Recurrent acute pancreatitis due to a santorinicele in a young patient

A cystic dilatation of the terminal portion of the minor pancreatic duct (duct of Santorini) is referred to as a santorinicele. It is usually associated with pancreas divisum and has been suggested to be a cause of relative stenosis of the minor papilla, often leading to recurrent pancreatitis. While this anomaly has been reported in the paediatric population, it is more commonly found in the elderly. We present a 27-year-old woman with recurrent acute pancreatitis attributed to a santorinicele with a dorsal duct-exclusive pancreatic drainage

IL-11 induces NLRP3 inflammasome activation in monocytes and inflammatory cell migration to the central nervous system

The objective of this study is to examine IL-11-induced mechanisms of inflammatory cell migration to the central nervous system (CNS). We report that IL-11 is produced at highest frequency by myeloid cells among the peripheral blood mononuclear cell (PBMC) subsets. Patients with relapsing-remitting multiple sclerosis (RRMS) have an increased frequency of IL-1

The functional outcome of direct lateral approach for fixation of proximal humeral fractures: A case series from a tertiary care hospital

Displaced proximal humeral fractures warrant surgical fixation for early rehabilitation and better functional outcome. These fractures are traditionally fixed by delto pectoral surgical approach. Direct lateral approach has recently gained interest as it involves less soft tissue dissection and is particularly helpful in certain fracture patterns. However, there have been concerns of axillary nerve damage with this approach. We report a case series of proximal humerus fractures fixed by direct lateral approach from our institution. All displaced Type 2 and 3 fractures were included in our study. Pathological and comminuted Type 4 fractures and fractures with ipsilateral clavicle or elbow fractures were excluded. Oxford Shoulder Score was done at regular intervals for assessment of functional outcome. We did not observe any axillary nerve damage in our case series and the outcomes of 70.5% of our patients were excellent while in 29.5% it was good. We recommend direct lateral approach for specific pattern of proximal humerus fractures

A study of adverse drug reaction profile of tuberculosis patients attending DOTS center at Dr. Bhim Rao Ambedkar memorial hospital, Raipur, Chhattisgarh, India

Background: Tuberculosis is second leading cause of death in the world. The causative organism is Mycobacterium tuberculosis. The objective was to study the adverse reactions of the patients attending the DOTS center and to assess their causality and severity of reported ADRs.Methods: Present study was a prospective observational study carried at the DOTS center of Dr. Bhim Rao Ambedkar Memorial Hospital, Raipur, Chhattisgarh, India between August 2011 to July 2012 (One year). The patients were monitored for adverse drug reactions. The assessment of ADRs were based upon the WHO assessment scale, Naranjo scale, European A.B.O scale.Results: Total number of patients attending DOTS center was 816. The number of males (428) exceeded that of females (388). Majority of patients in this study belonged to 21-30 years (26.96%) next 31-40 years (25.24%) and 41-50 years (16.5%) of age group. Prevalence of ADRs were more in males (57%) than in females 32 (43%). Majority of ADRs reported were moderate 33 (35.22%) followed by 29 (46,77%) were mild, no severe ADRs reported. According to severity of ADRs seen were gastritis 28 (45%) followed by 10 (16% ) rashes , 10 (16,12%) of arthralgia, 3 (4.83%) of hepatitis, 6 (9.7%) of peripheral neuropathy, 2 (3%) onsets of ADRs after starting anti-tubercular drug were 12 (19.35%) in 0-1 week followed by 19 (30%) ADRs showed onset in 1-2 week and 2-3 week, 8 (13%) in 3-4 week 3 (5%) in 4-5 week and 1 (2%) in 5-6 week.Conclusions: The casual link between the ADRs and the suspected anti-tubercular drug by Naranjo scale definitely relationship was established between the anti-tubercular drug and ADRs in 7 (11.25%) patient while 22 (35.45%) probable and 33 (53.22%) ADRs were categorized as possible

Rationality verses irrationality in fixed dose combinations: at a tertiary teaching hospital of rural Chhattisgarh, India

