Bone marrow examination in cases of pancytopenia

Background: Pancytopenia is a relatively common hematological entity. This study was undertaken to find out the various causes of pancytopenia by bone marrow examination of patients admitted to New civil hospital, Surat, Gujarat, India.Methods: This was a prospective study carried out to identify the causes of pancytopenia based on bone marrow examination. Bone marrow examinations were performed in 144 cases for different indications over a period of one year 2015, out of which 40 cases have fulfilled the criteria of pancytopenia.Results: Total 40 cases of pancytopenia were examined during period of one year. The commonest cause of pancytopenia was megaloblastic anemia (35%) followed by aplastic anemia (32.5%). other cause includes acute leukemia, myelodysplastic syndrome (MDS) and round cell tumor.Conclusions: Bone marrow aspiration coupled with trephine biopsy can diagnosed majority cases of pancytopenia. Megaloblastic anemia and aplastic anemia are the commonest causes of pancytopenia. A comprehensive clinical and hematological study of patients with pancytopenia will help in the identification of underlying cause

Epidural labor analgesia: a comparison of mixture of ropivacaine 0.125% with fentanyl versus ropivacaine 0.2% with fentanyl

Background: Ropivacaine is more selective for sensory fibers when compared to other local anesthetics, producing less motor block. This permits better maternal ambulation and also allows for normal progression of labor, which translates into lesser instrumental deliveries and higher vaginal deliveries. Objective was to evaluate 0.125% versus 0.2% ropivacaine, with 2 μg/ml of fentanyl in epidural labor analgesia, regarding their sensory and motor block characteristics.Methods: This prospective study was conducted among 40 patients, 20 in each group [group A (0.125% ropivacaine with 2 µg/ml fentanyl), group B (0.2% ropivacaine with 2 µg/ml fentanyl)], for epidural labor analgesia in obstetrics and gynecology department (labor room). The efficacy of the drugs was tested by comparing the onset of analgesia, duration of labor analgesia, dose requirement, pulse, BP, sensory effect, motor effect, FHR, APGAR score and side effects.Results: Total duration of labor analgesia was 230.25 minutes with 55.68 SD and 186.25 minutes with 57.7 SD in group A and group B respectively (p<0.05). The total dose of ropivacaine used was 81.00 mg and 68.50 mg in group A and B respectively (p<0.05). Total dose of fentanyl required was 94.50 µg and 73.50 µg in group A and group B respectively (p<0.05). There was no significant difference found in hemodynamic parameters in both groups.Conclusions: Both the concentrations are effective in producing epidural labor analgesia. However, onset of analgesia was significantly faster with 0.2% ropivacaine. The required dose of ropivacaine was significantly higher in 0.125% ropivacaine. 0.2% ropivacaine shorten the duration of labor compared to 0.125% ropivacaine

Paromomycin Affects Translation and Vesicle-Mediated Trafficking as Revealed by Proteomics of Paromomycin –Susceptible –Resistant Leishmania donovani

Leishmania donovani is a protozoan parasite that causes visceral leishmaniasis (VL) and is responsible for significant mortality and morbidity. Increasing resistance towards antimonial drugs poses a great challenge in chemotherapy of VL. Paromomycin is an aminoglycosidic antibiotic and is one of the drugs currently being used in the chemotherapy of cutaneous and visceral leishmaniasis. To understand the mode of action of this antibiotic at the molecular level, we have investigated the global proteome differences between the wild type AG83 strain and a paromomycin resistant (PRr) strain of L. donovani. Stable isotope labeling of amino acids in cell culture (SILAC) followed by quantitative mass spectrometry of the wild type AG83 strain and the paromomycin resistant (PRr) strain identified a total of 226 proteins at ≥95% confidence. Data analysis revealed upregulation of 29 proteins and down-regulation of 21 proteins in the PRr strain. Comparative proteomic analysis of the wild type and the paromomycin resistant strains showed upregulation of the ribosomal proteins in the resistant strain indicating role in translation. Elevated levels of glycolytic enzymes and stress proteins were also observed in the PRr strain. Most importantly, we observed upregulation of proteins that may have a role in intracellular survival and vesicular trafficking in the PRr strain. Furthermore, ultra-structural analysis by electron microscopy demonstrated increased number of vesicular vacuoles in PRr strain when compared to the wild-type strain. Drug affinity pull-down assay followed by mass spectrometery identified proteins in L. donovani wild type strain that were specifically and covalently bound to paromomycin. These results provide the first comprehensive insight into the mode of action and underlying mechanism of resistance to paromomycin in Leishmania donovani

Tuberculosis Screening and Treatment of Latent Tuberculosis Infection among International College Students

Tuberculosis (TB) remains in the crosshairs of many public health policies worldwide that are taking aim at eradicating this potentially curable and preventable illness. Although tuberculosis (TB) incidence has been declining in the United States for over a decade, it still remains a serious public health concern. Currently, there is no public health policy that requires the screening of non-immigrant international university students visiting the United States. Given the rising numbers of visiting international students, this population has come under scrutiny as potential vectors of transmission of TB into the United States. Foreign-born persons from countries with consistently elevated TB prevalence rates constitute an important high risk group for both TB exposure and infection in this setting. Although some universities have their own public health protocols, not all universities have a policy of screening international, non-immigrant students for TB. To further investigate the situation, we reviewed the medical charts of international students visiting the University of Florida. Students who visited the health department for evaluation of TB skin tests from January1998 to February 2002 were studied. Of the students with a positive tuberculin test (skin test \u3e10mm induration), 97.6% had normal chest radiographs. Only 31 students (10.8%) agreed to undergo treatment for latent TB infection (LTBI), of which only half completed a six to nine month course and 86.8% were lost to follow-up. To attempt complete eradication of TB from the United States, universities with at-risk populations should consider the implementation of strict guidelines and well defined policies for the screening, follow-up and treatment of active and latent TB in international students

