Case Report Ventricular Tachycardia Storm in Cardiac Sarcoidosis: A 76-Day-ICU-Nightmare

Abstract Ventricular Tachycardia (VT) is a life threatening complication in a patient with Cardiac Sarcoidosis. The management becomes extremely challenging when it is refractory to traditional anti-arrhythmic drugs. Herein, we describe a case where a 33-year-old patient with VT storm, with an implantable cardioverter defibrillator (ICD), was managed by medications, sedation, ventilator support and multiple Radio-Frequency (RF) ablation procedures over 76-days ICU stay period

PHARMACOGNOSTIC AND PHYTOCHEMICAL EVALUATION OF TREMA ORIENTALIS LEAF

Trema orientalis (Ulmaceae) is native to India. This tree species has been of interest to researchers because it is a medicinal plant employed in the Indian indigenous system of medicine. Pharmacognostic standardization, physic-chemical evaluation of the leafs of Trema orientalis was carried out to determine its macro-and micro-scopical characters and also some insoluble ash and sulphated ash values, alcohol-and water-soluble extractive values were determined for phytochemical evaluations. Preliminary phytochemical screening was also done to detect different phytoconstituents. Microscopically, Leaf showed trichomes, Lamina, midrib regions, stomata and calcium oxalate crystals. Powder microscopy showed mesophyll region, abundant xylem vessels with annular thickenings and xylem vessels, Unicellular, multiseriate covering trichomes and glandular trichomes, Rosette and prism shape calcium oxalate crystals, Anomocytic stomata. Total ash was approximately two times and four times more than acid insoluble and water soluble as, respectively Ethanol soluble extractive was approximately two times higher than water soluble extractive. TLC of petroleum ether and ethanol extract showed five spots using Hexane: Ethyl acetate (12:4) and four spot using Choloroform: Ethyl acetate (5:4). Phytochemically, root exhibited phytosterols, Flavanoids, Tannin and phenolic compounds

Postnatal liver growth and regeneration are independent of c-myc in a mouse model of conditional hepatic c-myc deletion

<p>Abstract</p> <p>Background</p> <p>The transcription factor <it>c-myc </it>regulates genes involved in hepatocyte growth, proliferation, metabolism, and differentiation. It has also been assigned roles in liver development and regeneration. In previous studies, we made the unexpected observation that c-Myc protein levels were similar in proliferating fetal liver and quiescent adult liver with c-Myc displaying nucleolar localization in the latter. In order to investigate the functional role of c-Myc in adult liver, we have developed a hepatocyte-specific <it>c-myc </it>knockout mouse, <it>c-myc^fl/fl</it>;<it>Alb</it>-<it>Cre</it>.</p> <p>Results</p> <p>Liver weight to body weight ratios were similar in control and <it>c-myc </it>deficient mice. Liver architecture was unaffected. Conditional <it>c-myc </it>deletion did not result in compensatory induction of other <it>myc </it>family members or in c-Myc's binding partner Max. Floxed <it>c-myc </it>did have a negative effect on <it>Alb</it>-Cre expression at 4 weeks of age. To explore this relationship further, we used the Rosa26 reporter line to assay Cre activity in the <it>c-myc </it>floxed mice. No significant difference in Alb-Cre activity was found between control and <it>c-myc^fl/fl</it>mice. c<it>-myc </it>deficient mice were studied in a nonproliferative model of liver growth, fasting for 48 hr followed by a 24 hr refeeding period. Fasting resulted in a decrease in liver mass and liver protein, both of which recovered upon 24 h of refeeding in the c<it>-myc^fl/fl;Alb</it>-Cre animals. There was also no effect of reducing <it>c-myc </it>on recovery of liver mass following 2/3 partial hepatectomy.</p> <p>Conclusions</p> <p>c-Myc appears to be dispensable for normal liver growth during the postnatal period, restoration of liver mass following partial hepatectomy and recovery from fasting.</p

Heavy Flavour Baryons in Hyper Central Model

Heavy flavor baryons containing single and double charm (beauty) quarks with light flavor combinations are studied using the hyper central description of the three-body problem. The confinement potential is assumed as hyper central coulomb plus power potential with power index $\upsilon$. The ground state masses of the heavy flavor, $J^P={1/2}^+$ and ${3/2}^+$ baryons are computed for different power index, $\nu$ starting from 0.5 to 2.0. The predicted masses are found to attain a saturated value in each case of quark combinations beyond the power index $\nu=1.0$.Comment: 10 pages, 4 figure

Effect of ondansetron on sensory level produced by intrathecal bupivacaine

Background: For spinal anesthesia there are drugs which can increase the level and quality of analgesia. Any drug which decreases sensory block level in spinal anesthesia is of great concern as it may need analgesic, sedative, supplement or even conversion to general anesthesia. Ondansetron is one such drug which has been reported to decrease the height of sensory block achieved after subarachnoid administration of bupivacaine. In this prospective observational study, we studied the effect of administration of ondansetron on the level of the sensory block achieved after subarachnoid blockade.Methods: In Group II, 4 mg ondansetron was given and 15 mins before giving spinal anesthesia Group II against control group receiving 2 ml saline intravenous (Group I). 15 mins before giving spinal anesthesia. Both groups received 3.5 ml of bupivacaine heavy was given intrathecally. Sensory and motor block was assessed 5, 15, and 30 mins. We analyzed both highest spinal block level achieved and time to regress to L1 level.Results: We found that in Group II both highest level of sensory block (T6 by median method) duration to regress to L1 level (1.43±0.22 hrs) was lesser as compared to group I and Group III T4 by median method and time to regress from T6 to L1 Group I 2.03±0.06 hrs Group III 1.84±0.27 hrs. Motor block did not differ between groups.Conclusions: We concluded that probably ondansetron was responsible for lower spinal block level and early recovery from spinal anesthesia after intrathecal bupivacaine and should not be given empirically for nausea and vomiting

