Role of staging laparoscopy in upstaging CT findings and influencing treatment decisions in gastric cancers

Background: It is estimated that 990000 new gastric cancer (GC) cases occur in the world annually. The aim of this study was to examine the accuracy of laparoscopy in staging patients with gastric cancer in comparison with preoperative computed tomography (CT) examination and to determine the influence of staging laparoscopy on treatment decisions in gastric cancers.Methods: This was a prospective study conducted in a tertiary care hospital between August 2014 and February 2016. Thirty patients out of a series of 60 patients with gastric adenocarcinoma underwent a preoperative staging CT followed by a staging laparoscopy. The strengths of the agreement between the CT stage, the laparoscopic stage, and the final histopathological stage were determined by the weighted Kappa statistic (Kw). The number of patients with treatment decision-changes was counted.Results: The strengths of agreement between the CT stage and the final histopathological stage were Kw- 0.314 (95% confidence interval [CI]; 0.03-0.66; P≥0.0001) for T stage and 0.00 (95% CI; 0.0-0.00) for M stage, compared with 0.668 (95% CI; 0.39-0.98; P≥0.0001) and 1.00 (95% CI; 1.0-1.0; P≥0.0001) for the laparoscopic T and M stages, respectively. Unsuspected metastases that were not detected by CT, were found in 12 patients at laparoscopy, all of whom had T3 or T4 locally advanced tumors evident on CT.Conclusions: Preoperative laparoscopic staging of gastric cancer is indicated for potential surgical candidates with locally advanced disease in the absence of metastases on CT and influences treatment decision making apart from preventing unnecessary laparotomies

Biodiversity of the Endophytic Fungi Isolated from Calotropis gigantea (L.) R.Br.

Calotropis gigantea(L)R.Br., a widely used medicinal plant in India, were exploited for endophytes as a possible source of bioactive secondary metabolites. About  700 segments from 10 plants of Calotropis gigantea, collected from different locations of Guindy Campus, University of Madras during the year 2009–2010, were processed for the presence of endophytic fungi. A total of 13 fungal species viz., Aspergillus niger, Aspergillus flavipes, Alternaria porri, Curvularia lunata, Fusarium oxysporum, Nigrospora sphaerica, Colletotrichum falacatum, Pestalotiopsis sydowiana, Phoma exigua, Phomopsis archeri, Leptosphaerulina chartarum,  and Mycelia sterilia, were isolated and identified based on the morphology of the fungal culture and characteristics of the spores

An empirical study on maternal and perinatal outcome of placenta previa-risk factors, morbidity and mortality in JNIMS, Imphal, India

Background: The observational study to analyse the maternal and perinatal outcome in pregnancies complicated with placental previa evaluating the potential risk factor, associated with morbidity and mortality.Methods: The study was a prospective longitudinal comprising of all the pregnant women after 28 week of gestation irrespective of gravid and parity that attended or admitted in the department of obstetrics and gynaecology, JNIMS, diagnosed as having placental previa by transabdominal ultrasonography and conducted for the period of 20 months i.e. from October 2017 to June 2019 analyzing 54 cases of placenta previa.Results: During this period there were total of 9967 deliveries with incidence of placenta previa being 0.54% in JNIMS, Porompat. The estimated risk factors out of total 54 cases were 20-30 (52%) years by age group, 25 (46%) gravida, 18 (32%) parity, 36 low lying placenta and 11 cases (20%) preterm.Conclusions: Highest levels of placenta previa are associated with poor maternal and perinatal outcome

Preclinical Study of Siddha Drug Venthamaraiyathi Chooranam for it’s Thrombolytic, Vasodilator, Hypolipidemic & Cardio Protective Activities