DEVELOPMENT AND VALIDATION OF FIRST ORDER DERIVATIVE SPECTROPHOTOMETRIC METHOD FOR SIMULTANEOUS ESTIMATION OF PARACETAMOL AND TAPENTADOL HYDROCHLORIDE IN TABLET DOSAGE FORM

A simple, precise, accurate and reproducible spectrophotometric method has been developed forSimultaneous estimation of Paracetamol and Tapentadol Hydrochloride by employing first order derivativezero crossing method in 0.1 N Sodium Hydroxide. The first order derivative absorption at 257.1 nm (zerocross point of Paracetamol) was used for quantification of Tapentadol HCl and 289.0 nm (zero cross point ofTapentadol HCl) for quantification of Paracetamol. The linearity was established over the concentrationrange of 15-3

Segmentation of the Retinal Vasculature within Spectral-Domain Optical Coherence Tomography Volumes of Mice

Automated approaches for the segmentation of the retinal vessels are helpful for longitudinal studies of mice using spectral-domain optical coherence tomography (SD-OCT). In the SD-OCT volumes of human eyes, the retinal vasculature can be readily visualized by creating a projected average intensity image in the depth direction. The created projection images can then be segmented using standard approaches. However, in the SD-OCT volumes of mouse eyes, the creation of projection images from the entire volume typically results in very poor images of the vasculature. The purpose of this work is to present and evaluate three machine-learning approaches, namely baseline, single-projection, and all-layers approaches, for the automated segmentation of retinal vessels within SD-OCT volumes of mice. Twenty SD-OCT volumes (400 × 400 × 1024 voxels) from the right eyes of twenty mice were obtained using a Bioptigen SD-OCT machine (Morrisville, NC) to evaluate our methods. The area under the curve (AUC) for the receiver operating characteristic (ROC) curves of the all-layers approach, 0.93, was significantly larger than the AUC for the single-projection (0.91) and baseline (0.88) approach with p < 0.05

Parental perceptions of children's oral health: The Early Childhood Oral Health Impact Scale (ECOHIS)

Abstract Background Dental disease and treatment experience can negatively affect the oral health related quality of life (OHRQL) of preschool aged children and their caregivers. Currently no valid and reliable instrument is available to measure these negative influences in very young children. The objective of this research was to develop the Early Childhood Oral Health Impact Scale (ECOHIS) to measure the OHRQL of preschool children and their families. Methods Twenty-two health professionals evaluated a pool of 45 items that assess the impact of oral health problems on 6-14-year-old children and their families. The health professionals identified 36 items as relevant to preschool children. Thirty parents rated the importance of these 36 items to preschool children; 13 (9 child and 4 family) items were considered important. The 13-item ECOHIS was administered to 295 parents of 5-year-old children to assess construct validity and internal consistency reliability (using Cronbach's alpha). Test-retest reliability was evaluated among another sample of parents (N = 46) using the intraclass correlation coefficient (ICC). Results ECOHIS scores on the child and parent sections indicating worse quality of life were significantly associated with fair or poor parental ratings of their child's general and oral health, and the presence of dental disease in the child. Cronbach's alphas for the child and family sections were 0.91 and 0.95 respectively, and the ICC for test-retest reliability was 0.84. Conclusion The ECOHIS performed well in assessing OHRQL among children and their families. Studies in other populations are needed to further establish the instrument's technical properties

Hemisection- A Window Of Hope For A Perishing Tooth

Mandibular first molars are the most commonly extracted teeth due to dental caries and periodontal disease. These teeth are the major standpoint for occlusion, and also have a wide peri-cemental area. Hence, any defect in the root either mesial or distal, extraction is the most common treatment planned. Under specific conditions, only the diseased part of the tooth can be extracted after an endodontic treatment. A modified fixed partial denture design is fabricated to splint the remaining portion of the tooth to adjacent teeth. This procedure though donting can be easily achieved and maintained successfully

OVI Emission in the Halos of Edge-on Spiral Galaxies

We have used the Far Ultraviolet Spectroscopic Explorer to search for OVI 1031.926, 1037.617 A emission in the halos of the edge-on spiral galaxies NGC4631 and NGC891. In NGC4631, we detected OVI in emission toward a soft X-ray bubble above a region containing numerous Halpha arcs and filaments. The line-of-sight component of the motion of the OVI gas appears to match the underlying disk rotation. The observed OVI luminosities can account for 0.2-2% of the total energy input from supernovae (assuming a full OVI emitting halo) and yield mass flux cooling rates between 0.48 and 2.8 M_sun/yr depending on the model used in the derivations. Based on these findings, we believe it is likely that we are seeing cooling, galactic fountain gas. No emission was detected from the halo of NGC891, a galaxy in a direction with considerably high foreground Galactic extinction.Comment: accepted for publication in ApJ, 16 pages including 4 figure