AN ELEVATED PULSE PRESSURE: A MAJOR RISK FACTOR FOR CARDIOVASCULAR DISEASES

Pulse pressure (PP) is a predictor and major risk factor for cardiovascular (CV) diseases as left ventricular hypertrophy, myocardial infarction, carotid hypertrophy, atherosclerosis, congestive heart failure and stroke as well as chronic renal failure progression. PP has been proved a strong forecaster of CV risk, particularly when it is higher than 60 mm Hg and more strongly relates to carotid hypertrophy and extent of atherosclerosis than systolic pressure. Isolated systolic hypertension (ISH) is common among the elderly and is accompanied by elevated pulse pressure. However, treatment of ISH may further raise the PP if diastolic pressure is lowered to a greater extent than systolic pressure. Several drugs for hypertension have the side effect of increasing resting PP irreversibly, other antihypertensive drugs, such as ACE inhibitors, have been shown to lower the PP. Various approaches made by researchers for the maintenance of normal PP to reduce the mortality caused due to CV events based on the abnormal PP. We briefly review the therapeutic consequences for the attenuation of elevated PP associated with various CV eventsKEYWORDSPulse pressure, Cardiovascular diseases, Arterial stiffness, Antihypertensive therap

A prospective cross-sectional study on prescribing pattern of antibiotics on patients suffering from ENT infections in tertiary care hospital, Pokhara, Nepal

Background: This survey was designed to assess and evaluate the prescribing pattern of antibiotics used in patients suffering from ENT (Eye, Nose, and Throat) infections in ENT outpatient departments (OPD) at Manipal Teaching Hospital (MTH), Phulbari, Pokhara, Nepal.Methods: A prospective cross-sectional study was conducted in out-patients of ENT department at MTH for 6 month in which a total of 216 prescriptions were observed randomly and data filled patient profile forms were collected and analyzed.Results: Out of 216 patients, 126(58.33%) were male and 90 (41.67%) were female. Patients of age group 21-30 were maximum (29.16%) followed by age group of 11-20 (22.22%). Only 6.7% of drugs were prescribed from their generic names. Data analysis revealed that about 72.24%, 24.53% and 3.23% of prescription contained one, two and three antibiotic drugs respectively. All together 970 drugs were prescribed in 216 prescriptions out of which 251 (25.87%) were antibiotics drugs. This suggested that the average no. of antibiotics per prescription was 1.16. Among prescribed antibiotics, Amoxicillin (7.56%) of penicillin group, Azithromycin (8.36%) of macrolides, Cefuroxime (9.56%) of 2nd generation cephalosporin followed by Cefpodoxime (32.27%) of 3rd generation cephalosporin and Ofloxacin (6.37%) of quinolones group were frequently prescribed. From analysis, we found that other concomitant medications were also prescribed such analgesics, antihistamines, PPI (Proton Pump Inhibitors) and vitamins, minerals and dietary enzymes. The prescribed antibiotics accounted for large percentage of oral dosage forms (89.90%) followed parental injection dosage forms 5.05%.Conclusions: Prescribing more than one antibiotics was commonly encountered indicating the occurrence of polypharmacy which were based on empirical therapy without any culture and sensitivity test report. Therefore, local hospital culture sensitivity database for ENT infections has to be developed and prescribing with generic name from existing essential drug list or formulary should be encouraged for rational drug therapy

