Pattern of antimicrobials use in chronic leg ulcers at a tertiary care hospital

Background: Chronic leg ulcers are common among elderly population with major risk factors being diabetes, smoking etc., and their sequelae are the most common cause of disability and hospital admission with a significant impact on the quality of life. This study was taken up to evaluate usage of Antimicrobial agents (AMA) in chronic leg ulcers using WHO prescribing indicators.Methods: A prospective, observational study, in which 101 prescriptions with antibiotics, prescribed for cases of chronic leg ulcer, were collected from the Department of Surgery, analysed and assessed using WHO prescribing indicators.Results: One hundred and one prescriptions collected over a period of 6 weeks, were analysed using WHO prescribing indicators. Total number of drugs prescribed was 721. Average number of drugs per prescription was 7. 36% of the drugs were prescribed by their generic name and only 35% of the total drugs were from EML (2011). Prescriptions of AMA accounted for 34.4%; most common being Beta lactam (25.6%) followed by Linezolid (20.8%), Metronidazole (17.7%), Fluoroquinolones (7.6%) and combination antibiotics (28%). All patients received one or more injections. The average duration of AMA therapy was 5 days.Conclusions: Majority of the AMAs used in the treatment of chronic leg ulcers were injection. However prescriptions from Essential Medicine List and by generic name were less frequent

An update of electro surgery devices options in minimal invasive surgery: a review

The rate and variety of advances in energy sealing technology in the last two decades has heralded new opportunities in laparoscopic and minimally invasive surgery. Reduced operating times, lower postoperative pain scores, and shorter length of stay are offset by the additional cost of such instruments. Critical to obtaining optimal clinical effects and reducing potential complications, is a thorough understanding of the proper use of each energy modality. No single device has shown a significant superiority over the other. However best combination to have is harmonic along with ligasure or perhaps now the latest wireless sonicision with ligasure to undertake most of the surgeries. Thunderbeat has advantages like faster cutting speed and minimal instrument changes. Ferromagnetic wand is the fastest available instrument with unique features. Argon beam coagulation has certain specific uses and is best for fulguration and it is definitely advantageous to have it in OT. Sonicision offered wireless ergonomics and better manoeuvrability, cheapest VSD was the conventional bipolar

Load Balancing By Cloud Computing

With the internet getting so popular data sharing and security of personal data has gain much more importance than before. Cloud provides and efficient way to outsource the data either online or offline but data security becomes one of the major issues in unreliable multi-cloud environment. This paper addresses the issues in multi-cloud environment and also provides a way to provide better security in multi-cloud environment. Further it discusses the different encryption algorithms that can be used to maintain a design framework for cloud environment

Evaluation of Indole production and Tellurite reduction for speciation of Candida species and Trichosporon species

Background: Candidiasis is one of the commonest infections in man, along with Trichosporon infection. Conventional methods for identification are often delayed, which leads to delay in empirical therapy in these infections. Methods: We here describe two newer methods, i.e. Indole production and Tellurite reduction for identification of these two genera. Results: Both these tests, combined together, were equally good as compared to conventional identification techniques. Conclusion: Indole production and Tellurite reduction are useful tests to identify these common yeast pathogens in the laboratory

Molecular docking and inhibition of matrix metalloproteinase-2 by novel difluorinatedbenzylidene curcumin analog

We recently described the synthesis and characterization of a novel difluorinatedbenzylidene analog of curcumin, commonly referred as CDF, which demonstrated significantly enhanced bioavailability and in vivo anticancer activity. CDF targets many factors similar to curcumin, albeit with more potency, as reported previously. To further highlight this differential behavior of CDF, we chose matrix metalloproteinase protein MMP-2 which is involved in the processes of invasion and metastasis of human tumors. Both curcumin and CDF were characterized for their binding characteristics using in silico docking studies; they were also evaluated via biological assays involving gelatin zymography, miRNA analysis, invasion assays and ELISA. CDF was found to inhibit MMP-2 expression and activity in A549 and H1299 NSCLC cells much more effectively than curcumin, validating molecular modeling results. miR-874, an MMP-2-targeting miRNA, was up-regulated by CDF. Thus, it appears that CDF can inhibit MMP-2 through multiple mechanisms. Our results are suggestive of a more potent inhibition of invasion and metastasis by CDF, compared to curcumin, thus warranting its further evaluation as an effective anticancer agent

Enhanced Efficacy of Aurora Kinase Inhibitors in G2/M Checkpoint Deficient TP53 Mutant Uterine Carcinomas Is Linked to the Summation of LKB1-AKT-p53 Interactions.

