Managing Equipment for Emergency Obstetric Care in Rural Hospitals

In resource poor countries substantial sums of money, from governments and international donors, are used to purchase equipment for health facilities. WHO estimates that 50-80% of such equipment remains non-functional. This article is based on the experiences from various projects in developing countries in Asia and Africa. The key issues in the purchase, distribution, installation, management and maintenance of equipment for emergency obstetric care (EmOC) services are identified and discussed. Some positive examples are described to show how common equipment management problems are solved.

Madhu Agnikarma in the pain management of Tennis Elbow - A Case Study

Lateral epicondylitis, also known as ‘tennis elbow’, is a very common condition that presents with pain and tenderness on the lateral side of the elbow due to the repetitive stress, results in inflammation of the common extensor tendon of the lateral epicondyle of the humerus. According to Ayurveda, Snayugata Vikara can be correlated with the condition of tennis elbow. Agnikarma being superior among all surgical and parasurgical procedure by its action seems to be more effective in providing instant pain relief. The therapeutic effects of Agnikarma with Kshoudra include relief of pain and muscle spasm, acceleration of healing, promotion of resolution of inflammation and increase in the range of movement of joint

Potential role of p21 Activated Kinase 1 (PAK1) in the invasion and motility of oral cancer cells.

Background Oral cancer malignancy consists of uncontrolled division of cells primarily in and around the floor of the oral cavity, gingiva, oropharynx, lower lip and base of the tongue. According to GLOBOCAN 2012 report, oral cancer is one of the most common cancers among males and females in India. Even though significant advancements have been made in the field of oral cancer treatment modalities, the overall prognosis for the patients has not improved in the past few decades and hence, this demands a new thrust for the identification of novel therapeutic targets in oral cancer. p21 Activated Kinases (PAKs) are potential therapeutic targets that are involved in numerous physiological functions. PAKs are serine-threonine kinases and they serve as important regulators of cytoskeletal dynamics and cell motility, transcription through MAP kinase cascades, death and survival signalling, and cell-cycle progression. Although PAKs are known to play crucial roles in cancer progression, the role and clinical significance of PAKs in oral cancer remains poorly understood. Results Our results suggest that PAK1 is over-expressed in oral cancer cell lines. Stimulation of Oral Squamous Cell Carcinoma (OSCC) cells with serum growth factors leads to PAK1 re-localization and might cause a profound cytoskeletal remodelling. PAK1 was also found to be involved in the invasion, migration and cytoskeletal remodelling of OSCC cells. Conclusions Our study revealed that PAK1 may play a crucial role in the progression of OSCC. Studying the role of PAK1 and its substrates is likely to enhance our understanding of oral carcinogenesis and potential therapeutic value of PAKs in oral cancer

A study on the prescription pattern of antifungal drugs in the Dermatology Department of a tertiary care teaching hospital in Southern Kerala

Background: Skin disorders form 2% of total Out Patient Department consultations worldwide. But no such data is available from India. Studying prescription pattern is a component of medical audit that help prescribers to provide rational and cost-effective medical care. This study is about the prescription pattern of antifungals in this institution and will help in developing local policies for appropriate use of antifungal drugs. The objective was to study the prescription pattern of antifungals in dermatological diseases.Methods: This is a retrospective study conducted from 1st June 2017 to 30th November 2017 in Dermatology Department. Prescriptions included all newly diagnosed patients with cutaneous fungal infection of both sex who attended Dermatology OPD. Factors considered were sociodemographic parameters, number of patients with combination and monotherapy, number of single topical agents and Fixed Dose Combination (FDC) details of prescribing indicators.Results: 1500 prescriptions were analysed; 500 prescriptions were of fungal infection. 40.2% of the patients were in 18-35 years age group. There were a greater number of males (59.6%) than females (40.4%).Conclusions: The most common oral antifungal used was fluconazole. Terbinafine and clotrimazole were the most commonly used topical agents

The platelet-surface thiol isomerase enzyme ERp57 modulates platelet function

Background: Thiol isomerases are a family of endoplasmic reticulum enzymes which orchestrate redox-based modifications of protein disulphide bonds. Previous studies have identified important roles for the thiol isomerases PDI and ERp5 in the regulation of normal platelet function. Objectives: Recently, we demonstrated the presence of a further five thiol isomerases at the platelet surface. In this report we aim to report the role of one of these enzymes - ERp57 in the regulation of platelet function. Methods/Results: Using enzyme activity function blocking antibodies, we demonstrate a role for ERp57 in platelet aggregation, dense granule secretion, fibrinogen binding, calcium mobilisation and thrombus formation under arterial conditions. In addition to the effects of ERp57 on isolated platelets, we observe the presence of ERp57 in the developing thrombus in vivo. Furthermore the inhibition of ERp57 function was found to reduce laser-injury induced arterial thrombus formation in a murine model of thrombosis. Conclusions: These data suggest that ERp57 is important for normal platelet function and opens up the possibility that the regulation of platelet function by a range of cell surface thiol isomerases may represent a broad paradigm for the regulation of haemostasis and thrombosis