The test drug “Venthamaraiyathi Chooranam ” was selected from the siddha literature “Pharmacopoeia of hospital of Indian medicine” authored by Dr.V.Narayanaswami for its Thrombolytic, vasodilator, Hypolipidemic and Cardioprotective activities. The dissertation started with an introduction explaining about the siddha concept, prevalence of hypertension and role of the test drug in treating it. • The test drug was prepared properly by the given procedure. All the ingredients were identified and authenticated by the botanist and experts of Gunapadam,Govt. Siddha medical college, Palayamkottai. • Review of literatue in various categories was carrid out siddha aspect botanical aspect abd pharmaceutical review disclosed about thae drug and disease pharmacological review was done to establish the methodologies. • According to siddha aspect hypertension (Kruthi Azhal Noi) is caused by derangement of vatha pitha humors. Spicy taste of test drug diminish the vatha humor the spicy taste where posses the seetha veriyam very much helpful to demines the aggrevated vatha pitha humors. • Various analysis such as physicochemical, microbiological, phytochemical, biochemical analysis, instrumental analysis were made. From the above analysis we came who known the presence of active ingredients responsible for its activity. Phytochemical analysis showed the presence of potassium, calcium, chloride, iron,. • Biochemical analyisis showed the the presence of calcium, sulphate, chloride, starch, iron ferrous, phosphate, unsaturation, reducing suger, amino acids. Thus from these results we come to known the effectiveness of the drugs is due to the presence of these constituents. • The instrumental analysis FTIR showed the peak values presence of Alkanes, Amines,Aromatics, Aliphatic amines, Alkyl halides, Carboxylic acids. • ICP-OES analysis of these drug shows heavy metals Like Arsenic, cadmium, Nickel, copper and lead are found in below detecting level. The toxic metals are found in BDL. It reveals the drug in safer for long term use. Calicum was associated with the lower risk of Hypertension. Sodium regulates the body’s acid base balance. Iron is essential for may numbers of biological functions such as growth, reproduction, healing and immune function. The phosphorus is involved in tissue repair Magnesium is regulates the blood pressure. Sulphate is potent anti oxidant activity in human body. Zinc has got potent anti-microbial activity. • Acute and sub-acute toxicity were carried out in wistar albino rats according to OECD guidelines(423). This drug has no acute toxicity as there was no mortality seen sub-acute toxicity is carried by repeated dose of test drug for 28 days. Mortality, the functional observations, haematological and bio-chemical investigations were done. There were no significant changes in the bio-chemical and haematological profile. So the toxicological study of these test drug, venthamaraiyathi chooranam establish the safety of the drug for long time administration. • In pharmacological studies, the thrambolytic activity is carried out in wistar albino rats by using enzymeimmunoassay sandwich method. The test drug venthamaraiyathi chooranam has significant thrambolytic activity. • The vasodilator activity of test drug venthamaraiyathi chooranam carried out wistar albino rats by using students organ bath. The present study suggests that the Venthamaraiyathi Choornam extract may exert its endothelium-dependent relaxation activity by stimulating the nitric oxide release from the vascular endothelium via muscarinic receptors. • The hypolipidemic activity of test drug venthamaraiyathi chooranam carried out wistar albino rats models. Hyperlipidemia is considered to be major risk factor for the premature atherosclerosis and essentially the cholesterol in atherosclerotic plaque is derived from that of circulatory cholesterol. The antihyperlipidemic effect on siddha formulation Venthamaraiyathi Chooranam in particular could be considered as a possible therapeutic value. • Cardioprotective activity present study shows that the cardiotoxicity induced by Dox is related with oxidative stress. Anti-proliferative, anti-initiation and free radical scavenging properties of Venthamaraiyathi Chooranam may boost myocardial integrity and attenuate the cardiac toxicity. Venthamaraiyathi Chooranam has shown to be cardioprotective, which may be attributed to its potent antioxidant properties. • Anti-microbial study of the test drug carried out by well diffusion method. It is observed that Venthamaraiyathi Chooranam is sensitive to Escherichia coli and Streptococcus mutant & Klebsiella pnemoniae. These VTC has significant antibacterial activity. • Result and discussion gives the necessary and essential justification to prove the potency of test drug Venthamaraiyathi Chooranam with the scientific validation. Thus the herbel formulation is validated for its safety efficiency in the management of diarrhoea and it would be the way for a drug of choice. CONCLUSION: It is concluded that the test drug Venthamaraiyathi Chooranam has significant activity to control blood clot possess thrombolytic activity and control to cholesterol level by possessing hypolipidemic action and also stimulating the nitric oxide release from the vascular endothelium via muscarinic receptors some significant vasodilator activity and boost myocardial integrity by possessing cardioprotective activity. Apart from this Venthamaraiyathi Chooranam has anti-bacterial sensitivity against various pathogens. Finally the drug Venthamaraiyathi Chooranam is scientifically validated by modern techniques