Can Physician Champions Improve Kangaroo Care? Trends over 5 Years in Rural Western India

Introduction: In 2013, approximately 2.8 million children worldwide died within the neonatal period. India is at the epicenter of this tragedy, accounting for one-third of all neonatal mortalities. Prematurity and/or with low birth weight are the leading cause of neonatal mortality and India has the highest number of neonates born preterm and weighing less than 2,500 grams worldwide. It is estimated that Kangaroo Care can avert up to 48% of all neonatal deaths among premature babies by 2025. However, the promise of Kangaroo Care as a low-cost, safe, and efficacious intervention to reduce neonatal mortality in India has not been realized due to suboptimal implementation. Physician champions can improve Kangaroo Care implementation, but the magnitude of their impact is unknown. Methods: A retrospective cohort study of 648 infants identified using clinical data from a NICU located in rural western India. Physicians who led Kangaroo Care training sessions with neonates and coached peer healthcare professionals were considered champions. Two Kangaroo Care champions were on staff full-time from January 2010 through June 2011, part-time from July 2011 through June 2012, and absent thereafter. We examined the effect of the withdrawal of physician champions on overall use using logistic regression, time to initiation using competing risk cox regression, and intensity using linear regression models of the two main components of Kangaroo Care, skin-to-skin care and breastfeeding, separately. Findings: In comparison to when Kangaroo Care champions were present, their absence was associated with a 45% decrease in the odds of receiving skin-to-skin care (95% CI): 64% to 17%), 38% decrease in the rate of initiation of skin-to-skin care (95% CI: 53% to 82%), and on average, 1.47 less hours of skin-to-skin care (95% CI: -2.07 to -0.86). Breastfeeding practices were similar across different champion environments. Interpretation: Withdrawal of Kangaroo Care champions from neonatal intensive care unit in rural western India is associated with diminished administration, delayed initiation, and shorter duration of skin-to-skin care, but did not impact breastfeeding practices. Training healthcare workers and community stakeholders to become champions could help in scaling up and maintaining Kangaroo Care practices. Funding: This research was supported by TL1-TR001454 (to A.S.) from National Center for Advancing Translational Sciences, and P60-MD006912-05 (to J.A.) from National Institute on Minority Health and Disparities. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH

Properties of Light Flavour Baryons in Hypercentral quark model

The light flavour baryons are studied within the quark model using the hyper central description of the three-body system. The confinement potential is assumed as hypercentral coulomb plus power potential ($hCPP_\nu$) with power index $\nu$. The masses and magnetic moments of light flavour baryons are computed for different power index, $\nu$ starting from 0.5 to 1.5. The predicted masses and magnetic moments are found to attain a saturated value with respect to variation in $\nu$ beyond the power index $\nu>$ 1.0. Further we computed transition magnetic moments and radiative decay width of light flavour baryons. The results are in good agreement with known experimental as well as other theoretical models.Comment: Accepted in Pramana J. of Physic

The Profile of Non-Communicable Disease (NCD) research in the Middle East and North Africa (MENA) region: Analyzing the NCD burden, research outputs and international research collaboration.

OBJECTIVES: Despite the rising risk factor exposure and non-communicable disease (NCD) mortality across the Middle East and the North African (MENA) region, public health policy responses have been slow and appear discordant with the social, economic and political circumstances in each country. Good health policy and outcomes are intimately linked to a research-active culture, particularly in NCD. In this study we present the results of a comprehensive analysis of NCD research with particular a focus on cancer, diabetes and cardiovascular disease in 10 key countries that represent a spectrum across MENA between 1991 and 2018. METHODS: The study uses a well validated bibliometric approach to undertake a quantitative analysis of research output in the ten leading countries in biomedical research in the MENA region on the basis of articles and reviews in the Web of Science database. We used filters for each of the three NCDs and biomedical research to identify relevant papers in the WoS. The countries selected for the analyses were based on the volume of research outputs during the period of analysis and stability, included Egypt, Iran, Jordan, Kuwait, Lebanon, Oman, Qatar, Saudi Arabia, Turkey and the United Arab Emirates. RESULTS: A total of 495,108 biomedical papers were found in 12,341 journals for the ten MENA countries (here we consider Turkey in the context of MENA). For all three NCDs, Turkey's output is consistently the highest. Iran has had considerable growth in research output to occupy second place across all three NCDs. It appears that, relative to their wealth (measured by GDP), some MENA countries, particularly Oman, Qatar, Kuwait and the United Arab Emirates, are substantially under-investing in biomedical research. In terms of investment on particular NCDs, we note the relatively greater commitment on cancer research compared with diabetes or cardiovascular disease in most MENA countries, despite cardiovascular disease causing the greatest health-related burden. When considering the citation impact of research outputs, there have been marked rises in citation scores in Qatar, Lebanon, United Arab Emirates and Oman. However, Turkey, which has the largest biomedical research output in the Middle East has the lowest citation scores overall. The level of intra-regional collaboration in NCD research is highly variable. Saudi Arabia and Egypt are the dominant research collaborators across the MENA region. However, Turkey and Iran, which are amongst the leading research-active countries in the area, show little evidence of collaboration. With respect to international collaboration, the United States and United Kingdom are the dominant research partners across the region followed by Germany and France. CONCLUSION: The increase in research activity in NCDs across the MENA region countries during the time period of analysis may signal both an increasing focus on NCDs which reflects general global trends, and greater investment in research in some countries. However, there are several risks to the sustainability of these improvements that have been identified in particular countries within the region. For example, a lack of suitably trained researchers, low political commitment and poor financial support, and minimal international collaboration which is essential for wider global impact