Mannheim Peritonitis Index in predicting the morbidity and mortality in patients with peritonitis due to Hollow Viscus Perforation: A Prospective study

INTRODUCTION: Peritonitis due to hollow viscus perforation is one of the common cause for emergency ward admission under surgery department at RGGGH, Chennai. Peritonitis causes vary from the one requiring immediate surgical intervention to that requiring conservative management. The accurate diagnosis and management of Peritonitis is a challenge to every surgeon. The complex nature of surgical infections, the multifaceted aspects of treatment, and the increasing complexity of ICU support make evaluation of new diagnostic and therapeutic advances in this field very difficult. Scoring systems that provide objective descriptions of the patient’s conditions at specific points in the disease process aid our understanding of these problems. Hence this study is undertaken to study the effectiveness of Mannheim peritonitis index in predicting the outcome in peritonitis patients who presented to our hospital. OBJECTIVES OF THE STUDY: To evaluate the prognostic value of MPI scoring system in patients with peritonitis due to hollow viscus perforation. MATERIALS & METHODS: This study is a clinical, prospective, observational and open study conducted at Rajiv Gandhi Government General Hospital, Madras Medical College, Chennai, during the period from April 2014 to September 2014.The data regarding patient particulars, diagnosis, investigations, and surgical procedures is collected in a specially designed case recording form and transferred to a master chart subjected to statistical methods like mean, standard deviation, proportion, percentage calculation and wherever necessary chi square test for proportion are used. RESULTS: In this study of 100 cases of secondary and tertiary peritonitis. The mean age of patients was 44.89 (SD 16.2) years ranging from 16 to 79 yrs . Majority(50%) of patients had MPI less than 21. 52.5% of patients with MPI score less than 21 developed complications . 45% of patients had complications with MPI score 21 to 27 . Complications include minor(wound infection) and major(Respiratory, Renal, Circulatory, Post operative leak) categories. There was no mortality in patients with MPI less than 21, whereas those patients with MPI score more than 29 had the highest mortality rate of 76.9%. Patient with MPI score from 21 to 29 had mortality rate of 23.1%. The outcome of the study is statistically significant by chi-square test with p Value <0.0001. CONCLUSION : MPI scoring system is simple score to apply ; the determination of risk is available during operation and the surgeon can know about the possible outcome and the appropriate management can be decided. The Mannheim Peritonitis Index (MPI) is an useful and simple index which can be effectively used in prediction of outcome of patients presenting with Peritonitis due to Hollow Viscus perforation

Structure and stability of glucoamylase II from Aspergillus niger: a circular dichroism study

Glucoamylase II (EC 3.2.1.3) from Aspergillus niger has 31 % &#945;-helix, 36 % &#946;-structure and rest aperiodic structure at pH 4.8 as analysed by the method of Provencher and Glockner (1981,Biochemistry, 20,33). In the near ultra-violet circular dichroism spectrum the enzyme exhibits peaks at 304, 289, 282 and 257 nm and troughs at 285, 277 and 265 nm respectively. The enzyme activity and structure showed greater stability at pH 4.8 than at pH 7.0, were highly sensitive to alkaline pH but less sensitive to acid pH values. The enzyme retained most of its catalytic activity and structure even on partial removal of carbohydrate moieties by periodate treatment but was less stable at higher temperatures and storage at 30&#8225;C. Reduction of the periodate treated enzyme did not reverse the loss of stability. Binding of the synthetic substrate, p-nitrophenyl-&#945;-D-glucoside, perturbed the environment around aromatic amino acids and caused a decrease in the ordered structure