Clinical diagnosis by junior doctors - How confident and accurate are they

Objectives: Aim of this study is to determine the ability of junior doctors to document a clinical diagnosis and accuracy of the diagnosis.Methods: This single centre study included case records of patients admitted to the Professorial Medical Unit (PMU) and Emergency Treatment Unit (ETU) at Colombo South Teaching Hospital (CSTH). The junior doctors’ on admission diagnosis is compared with the medical consultants’ diagnosis. Only case records of patients belonging to four common specialty domains were studied.Results: In the PMU out of 200 case records no diagnosis or symptom as a diagnosis was documented in 99(49.5%) cases and a diagnosis was documented in 68(34.0%) case records of which 53(77.9%) diagnoses were concordant with the medical consultants’ diagnosis. When case records of patients admitted to ETU were considered, no diagnosis or symptom as a diagnosis was documented in 56(56.0%) case records and a diagnosis was documented in only 21(21.0%) case records of which 15(71.4%) diagnoses were concordant with the medical consultants’ diagnosis. Documentation of correct diagnosis improved with the grade of the doctor, from IMO to MR in both study settings and also with the order of clerking.Conclusions: Recording of symptom based diagnosis or no diagnosis remains high among most of the junior doctors in all specialty domains and at all grades

Single center study of mortality in out of working hours’ acute medical admissions

Objectives: Aim of this study was to find the outcome of acute medical admissions at weekend, out of hour’s period and night.Methods: This retrospective single center study included all acute medical admissions to Colombo South Teaching hospital during the first six months of the year 2011. We have compared the mortality rates at weekdays with weekend, working hours with out of working hours and night with day time. All these death rates were calculated for both overall mortality and late mortality.Results: Total in hospital mortality was significantly increased for admissions on Thursdays, at night and during out of working hours. Although the mortality rates at weekends were higher than the mortality at weekdays for both overall deaths and late deaths the difference was not statistically significant. For late deaths (after seven days) mortality is significantly increased only for admissions at night when compared with the day time.Conclusions: Patients with acute medical conditions are more likely to die in hospital if they are admitted on a Thursday, at night or at out of working hours’ period. This effect is likely to be due to the disease severity on admission as well as reduced staffing level at night and out of hour’s period.

THIRTY FIVE YEARS OF OPERATIONAL RESEARCH PROJECT FOR DRYLAND AGRICULTURE : ACHIEVEMENTS AND IMPACTS (1976 to 2012)

Not AvailableAgriculture is the backbone of Indian economy and rainfed agro-ecosystem occupies an important place in Indian agriculture, covering 68 per cent of the cultivated area (96 m.ha) supporting 40 per cent human, 60 per cent livestock population and producing 44 per cent of the food requirements thus playing a pivotal role in India’s food security. Five out of ten Agro-Climatic Zones in Karnataka were classified as dry zones covering 63 per cent of the total geographical area and 71 per cent of the net sown area, with substantial contribution to agricultural production from dry lands. About 57 per cent of food grain production in Karnataka comes from rainfed areas while, 97 per cent of total pulses and 80 per cent oilseeds were produced in dry land areas. Research on dryland agriculture in the red soil regions of Karnataka was started in 1970 with the establishment of All India Coordinated Research Project for Dryland Agriculture (AICRPDA) at Gandhi Krishi Vignana Kendra (GKVK), Bangalore,Not Availabl

The development of therapeutic proteins can be hindered by poor decision-making strategies in the early stage

In this study we address two major issues related to the current development process of therapeutic proteins and their characterization. First, due to limited samples amounts, the selection of lead molecules in the early stages is often based on the results from a limited physicochemical characterization. The latter can be based on measurements of only 2-3 parameters, e.g. protein melting temperature, protein aggregation temperature, and is usually performed in only one buffer, e.g. PBS. The hypothesis we present is that such approach can lead to the rejection of lead candidates that can still be manufacturable and can move on to clinical trials. The second matter we address are the often-reported correlations between protein physicochemical parameters in the literature. We propose that such correlations can be found only in a small sample population, e.g. one protein in different solution conditions or different proteins from the same class. However, we expect that such correlations would not be valid in a large population, including various protein structures and solution conditions. In order to address the above-mentioned issues, we created the PIPPI consortium (http://www.pippi.kemi.dtu.dk) and applied systematic approach to map the physicochemical properties of a wide range of proteins and extensively study their stability as a function of the solution conditions. We show that promising therapeutic protein lead candidate can appear as non-manufacturable when only limited physicochemical characterization is performed, e.g. a few methods are used and only a few solution conditions are tested. Therefore, the rejection rate during early-stage development can be improved by more thorough physicochemical characterization. Moreover, only weak linear correlations between biophysical properties of proteins are observed in a large populations. This suggests that the often-reported correlations between parameters describing the protein stability are not representative of a global population. Understanding the connections between various physiochemical parameters would require a systematic database which is currently in development by the PIPPI consortium