Uterine carcinoma (UC) is the most common gynecologic malignancy in the United States. TP53 mutant UCs cause a disproportionate number of deaths due to limited therapies for these tumors and the lack of mechanistic understanding of their fundamental vulnerabilities. Here we sought to understand the functional and therapeutic relevance of TP53 mutations in UC. We functionally profiled targetable TP53 dependent DNA damage repair and cell cycle control pathways in a panel of TP53 mutant UC cell lines and patient-derived organoids. There were no consistent defects in DNA damage repair pathways. Rather, most models demonstrated dependence on defective G2/M cell cycle checkpoints and subsequent upregulation of Aurora kinase-LKB1-p53-AKT signaling in the setting of baseline mitotic defects. This combination makes them sensitive to Aurora kinase inhibition. Resistant lines demonstrated an intact G2/M checkpoint, and combining Aurora kinase and WEE1 inhibitors, which then push these cells through mitosis with Aurora kinase inhibitor-induced spindle defects, led to apoptosis in these cases. Overall, this work presents Aurora kinase inhibitors alone or in combination with WEE1 inhibitors as relevant mechanism driven therapies for TP53 mutant UCs. Context specific functional assessment of the G2/M checkpoint may serve as a biomarker in identifying Aurora kinase inhibitor sensitive tumors

Widespread fear of dengue transmission but poor practices of dengue prevention : A study in the slums of Delhi, India

Background This study has been conducted to throw light on the knowledge and practices related to dengue fever among the poor population living in Delhi's slums. Materials A household survey was conducted in 2013 among 3,350 households. The households were stratified by a number of variables related to socio-economic status and health events such as hospitalisation. The data collection was completed through face-to-face interviews conducted with the help of 25 field investigators. Results About 8% of the households had at least one diagnosed dengue case. In comparison to the population surveyed, teenagers (15-19 years) and adults (30-34 years) were more affected whereas children under four years of age were underrepresented. Housewives are more affected by dengue (24%) compared to their share of the population surveyed (17%). Despite the fact that 77% of the respondents are worried about mosquitoes, only 43% of them monitor environment to avoid the presence of breeding sites. Conclusion One cannot exclude the possibility that though young children under the age of four years are exposed to the virus, either their cases were asymptomatic or family members infected during this period had potentially more serious symptoms leading to hospitalisation. This result could thus be explained by budget-related health choices made by this population which do not favour small children. Educational programs should target housewives to improve their impact, as they are the ones mostly responsible for water storage and cleanliness of the house and its neighbourhood. Even with a dengue experience and potentially an acute perception of the risk and its factors, a proper management of environmental conditions is lacking. This along with the fact that word-of-mouth is the main source of information quoted should be a message for municipality health workers to give door-to-door information on how to prevent breeding sites and dengue infection

Amphipathic helices target perilipins 1-3 to lipid droplets

Perilipins (PLINs) play a key role in energy storage by orchestrating the activity of lipases on the surface of lipid droplets. Failure of this activity results in severe metabolic disease in humans. Unlike all other lipid droplet-associated proteins, PLINs localize almost exclusively to the phospholipid monolayer surrounding the droplet. To understand how they sense and associate with the unique topology of the droplet surface, we studied the localization of human PLINs inSaccharomyces cerevisiae,demonstrating that the targeting mechanism is highly conserved and that 11-mer repeat regions are sufficient for droplet targeting. Mutations designed to disrupt folding of this region into amphipathic helices (AHs) significantly decreased lipid droplet targetingin vivoandin vitro Finally, we demonstrated a substantial increase in the helicity of this region in the presence of detergent micelles, which was prevented by an AH-disrupting missense mutation. We conclude that highly conserved 11-mer repeat regions of PLINs target lipid droplets by folding into AHs on the droplet surface, thus enabling PLINs to regulate the interface between the hydrophobic lipid core and its surrounding hydrophilic environment.This work was supported by grants from The Wellcome Trust (091551 and 107064 to DBS), the U.K. NIHR Cambridge Biomedical Research Centre, the Medical Research Council (G0701446 to SS and a Doctoral training grant awarded to the University of Cambridge for ERR), core facilities at the MRC Metabolic Diseases Unit (MC_UU_12012/5) and by the Innovative Medicines Initiative Joint Undertaking, EMIF-Metabolism award.This is the final version of the article. It first appeared from ASBMB via https://doi.org/10.1074/jbc.M115.69104

Contribution of spatially explicit models to climate change adaptation and mitigation plans for a priority forest habitat

Climate change will impact forest ecosystems, their biodiversity and the livelihoods they sustain. Several adaptation and mitigation strategies to counteract climate change impacts have been proposed for these ecosystems. However, effective implementation of such strategies requires a clear understanding of how climate change will influence the future distribution of forest ecosystems. This study uses maximum entropy modelling (MaxEnt) to predict environmentally suitable areas for cork oak (Quercus suber) woodlands, a socio-economically important forest ecosystem protected by the European Union Habitats Directive. Specifically, we use two climate change scenarios to predict changes in environmental suitability across the entire geographical range of the cork oak and in areas where stands were recently established. Up to 40 % of current environmentally suitable areas for cork oak may be lost by 2070, mainly in northern Africa and southern Iberian Peninsula. Almost 90 % of new cork oak stands are predicted to lose suitability by the end of the century, but future plantations can take advantage of increasing suitability in northern Iberian Peninsula and France. The predicted impacts cross-country borders, showing that a multinational strategy, will be required for cork oak woodland adaptation to climate change. Such a strategy must be regionally adjusted, featuring the protection of refugia sites in southern areas and stimulating sustainable forest management in areas that will keep long-term suitability. Afforestation efforts should also be promoted but must consider environmental suitability and land competition issues