Endoscopic Management of Pediatric Airway and Esophageal Foreign Bodies

The use of endoscopy is critical to the management of pediatric tracheobronchial and esophageal foreign bodies. Children may present with nonspecific symptoms, and the diagnosis can be difficult when the ingestion or aspiration events go unwitnessed. Advances in endoscopic techniques and the use of optical graspers in the removal of foreign bodies in children have helped decrease morbidity and mortality. In this chapter, the history, clinical presentations, workup, and management for pediatric aerodigestive foreign bodies are discussed

Design of Online Lecture Videos by Non-Native English Speaking (NNES) Instructors to Promote Critical Learning

The current study seeks to investigate the effects of instructor presence in online lecture videos, focusing on non-native-English-speaking (NNES) instructors. NNES instructors should consider higher video presence during teaching to promote students\u27 learning outcomes.https://encompass.eku.edu/pedagogicon_postergallery/1005/thumbnail.jp

The study for sources of stress and management among medical students

Background: In recent years there has been a growing appreciation of the issues of quality of life and stresses involved medical training as this may affect their learning and academic performance. This study was carried out to assess the prevalence of sources and severity of stress and coping strategies among medical students.Methods: A questionnaire-based study was carried out among the undergraduate medical students of Himalayan Institute of medical sciences, Jolly grant, Dehradun from July July 2015 to January 2016. The questionnaire consisted of questions on the basis of Academic, Intrapersonal, Interpersonal, Social Related Stressors and also various methods adopted by them to overcome stress.Results: Out of 150 students only 136 (90%) responded. All the participants were of first and second professional MBBS course. Overall 56% Students felt studies are contributing to stress followed by 26% due to college, 18% due to friends and 9% due to family pressure. Due to academic stress performance anxiety for upcoming examinations was felt by 59% of the students. Among the personal stressor 58% experienced health related issues and their effect on level of fitness. Stress relievers like 67% of the total students preferred watching movies, while their preference for listening to music was observed in 38% to relieve stress.Conclusions: It was concluded that students have a high level of academic stress followed by the social and personal stress. Since the stressors cannot be permanently eliminated, authors have to necessarily devise efficient methods for managing them

Inhibition of NF-κB activation by 5-lipoxygenase inhibitors protects brain against injury in a rat model of focal cerebral ischemia

BACKGROUND: Stroke is one of the leading causes of death worldwide and a major cause of morbidity and mortality in the United States of America. Brain ischemia-reperfusion (IR) triggers a complex series of biochemical events including inflammation. Leukotrienes derived from 5-lipoxygenase (5-LOX) cause inflammation and are thus involved in the pathobiology of stroke injury. METHODS: To test the neuroprotective efficacy of 5-LOX inhibition in a rat model of focal cerebral IR, ischemic animals were either pre- or post-treated with a potent selective 5-LOX inhibitor, (N- [3-[3-(-fluorophenoxy) phenyl]-1-methyl-2-propenyl]-N-hydroxyurea (BW-B 70C). They were evaluated at 24 h after reperfusion for brain infarction, neurological deficit score, and the expression of 5-LOX. Furthermore, the mechanism and the anti-inflammatory potential of BW-B 70C in the regulation of nuclear factor kappa B (NF-κB) and inflammatory inducible nitric oxide synthase (iNOS) were investigated both in vivo and in vitro. RESULTS AND DISCUSSION: Both pre- and post-treatment with BW-B 70C reduced infarctions and improved neurological deficit scores. Immunohistochemical study of brain sections showed IR-mediated increased expression of 5-LOX in the neurons and microglia. BW-B 70C down-regulated 5-LOX and inhibited iNOS expression by preventing NF-κB activation. Two other structurally different 5-LOX inhibitors were also administered post IR: caffeic acid and 2, 3, 5-trimethyl-6- [12-hydroxy-5, 10-dodecadiynyl]-1, 4-benzoquinone (AA-861). As with BW-B 70C, they provided remarkable neuroprotection. Furthermore, in vitro, BW-B 70C inhibited lipopolysaccharide (LPS) mediated nitric oxide production, iNOS induction and NF-κB activation in the BV2 microglial cell line. Treating rat primary microglia with BW-B70C confirmed blockage of LPS-mediated translocation of the p65 subunit of NF-κB from cytosol to nucleus. CONCLUSION: The study demonstrates the neuroprotective potential of 5-LOX inhibition through down-regulation of NF-κB in a rat model of experimental stroke