Background: Rational drug prescribing can be defined as appropriate drugs prescribed in the right dose, at correct time intervals and for a sufficient duration. Irrational drug use is a common problem in many countries of the world.Methods: A prospective observational study was conducted, total 300 patients attending various outpatient departments of tertiary health care rural hospital in Rajnandgaon district were interviewed and their prescriptions were analysed.Results: Total 350 drugs were prescribed 60 (17.14%) were prescribed by generic name and the rest 290 (82.86%) were prescribed by brand name. Only 18 (5.14%) drugs were not prescribed from hospital formulary. 264 (75.43%) drugs were dispensed from hospital pharmacy. On the basis of rationality score 53% prescriptions were rational, 30% semi rational and 17% irrational.Conclusions: In a rural hospital, where hospital formulary is based on WHO Essential medicine list, hundred percent utilization of hospital pharmacy service doctors and patients would ensure rational prescribing benefits of the patients coming from rural and uneducated background

Assessment of knowledge of pharmacotherapeutics amongst medical undergraduates of a tertiary care teaching hospital of Chhattisgarh, India: a questionnaire based study

Background: Knowledge of pharmacology forms the basis of rational pharmacotherapy practice. Teaching the medical students about systematic application of pharmacology in patients’ care forms an essential component. It facilitates the medical students to develop a methodical approach in solving patients’ clinical problems.Methods: A questionnaire-based study was conducted, at Government Medical College Rajnandgaon involving second year MBBS students. Total 100 students participated in the study.Results: Hundred percent of the students responded that pharmacology was presently taught to them, seventy nine percent of them agreed with the fact that pharmacology was preferred to pass the MBBS, eighty eight percent of them responded that in pharmacokinetics was the least preferred topic, ninety seven of them were not aware of the essential drug list. Their suggestions regarding the change in teaching methodology was recorded.Conclusions: This study concludes that efforts are needed to develop a curriculum that encompasses important aspects of clinical pharmacology and therapeutics along with incorporation of the useful suggestions by the undergraduate students

Multi-Gigabit CO-OFDM System over SMF and MMF Links for 5G URLLC Backhaul Network

RÉSUMÉ: The 5G cellular network aims at providing three major services: Massive machine-type communication (mMTC), ultra-reliable low-latency communications (URLLC), and enhanced-mobile-broadband (eMBB). Among these services, the URLLC and eMBB require strict end-to-end latency of 1 ms while maintaining 99.999% reliability, and availability of extremely high data rates for the users, respectively. One of the critical challenges in meeting these requirements is to upgrade the existing optical fiber backhaul network interconnecting the base stations with a multigigabit capacity, low latency and very high reliability system. To address this issue, we have numerically analyzed 100 Gbit/s coherent optical orthogonal frequency division multiplexing (CO-OFDM) transmission performance over 400 km single-mode fiber (SMF) and 100 km of multi-mode fiber (MMF) links. The system is simulated over optically repeated and non-repeated SMF and MMF links. Coherent transmission is used, and the system is analyzed in a linear and non-linear regime. The system performance is quantified by bit error ratio (BER). Spectrally efficient and optimal transmission performance is achieved for 400 km SMF and 100 km MMF link. The results designate that MMF links can be employed beyond short reach applications by using them in the existing SMF infrastructure for long haul transmission. In particular, the proposed CO-OFDM system can be efficiently employed in 5G backhaul network. The multi-gigabit capacity and lower BER of the proposed system makes it a suitable candidate especially for the eMBB and URLLC requirements for 5G backhaul network

Biosynthesized Silver Nanoparticle (AgNP) From Pandanus odorifer Leaf Extract Exhibits Anti-metastasis and Anti-biofilm Potentials

Cancer and the associated secondary bacterial infections are leading cause of mortality, due to the paucity of effective drugs. Here, we have synthesized silver nanoparticles (AgNPs) from organic resource and confirmed their anti-cancer and anti-microbial potentials. Microwave irradiation method was employed to synthesize AgNPs using Pandanus odorifer leaf extract. Anti-cancer potential of AgNPs was evaluated by scratch assay on the monolayer of rat basophilic leukemia (RBL) cells, indicating that the synthesized AgNPs inhibit the migration of RBL cells. The synthesized AgNPs showed MIC value of 4–16 µg/mL against both Gram +ve and Gram -ve bacterial strains, exhibiting the anti-microbial potential. Biofilm inhibition was recorded at sub- MIC values against Gram +ve and Gram -ve bacterial strains. Violacein and alginate productions were reduced by 89.6 and 75.6%, respectively at 4 and 8 µg/mL of AgNPs, suggesting anti-quorum sensing activity. Exopolysaccharide production was decreased by 61–79 and 84% for Gram +ve and Gram -ve pathogens respectively. Flagellar driven swarming mobility was also reduced significantly. Furthermore, In vivo study confirmed their tolerability in mice, indicating their clinical perspective. Collective, we claim that the synthesized AgNPs have anti-metastasis as well as anti-microbial activities. Hence, this can be further tested for therapeutic options to treat cancer and secondary bacterial infections