Two-dimensional (2D) d-Silicates from abundant natural minerals

In the last decade, the materials community has been exploring new 2D materials (graphene, metallene, TMDs, TMCs, MXene, among others) that have unique physical and chemical properties. Recently, a new family of 2D materials, the so-called 2D silicates, have been proposed. They are predicted to exhibit exciting properties (such as high catalytic activity, piezoelectricity, and 2D magnetism). In the current work, we demonstrate a generic approach to the synthesis of large-scale 2D silicates from selected minerals, such as Diopside (d). Different experimental techniques were used to confirm the existence of the 2D structures (named 2D-d-silicates). DFT simulations were also used to gain insight into the structural features and energy harvesting mechanisms (flexoelectric response generating voltage up to 10 V). The current approach is completely general and can be utilized for large-scale synthesis of 2D silicates and their derivatives, whose large-scale syntheses have been elusive

Effect of HDAC Inhibitor on DNA Methylation and Cell Cycle Regulation in Prostate Cancer

Objective: Our study was aimed to analyse the expression of methyltransferase levels in LNCaP (prostate Cancer) cells during SAHA treatment. Background: Prostate cancer is the second leading cause of death in men after lung cancer in the US. Nearly 1 in 8 men will be diagnosed of prostate cancer in their lifetime, and the risk increases significantly once the men cross the age of 70. Recognizing ways to reduce the death of prostate cancer is therefore a top research priority. Epigenetic regulation of gene plays an important role in the controlling cell cycle and tumor growth in various cancers. Epigenetic changes generally occur through alterations in DNA and Histone modification such as acetylation, methylation, phosphorylation, and ubiquitination. SAHA (Suberoylanilide Hydroxamic Acid) is a broad spectram inhibitor of histone deacetylase (HDAC), which is used to modify the status of Histone Acetylation during cancer treatments. However, the impact of SAHA on methyltransferase levels or methylation status of DNA has not been studied in detail. Methods: LNCaP cells were cultured in complete RPMI-1640 growth medium and treated with SAHA (7.5 uM) for 24 hours. Western blot technique was used to analyze the expression levels of DNMT3A, SUV39H1, PRMT1, and p21. Results: Our experimental results have shown that SAHA treatment reduce the levels of the methyltransferase enzymes listed above. Furthermore, SAHA treatment increased the protein levels of p21, which is a CDKI (cyclin-dependent kinase inhibitor). Conclusion: Methylation is an important modification of DNA that can regulate gene expressions. Our results indicate that SAHA treatment, which is known to regulate histone acetylation, can impact the methylation status also through an indirect mechanism and allow for the control of transcription of tumor suppressor genes. Acknowledgement: This Research was supported by the Royal Dames of Cancer Research Inc., Ft. Lauderdale, Florida

Basal cell hyperplasia of prostate - an entity a urologist must know

We report 2 cases of basal cell hyperplasia of prostate, which is an uncommon and elusive lesion. It is commonly associated with benign prostatic hyperplasia (BPH) and may sometimes be mistaken for malignancy. The know-ledge about this disease helps in the correct diagnosis and avoidance of unnecessary or overtreatment

Genetic characterization of sulphur and iron oxidizing bacteria in manganese mining area of Balaghat and Chhindwara, Madhya Pradesh, India

595-601The aim of present study was to explore microbiology of manganese mining area of Balaghat and Chhindwara, Madhya Pradesh, India with the objective of reducing load of mine based pollution to support environmental sustainability with help of bacterial isolates. The research involves physicochemical analysis, culture dependent methods, 16S rDNA based sequencing and computational phylogenetic analysis. The 16S rDNA sequence analysis revealed the occurrence of two iron oxidizing bacteria (Staphylococcus hominis and Pseudomonas sp.) and four sulphur oxidizing bacteria (Bacillus cereus HYM74, B. anthracis, B. cereus D42 and Pantoea calida) in the selected sites. All cultures were able to grow on acidic as well as neutral pH medium and at low temperature of 4oC. Bacterial isolates were also found with heavy metal tolerance for Mn+7 and Cr+6 up to the concentration of 1000 ppm. This study assists the idea of biomineralization, bioremediation and future reclamation in the selected mining area with the help of bacteria