സമുദ്ര, സമുദ്രതീര ജീവികൾ

സമുദ്ര, സമുദ്രതീര ജീവിക

Circularly Polarized Split Ring Resonator Loaded Slot Antenna

A compact circularly polarized printed slot antenna operating at 2.45 GHz is reported. The antenna consists of a pair of rotated square split ring resonators (SRR) inside a rectangular slot etched on the ground plane of an FR-4 dielectric substrate. A microstrip open-loop feed is etched on the backside of the dielectric substrate to feed the slot and the split ring resonators. The overall size of the antenna is 60x42x1.6 mm3. The measured -10dB impedance bandwidth is 10.48% (2.38-2.64 GHz) and the measured 3dB axial ratio (AR) bandwidth covers the entire impedance bandwidth

Atmospheric dispersion corrector for a multi-object spectroscopic mode of HROS-TMT

Highly multiplexed spectroscopic surveys have changed the astronomy landscape in recent years. However, these surveys are limited to low and medium spectral resolution. High spectral resolution spectroscopy is often photon starved and will benefit from a large telescope aperture. Multiplexed high-resolution surveys require a wide field of view and a large aperture for a suitable large number of bright targets. This requirement introduces several practical difficulties, especially for large telescopes, such as the future ELTs. Some of the challenges are the need for a wide field atmospheric dispersion corrector and to deal with the curved non-telecentric focal plane. Here, we present a concept of Multi-Object Spectroscopy (MOS) mode for TMT High-Resolution Optical Spectrograph (HROS), we have designed an atmospheric dispersion corrector for individual objects that fit inside a fiber positioner. We present the ZEMAX design and the performance of the atmospheric dispersion corrector for all elevations accessible by TMT

RXR ligands negatively regulate thrombosis and hemostasis

OBJECTIVE: Platelets have been found to express intracellular nuclear receptors including the Retinoid X receptors (RXRα and RXRβ). Treatment of platelets with ligands of RXR has been shown to inhibit platelet responses to ADP and thromboxane A2, however the effects on responses to other platelet agonists as well as the underlying mechanism has not been fully characterised. APPROACH AND RESULTS: The effect of 9-cis-retinoic acid (9-cis-RA), docosahexaenoic acid and synthetic ligand for RXR, methoprene acid on collagen receptor (GPVI) agonists and Thrombin stimulated platelet function; including aggregation, granule secretion, integrin activation, calcium mobilisation, integrin αIIbβ3 outside-in signalling and thrombus formation in vitro and in vivo were determined. Treatment of platelets with RXR ligands resulted in attenuation of platelet functional responses following stimulation by GPVI agonists and thrombin and inhibition of integrin αIIbβ3 outside-in signalling. Treatment with 9-cis-RA caused inhibition of thrombus formation in vitro and an impairment of thrombosis and haemostasis in vivo. Both RXR ligands stimulated protein kinase A activation, measured by VASP S157 phosphorylation, that was found to be dependent on both cAMP and NFκB activity. CONCLUSIONS: This study identifies a widespread, negative regulatory role for RXR in the regulation of platelet functional responses and thrombus formation and describes novel events that lead to the upregulation of PKA, a known negative regulator of many aspects of platelet function. This mechanism may offer a possible explanation for the cardioprotective effects described in vivo following treatment with RXR ligands

The metabolites of the dietary flavonoid quercetin possess potent antithrombotic activity, and interact with aspirin to enhance antiplatelet effects

Quercetin, a dietary flavonoid, has been reported to possess antiplatelet activity. However, its extensive metabolism following ingestion has resulted in difficulty elucidating precise mechanisms of action. In this study, we aimed to characterize the antiplatelet mechanisms of two methylated metabolites of quercetin—isorhamnetin and tamarixetin—and explore potential interactions with aspirin. Isorhamnetin and tamarixetin inhibited human platelet aggregation, and suppressed activatory processes including granule secretion, integrin αIIbβ3 function, calcium mobilization, and spleen tyrosine kinase (Syk)/linker for activation of T cells (LAT) phosphorylation downstream of glycoprotein VI with similar potency to quercetin. All three flavonoids attenuated thrombus formation in an in vitro microfluidic model, and isoquercetin, a 3-O-glucoside of quercetin, inhibited thrombosis in a murine laser injury model. Isorhamnetin, tamarixetin, and quercetin enhanced the antiplatelet effects of aspirin more-than-additively in a plate-based aggregometry assay, reducing aspirin IC50 values by an order of magnitude, with this synergy maintained in a whole blood test of platelet function. Our data provide mechanistic evidence for the antiplatelet activity of two quercetin metabolites, isorhamnetin and tamarixetin, and suggest a potential antithrombotic role for these flavonoids. In combination with their interactions with aspirin, this may represent a novel avenue of investigation for the development of new antithrombotic strategies and management of current therapies