Prevalence of venous thromboembolism risk factors and prophylactic adequacy among general surgical patients in a tertiary care hospital

AbstractIntroductionVenous thromboembolism (VTE) is a disease manifested as deep vein thrombosis and pulmonary embolism. General surgical procedures are associated with significant risk of precipitating VTE, and despite the surging evidences, it is often overlooked. The study attempted at estimating the prevalence of VTE and bleeding risk factors coupled with the adequacy of thromboprophylaxis administered.MethodologyThe study spanning 1-year duration was executed through collection of data from patients older than 18 years, admitted to the general surgery department of a tertiary care hospital. The data were collected using internally validated data collection form and the appraisal of data was done using SPSS 18.ResultsAmong the 400 subjects enrolled, number of patients in low, moderate, and high risk, as per the Caprini score, was 24%, 35%, and 41%, respectively, with the difference being significant with p<0.001. Bleeding risk was positive in 28% subjects and 36% received any form of prophylaxis other than early ambulation. 28% subjects were identified to have received adequate thromboprophylaxis.ConclusionAlthough the prevalence of 41% individuals at high risk for VTE is comparable to the global prevalence of 41.5%, prophylactic adequacy of 28% was lower than the 33% observed globally. Meticulous planning coupled with operational interventions, such as institutional multidisciplinary thromboprophylactic team, can be an effective strategy at enhancing the prophylactic standards and thereby attaining optimal patient outcomes

Implications of traditional medicine in the treatment of Hepatitis A in Kerala

Introduction: The recent outbreaks of Hepatitis A in Kerala are suggestive of decrease in endemicity as most adults were not exposed during the childhood. In allopathic system of medicine, there is no established treatment for Hepatitis A and hence most people tend to rely on the alternate systems of medicine. The study was aimed at identifying the burden of Hepatitis A in the locality and to uncover the degree of dependence of the people on traditional systems of medicine. Methods: The study spanned over 7 months and was conducted in Malappuram district of Kerala. A simple questionnaire having closed-ended questions was prepared and circulated among the physicians in the area. Demographic and other relevant details were obtained from the patients and the medicine system relied on was scrutinized. Results: Of the 348 patients enrolled, majority of the patients were between the age of 10–30 years. The study revealed that females were more affected than males. Similarly people in rural areas were greater than those from urban areas. Most patients (73.28%) relied on Ayurvedic treatment after one week of onset of symptoms. Discussion and conclusion: The preparations such as triphala which has great efficacy in treatment has to be further studied to establish the pathways and mechanism through which it acts. A collaborative effort between government, modern medicine and alternate medicine system can be highly effective in reducing the outbreaks of such epidemics through proper preventive and therapeutic strategies

Absence seizure associated with coloprep consumption in colonoscopy

Abstract Coloprep is a bowel preparatory solution given before endoscopic procedures to get a unobscured internal vision. It has among its constituents&#8217; sodium sulphate, potassium sulphate and magnesium sulphate which produce an osmotic effect in the bowel. However, the use of such agents in hyponatremic and patients predisposed to seizures can have adverse ramifications. The current case outlines manifestation of absence seizure in a 52-year-old male patient who was administered Coloprep for colonoscopy. There was absence of other predisposing factors and the symptoms were ameliorated using timely identification and rectification of the underlying derangements

Phosphokinome Analysis of Barth Syndrome Lymphoblasts Identify Novel Targets in the Pathophysiology of the Disease

Barth Syndrome (BTHS) is a rare X-linked genetic disease in which the specific biochemical deficit is a reduction in the mitochondrial phospholipid cardiolipin (CL) as a result of a mutation in the CL transacylase tafazzin. We compared the phosphokinome profile in Epstein-Barr-virus-transformed lymphoblasts prepared from a BTHS patient with that of an age-matched control individual. As expected, mass spectrometry analysis revealed a significant (>90%) reduction in CL in BTHS lymphoblasts compared to controls. In addition, increased oxidized phosphatidylcholine (oxPC) and phosphatidylethanolamine (PE) levels were observed in BTHS lymphoblasts compared to control. Given the broad shifts in metabolism associated with BTHS, we hypothesized that marked differences in posttranslational modifications such as phosphorylation would be present in the lymphoblast cells of a BTHS patient. Phosphokinome analysis revealed striking differences in the phosphorylation levels of phosphoproteins in BTHS lymphoblasts compared to control cells. Some phosphorylated proteins, for example, adenosine monophosphate kinase, have been previously validated as bonafide modified phosphorylation targets observed in tafazzin deficiency or under conditions of reduced cellular CL. Thus, we report multiple novel phosphokinome targets in BTHS lymphoblasts and hypothesize that alteration in the phosphokinome profile may provide insight into the pathophysiology of BTHS and potential therapeutic targets.Medicine, Faculty ofNon UBCPathology and Laboratory Medicine, Department ofReviewedFacult