Biosynthesized Silver Nanoparticle (AgNP) From Pandanus odorifer Leaf Extract Exhibits Anti-metastasis and Anti-biofilm Potentials

Cancer and the associated secondary bacterial infections are leading cause of mortality, due to the paucity of effective drugs. Here, we have synthesized silver nanoparticles (AgNPs) from organic resource and confirmed their anti-cancer and anti-microbial potentials. Microwave irradiation method was employed to synthesize AgNPs using Pandanus odorifer leaf extract. Anti-cancer potential of AgNPs was evaluated by scratch assay on the monolayer of rat basophilic leukemia (RBL) cells, indicating that the synthesized AgNPs inhibit the migration of RBL cells. The synthesized AgNPs showed MIC value of 4–16 µg/mL against both Gram +ve and Gram -ve bacterial strains, exhibiting the anti-microbial potential. Biofilm inhibition was recorded at sub- MIC values against Gram +ve and Gram -ve bacterial strains. Violacein and alginate productions were reduced by 89.6 and 75.6%, respectively at 4 and 8 µg/mL of AgNPs, suggesting anti-quorum sensing activity. Exopolysaccharide production was decreased by 61–79 and 84% for Gram +ve and Gram -ve pathogens respectively. Flagellar driven swarming mobility was also reduced significantly. Furthermore, In vivo study confirmed their tolerability in mice, indicating their clinical perspective. Collective, we claim that the synthesized AgNPs have anti-metastasis as well as anti-microbial activities. Hence, this can be further tested for therapeutic options to treat cancer and secondary bacterial infections

Measuring Coverage in MNCH:A Prospective Validation Study in Pakistan and Bangladesh on Measuring Correct Treatment of Childhood Pneumonia

Antibiotic treatment for pneumonia as measured by Demographic and Health Surveys (DHS) and Multiple Indicator Cluster Surveys (MICS) is a key indicator for tracking progress in achieving Millennium Development Goal 4. Concerns about the validity of this indicator led us to perform an evaluation in urban and rural settings in Pakistan and Bangladesh.Caregivers of 950 children under 5 y with pneumonia and 980 with "no pneumonia" were identified in urban and rural settings and allocated for DHS/MICS questions 2 or 4 wk later. Study physicians assigned a diagnosis of pneumonia as reference standard; the predictive ability of DHS/MICS questions and additional measurement tools to identify pneumonia versus non-pneumonia cases was evaluated. Results at both sites showed suboptimal discriminative power, with no difference between 2- or 4-wk recall. Individual patterns of sensitivity and specificity varied substantially across study sites (sensitivity 66.9% and 45.5%, and specificity 68.8% and 69.5%, for DHS in Pakistan and Bangladesh, respectively). Prescribed antibiotics for pneumonia were correctly recalled by about two-thirds of caregivers using DHS questions, increasing to 72% and 82% in Pakistan and Bangladesh, respectively, using a drug chart and detailed enquiry.Monitoring antibiotic treatment of pneumonia is essential for national and global programs. Current (DHS/MICS questions) and proposed new (video and pneumonia score) methods of identifying pneumonia based on maternal recall discriminate poorly between pneumonia and children with cough. Furthermore, these methods have a low yield to identify children who have true pneumonia. Reported antibiotic treatment rates among these children are therefore not a valid proxy indicator of pneumonia treatment rates. These results have important implications for program monitoring and suggest that data in its current format from DHS/MICS surveys should not be used for the purpose of monitoring antibiotic treatment rates in children with pneumonia at the present time