KNOWLEDGE AND PRACTICE REGARDING FOOT CARE AMONG TYPE 2 DIABETES MELLITUS PATIENTS AT A TERTIARY CARE HOSPITAL IN COASTAL SOUTH INDIA

Objective: The present study was designed to assess the knowledge and practice among diabetic patients in a tertiary care hospital regarding diabeticfoot care.Methods: A cross-sectional study was conducted in government district hospital of Mangalore in the month of January 2014. A pre-designed semistructuredquestionnairewasused tocollectthe informationpertainingtotheknowledgeand practicesofthediabetic patients regardingfootcare.Thecollecteddata wereanalyzedusing Statistical PackagesforSocial Sciences version11.5.The resultsobtained wereexpressedin proportions.Results: A total of 133 subjects were assessed regarding their knowledge and practice regarding diabetic foot care. Around three-fourth (75.2%) ofparticipants had adequate knowledge. More than half (55.5%) of the subjects had adequate practice. No significant association was found betweenstudy variables such as gender, socioeconomic status, and education status with awareness regarding diabetic foot care in the present study (p>0.05).Gender, socioeconomic, and educational statuses were found to be significantly associated with diabetic foot care practices.Conclusion: The gap between knowledge and practice regarding self-care among diabetic patients can be bridged by providing continuous healtheducation by the health workers. Foot care should be promoted at all available opportunities whenever the patient comes in contact with the health system.Keywords: Mangalore, Foot care, Diabetes

Pediatric Head and Neck Malignancies

Head and neck malignancies are a part of the differential diagnosis of head and neck masses seen in the pediatric age group. It is critical to make prompt diagnosis and employ proper treatment. We will review the most common malignant pathologies as well as their specific clinical presentations and management. Centers that are able to provide multidisciplinary care for pediatric patients with head and neck pathology can help achieve the best outcomes

Blockade of TRPM7 Channel Activity and Cell Death by Inhibitors of 5-Lipoxygenase

TRPM7 is a ubiquitous divalent-selective ion channel with its own kinase domain. Recent studies have shown that suppression of TRPM7 protein expression by RNA interference increases resistance to ischemia-induced neuronal cell death in vivo and in vitro, making the channel a potentially attractive pharmacological target for molecular intervention. Here, we report the identification of the 5-lipoxygenase inhibitors, NDGA, AA861, and MK886, as potent blockers of the TRPM7 channel. Using a cell-based assay, application of these compounds prevented cell rounding caused by overexpression of TRPM7 in HEK-293 cells, whereas inhibitors of 12-lipoxygenase and 15-lipoxygenase did not prevent the change in cell morphology. Application of the 5-lipoxygenase inhibitors blocked heterologously expressed TRPM7 whole-cell currents without affecting the protein's expression level or its cell surface concentration. All three inhibitors were also effective in blocking the native TRPM7 current in HEK-293 cells. However, two other 5-lipoxygenase specific inhibitors, 5,6-dehydro-arachidonic acid and zileuton, were ineffective in suppressing TRPM7 channel activity. Targeted knockdown of 5-lipoxygenase did not reduce TRPM7 whole-cell currents. In addition, application of 5-hydroperoxyeicosatetraenoic acid (5-HPETE), the product of 5-lipoxygenase, or 5-HPETE's downstream metabolites, leukotriene B4 and leukotriene D4, did not stimulate TRPM7 channel activity. These data suggested that NDGA, AA861, and MK886 reduced the TRPM7 channel activity independent of their effect on 5-lipoxygenase activity. Application of AA861 and NDGA reduced cell death for cells overexpressing TRPM7 cultured in low extracellular divalent cations. Moreover, treatment of HEK-293 cells with AA861 increased cell resistance to apoptotic stimuli to a level similar to that obtained for cells in which TRPM7 was knocked down by RNA interference. In conclusion, NDGA, AA861, and MK886 are potent blockers of the TRPM7 channel capable of attenuating TRPM7's function during cell stress, making them effective tools for the biophysical characterization and suppression of TRPM7 channel conductance in vivo