Antibacterial Evaluation of Plant Extracts: an insight into Phytomedicine

This study was carried out to evaluate the antibacterial activity of petroleum ether, methanol and aqueous extract of the two plant Ocimum sanctum and pepper nigrum extract using agar well diffusion and broth dilution method against gram-positive bacterial strains (B. firmus, B. megaterium and B. cereus) and gram-negative bacterial strains (Escherichia coli, Enterobacter sp. and Klebsiella pneumoniae). The results indicate that petroleum ether extract compare to methanol and aqueous extract of O. sanctum and P. nigrum exhibited significant antibacterial activity against gram-positive bacteria with minimum inhibitory concentration (MIC) ranging from 0.13 to 0.21x 10-4 mg/well concentration. Moreover, gram-negative bacteria were less susceptible against petroleum ether, methanol and aqueous extract of O. sanctum and P. nigrum and their MIC ranging from 0.13 to 0.21x 10-2. The most susceptible organism to the organic extracts from both studied plants was B. firmus and the most resistant organism was Enterobacter sp. The result obtained with B. cereus and K. pneumoniae were particularly interesting, since it was inhibited by antibiotic ampicillin used and susceptibility was observed with the individual extracts, where higher antibacterial activity with petroleum ether and aqueous extracts of O. sanctum and P. nigrum respectively.  The presence of phytochemicals such as alkaloids, tannins, saponin, triterpenoids, steroids and glycosides in the extracts of these plants supports their traditional uses as medicinal plants for the treatment of various ailments. The present study reveals potential use of these plants for developing new antibacterial herbal drugs against pathogenic microorganisms

Antibacterial Evaluation of Plant Extracts: an insight into Phytomedicine

This study was carried out to evaluate the antibacterial activity of petroleum ether, methanol and aqueous extract of the two plant Ocimum sanctum and pepper nigrum extract using agar well diffusion and broth dilution method against gram-positive bacterial strains (B. firmus, B. megaterium and B. cereus) and gram-negative bacterial strains (Escherichia coli, Enterobacter sp. and Klebsiella pneumoniae). The results indicate that petroleum ether extract compare to methanol and aqueous extract of O. sanctum and P. nigrum exhibited significant antibacterial activity against gram-positive bacteria with minimum inhibitory concentration (MIC) ranging from 0.13 to 0.21x 10-4 mg/well concentration. Moreover, gram-negative bacteria were less susceptible against petroleum ether, methanol and aqueous extract of O. sanctum and P. nigrum and their MIC ranging from 0.13 to 0.21x 10-2. The most susceptible organism to the organic extracts from both studied plants was B. firmus and the most resistant organism was Enterobacter sp. The result obtained with B. cereus and K. pneumoniae were particularly interesting, since it was inhibited by antibiotic ampicillin used and susceptibility was observed with the individual extracts, where higher antibacterial activity with petroleum ether and aqueous extracts of O. sanctum and P. nigrum respectively.  The presence of phytochemicals such as alkaloids, tannins, saponin, triterpenoids, steroids and glycosides in the extracts of these plants supports their traditional uses as medicinal plants for the treatment of various ailments. The present study reveals potential use of these plants for developing new antibacterial herbal drugs against pathogenic microorganisms

Enhancing the wettability of polyetheretherketone (PEEK) membrane with ozone for improving fuel cell performance

Ozone was reacted with the aromatic membrane polyetheretherketone (PEEK) to form oxidized functional groups on the surface to enhance the attraction and transport of protons in fuel cells. Ozonation of unsaturated C-C sp2 bonds in PEEK formed a primary ozonide which dissociated to primarily produce O=C-O/O=C-OH moieties, and the root mean squared roughness factor (Rq) decreased from 7.4 nm, for the untreated sample, down to 3.1 nm. The oxidation of the surface and decrease in surface roughness made the surface increase in hydrophilicity as observed by the decrease in the water contact angle (CA) from 80.3° for untreated PEEK down to 21.7°. Washing the treated surface with solvent decreased the O at % on the surface indicating the formation of a weak boundary layer because of bond breakage during the decomposition of the ozonide

Type IIA2 urethral duplication: Report of an unusual case

Objective This report describes a rare case of type IIA2 sagittal urethral   duplication. Summary background data The presentation, investigation, and  management of this rare anomaly are briefly discussed.Methods A 3½-year-old boy presented with urinary obstruction and recurrent urinary tract infection due to a stenosed dorsal urethra and segmental stenosis of the dominant ventral urethra. The child also had left-sided vesicoureteric reflux. Staged surgical management consisted of an initial vesicostomy followed by serial dilatation of the ventral urethral stricture, left ureteric reimplantation, and a 2-cm long distal urethrourethrostomy between the dorsal urethra, opening at the tip of the penis, and the ventral urethra, which had a hypospadic opening at the base of the glans.Results The functional and cosmetic outcomes were satisfactory.Conclusion The management needs to be individualizedas best suited for the patient.Keywords: urethra, urethral duplication, urethral strictur