Recurrent Painless Haematuria in a Well Child—A Case Report

\ua9 Association of Surgeons of India 2024.We report a case of appendico-vesical fistula (AVF) in a 12-year-old boy presenting with a 2-month history of solely recurrent painless macroscopic haematuria. Ultrasound and MRI scans were suggestive of an urachus remnant with a calculus in the bladder dome. Cystoscopy showed a bladder diverticulum with mucosal inflammation. Open laparotomy eventually revealed the AVF, as a complication of a clinically ‘silent’ acute appendicitis. AVF is a rare complication of acute appendicitis. A literature review identified 17 further paediatric cases. Whilst faecaluria and pneumaturia are pathognomonic for AVF, these were present in only 24% of patients. Most patients presented with recurrent urinary tract infections or urinary symptoms, and most had a history of abdominal pain and vomiting. Imaging studies and cystoscopy were often inconclusive, and most diagnoses were made at surgery. A high index of clinical suspicion helps to guide diagnosis and treatment

Amphotericin B in the management of COVID-19 associated mucormycosis

Background: Amphotericin B is considered the drug of choice for primary treatment of mucormycosis. During second wave of COVID-19 pandemic there was severe scarcity of liposomal amphotericin B. This study aims to determine role of various formulations of amphotericin and their side effects when used for the treatment of COVID-19 associated mucormycosis. Methods: A retrospective study was conducted between May 2021 and December 2021 at a tertiary care centre. 380 patients with post-COVID rhino-orbito-cerebral mucromycosis (ROCM) were included in the study. Liposomal amphotericin B, conventional amphotericin deoxycholate, lipid complex amphotericin B was used in the treatment. Patients were observed for side effects like fever, chills, rigors, hypokalemia, renal function derangements, thrombophlebitis and respiratory difficulties. Results: Majority of patients received liposomal amphotericin B (331) and 31 patients received conventional amphotericin deoxycholate and 5 patients were given lipid complex amphotericin B injections. The most commonly encountered side effects were of the mild type constituting chills (98% with liposomal and 100% with amphotericin deoxycholate), and fever (94% with liposomal and 74% with amphotericin deoxycholate). Conclusions: Our study highlights the role of various formulations of amphotericin B in the treatment of COVID-19 mucormycosis

DEVELOPMENT AND VALIDATION OF STABILITY-INDICATING REVERSE-PHASE HIGH-PERFORMANCE LIQUID CHROMATOGRAPHY METHOD FOR THE ESTIMATION OF LEDIPASVIR IN BULK AND TABLET DOSAGE FORM

Objective: The objective of this study was to develop a stability-indicating reverse-phase high-performance liquid chromatography (RP-HPLC) method for the estimation of ledipasvir (LDP) in bulk and tablet formulation. Methods: Stability-indicating RP-HPLC method was developed and validated for the estimation of LDP in bulk and tablet formulation. RP-HPLC was carried out on HiQ SiL C18 columns (250 mm × 4.6 mm, 5 μ particle size) using mobile phase acetonitrile:1 mM ammonium acetate buffer in the ratio of 90:10 v/v at a flow rate of 1 ml/min. The analytes were monitored using MD 2010 PDA detector at 333 nm. Results: The retention time was found to be 3.843 min. The proposed method was found to be having linearity in the concentration range of 5–30 μg/ml. The number of theoretical plates obtained was 4236.50 which indicate the efficient performance of the column. The limit of detection was 0.305 μg/ml and limit of quantification was 0.923 μg/ml, which indicate the sensitivity of the method; the high percentage recovery indicates that the proposed method is highly accurate. The developed method has been validated according to the ICH guidelines and found to be simple, specific, precise, and accurate. Conclusion: The proposed method is precise, accurate, and stability indicating. Therefore, the proposed method can be used for routine quality control and analysis of LDP during stability studies in bulk samples and tablet dosage forms

Assessment of safety and effectiveness of desoximetasone emollient cream 0.25% in comparison to mometasone cream 0.1% in Indian patients with eczema

Background: Topical corticosteroids have become indispensable in the treatment of eczema. The current study was conducted to assess the safety and effectiveness of Desoximetasone emollient cream 0.25% (DESO) compared to Mometasone cream 0.1% (MOM) in patients with eczema.Methods: This was a prospective, observational, open label, multicentre post marketing study at real-life scenario. Newly diagnosed, treatment naïve patients with clinical diagnosis of eczema were enrolled. All patients received either DESO or MOM for 3 weeks. Primary end point was proportion of patients developing adverse events. Secondary endpoints comprised of change in visual analog scale for perception of improvement in intensity of pruritus at day 14 and day 21 from baseline, change in eczema area and severity index (EASI) score at day 0 and day 21.Results: 45 patients in DESO group and 43 patients in MOM group completed study. DESO and MOM were well tolerated. Severity of pruritus was significantly reduced in 54.59% patients in DESO group compared to 45.60% patients in MOM group on day 14 (p=0.023). Severity of pruritus was reduced in 69.16% patients in DESO group as compared to 66.97 % patients in MOM group on day 21 (p=NS). There was a statistically significant reduction (p<0.001) in EASI score at day 21 and as compared to baseline within the study groups, but without any difference between the groups.Conclusions: Desoximetasone 0.25% emollient cream was well tolerated in the treatment of eczema with earlier reduction in pruritus as compared to Mometasone furoate 1% cream

