX3CR1, their ligands, RANTES, SDF-1 and cytokines like IL-10, IL-4, among others. The CCR5Δ32 allele is the most important genetic factor known to confer resistance to HIV-1 infection. However, other mutations in CCR5, CX3CR1 and SDF-1 have also been identified in Indian population. Polymorphisms in DC-SIGN, MHC class-I and II molecules are also known to affect HIV-1 progression. These polymorphisms can be utilized as genetic markers for evaluating disease progression and developing effective therapeutics. The review also describes the development of anti-viral therapy, involving the use of catalytic nucleic acids like DNA-enzymes and ribozymes and the expression of ribozymes and si-RNA using lentiviral vectors for stem cell based anti-HIV therapy