EVALUATION OF BIOLOGICAL ACTIVITIES OF NANOCRYSTALLINE TETRAGONAL ZIRCONIA SYNTHESIZED VIA SOL-GEL METHOD

Objective: The objective of the following study was a synthesis of nanocrystalline tetragonal zirconia (ZrO2) using simple sol–gel method and evaluation of its structural and biological properties.Methods: The sample was characterized by X-ray powder diffraction (XRD), Field Emission Scanning Electron Microscopy (FESEM), Transmission Electron Microscopy (TEM) and evaluated for cell growth study using 3T3 mouse fibroblast cells and for degradation using Phosphate Buffered Saline (PBS) solution. The synthesized materials were also evaluated for their antibacterial activity against Escherichia coli (E. coli) and Staphylococcus aureus (S. aureus) bacterial strains.Results: The XRD pattern shows that the tetragonal phase of nanocrystalline zirconia was obtained at relatively low temperature i.e. 300 °C. The FESEM images showed that the prepared sample consists of particles in the range of 35-69 nm and homogenous particle size distribution. The TEM images confirmed the results shown by FESEM images. The sample of zirconia has excellent tissue biocompatibility, higher cell growth and does not show the toxicity towards normal 3T3 mouse fibroblast cells. The result of qualitative antibacterial tests revealed that the nanocrystalline zirconia had an important inhibitory activity on E. coli and S. aureus. The sample shows stability at the physiological condition and does not show degradation.Conclusion: Nanocrystalline tetragonal zirconia shows higher cell growth and efficient antibacterial activity against E. coli and S. aureus bacterial pathogen and also it is stable at the physiological condition. Hence, it can be used for various biomedical applications.Keywords: Nanocrystalline zirconia, Sol-gel route, Antimicrobial action, Biomedical applicatio

Formulation and Evaluation of Chewable Tablets of Pomegranate Peel Extract

Nowadays, dental caries is one of major oral disease caused due to facultatively anaerobic, gram-positive Streptococcus mutans. Pomegranate peel powder extract is known to have activity against Streptococcusmutans. The ethanolic extract of pomegranate peel powder was tested against streptococcus mutans (MTCC 497t). The Minimum inhibitory concentrations was found to be 6.24 mg/ml. Chewable tablet containing 10х MIC of the pomegranate peel powder was tested by cup plate method for its antibacterial activity against Streptococcus mutans. The study concludes that pomegranate peel extract is a&nbsp; natural antibacterial source can be used in formulating chewable tablet which are better than chemical formulations specially mouth washes as stay-in-mouth time of these chewable tablet&nbsp; are extended ensuring good antibacterial activity with good organoleptic properties. Keywords: Dental caries, Chewable tablet, Pomegranate peel, Streptococcus mutans

Data and Image Transfer Using Mobile Phones to Strengthen Microscopy-Based Diagnostic Services in Low and Middle Income Country Laboratories

Background: The emerging market of mobile phone technology and its use in the health sector is rapidly expanding and connecting even the most remote areas of world. Distributing diagnostic images over the mobile network for knowledge sharing, feedback or quality control is a logical innovation. Objective: To determine the feasibility of using mobile phones for capturing microscopy images and transferring these to a central database for assessment, feedback and educational purposes. Methods: A feasibility study was carried out in Uganda. Images of microscopy samples were taken using a prototype connector that could fix a variety of mobile phones to a microscope. An Information Technology (IT) platform was set up for data transfer from a mobile phone to a website, including feedback by text messaging to the end user. Results: Clear images were captured using mobile phone cameras of 2 megapixels (MP) up to 5MP. Images were sent by mobile Internet to a website where they were visualized and feedback could be provided to the sender by means of text message. Conclusion: The process of capturing microscopy images on mobile phones, relaying them to a central review website and feeding back to the sender is feasible and of potential benefit in resource poor settings. Even though the system needs furthe

Larval parasitoids and pathogens of the groundnut leaf miner, Aproaerema modicella (Lep.: Gelechiidae), in India

Natural enemies of the groundnut leaf miner,Aproaerema modicella (Deventer), were studied at the International Crops Research Institute for the Semi-Arid Tropics (ICRISAT) located near Hyderabad in peninsular India. Hymenopterous parasitoids attacking leaf miner larvae were the most important group of natural enemies. Nine primary and eight secondary parasitoids emerged from host larvae, and killed up to 50% of the leaf miner larvae sampled. The trophic relationships between primary and secondary parasitoids are incompletely understood. The influence of pathogens of this species is reported for the first time. These pathogens killed up to 30% of the leaf miner larvae. The combined effects of all mortality agents killed up to 95% of the leaf miner larvae per sample period. However, use of insecticides in sprayed plots reduced the efficacy of parasitoids. The impact of predators on larval populations was not studied and may explain underestimates of leaf miner mortality rate

The international EAACI/GA²LEN/EuroGuiDerm/APAAACI guideline for the definition, classification, diagnosis, and management of urticaria

This update and revision of the international guideline for urticaria was developed following the methods recommended by Cochrane and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) working group. It is a joint initiative of the Dermatology Section of the European Academy of Allergology and Clinical Immunology (EAACI), the Global Allergy and Asthma European Network (GA(2)LEN) and its Urticaria and Angioedema Centers of Reference and Excellence (UCAREs and ACAREs), the European Dermatology Forum (EDF; EuroGuiDerm), and the Asia Pacific Association of Allergy, Asthma and Clinical Immunology with the participation of 64 delegates of 50 national and international societies and from 31 countries. The consensus conference was held on 3 December 2020. This guideline was acknowledged and accepted by the European Union of Medical Specialists (UEMS). Urticaria is a frequent, mast cell-driven disease that presents with wheals, angioedema, or both. The lifetime prevalence for acute urticaria is approximately 20%. Chronic spontaneous or inducible urticaria is disabling, impairs quality of life, and affects performance at work and school. This updated version of the international guideline for urticaria covers the definition and classification of urticaria and outlines expert-guided and evidence-based diagnostic and therapeutic approaches for the different subtypes of urticaria