Role of C- Reactive Protein, Serum Amylase and Apache II Scoring System in predicting the severity of Acute Pancreatitis

INTRODUCTION: Acute pancreatitis is an inflammatory disease ranging from mild self- limiting course to a fulminant phase with multiple organ failure and mortality. It occur in two forms, 80% of patients develops edematous pancreatitis and 20% manifest as acute necrotising pancreatitis. The average mortality rate for edematous type is < 1% and necrotising type ranges from 10-20%. Patients with mild type managed with aggressive fluid resuscitation and supportive care. Severe AP may require maximal non operative care and nutritional support. Severe AP is divided into two-phase systemic disease. In the early phase (Within initial 2 weeks) development of pancreatic inflammation and necrosis, followed by systemic inflammatory response syndrome (SIRS) ultimately leading to multiple organ dysfunction syndromes (MODS). Mortality is high due to MODS. If the early phase is not corrected by therapeutic intervention, then late phase occurs after the second week of onset, and includes the formation of infected pancreatic necrosis or fluid collection with possible progression to overt sepsis, MODS and death. Organ failure is present in only half of the patients with pancreatic necrosis. The mortality rate for MODS ranges from 30 to 100%. Respiratory failure is the most common type of organ failure in AP. Increasing knowledge of the importance of proinflammatory and anti-inflammatory cytokine helps in development of anti-inflammatory therapy which is beneficial. AIMS OF THE STUDY: 1. To correlate and analyse the various clinical presentations of acute pancreatitis. 2. To predict the severity of acute pancreatitis with available clinico biochemical parameters. 3. To assess the severity in relation to serum C REACTIVE PROTEIN. 4. To prognosticate and assess the severity of the disease. 5. To predict the outcome of acute pancreatitis with regard to serum CRP. MATERIALS & METHODS: 54 patients are included in this study who presented with acute pancreatitis in the department of surgical emergency, Thanjavur medical college during the period of October 2015- August 2016. STUDY DESIGN: Prospective study from October 2015- August 2016. INCLUSION CRITERIA: Patients diagnosed as acute pancreatitis irrespective of sex and age over 25 years. EXCLUSION CRITERIA: 1. Patient age < 25 years. 2. Patient diagnosed as chronic pancreatitis. 3. Withdrawl / refusal to consent. CONCLUSION: 1. Serum CRP is the important single prognostic marker of predicting the severe pancreatitis with the cut off value of 150mg/L. 2. CRP levels increase significantly in early stages of pancreatic necrosis. 3. CRP plays a critical role in initial process of diagnosis, as an early predictive indicator of severity of the disease and helps in detecting the mortality in this study. 4. Serum CRP plays a major role in stratifying the patients for early aggressive intervention of acute pancreatitis to reduce morbidity and mortality

Influence of Growth Time on Zinc Oxide Nano Rods Prepared By Dip Coating Method

ABSTRACT: The Dip coating method was used for the preparation of ZnO nano rods and their structural, morphological, optical and photoluminescence properties were taken for study. ZnO seed layer thin films were prepared by dip coating method on well cleaned glass substrates. ZnO seed-coated glass substrates were immersed in aqueous solution of zinc nitrate and hexamethylenetetramine (HMT) at three different growth time of 3, 4 and 5 hours at low temperature of 90°C. 0.02 mol of Zinc nitrate and 0.2 mol of Hexamethylenetetramine (HMT) on 1:10 molar concentration were used for the growth of Zinc oxide nano rods. The growth time influence on the surface morphology of the films was examined. The structure of the ZnO nano rod was studied with X-ray diffraction. The surface morphology was studied with Scanning Electron Microscope. The absorption and transmittance was studied with UVVis spectrophotometer. The excitation studies were examined with photoluminescence spectroscopy. Experimental results have shown that prepared ZnO nano rods by this method have increase in c-axis orientation due to increase in growth time

Identification of a novel prophage regulator in Escherichia coli controlling the expression of type III secretion

This study has identified horizontally acquired genomic regions of enterohaemorrhagic Escherichia coli O157:H7 that regulate expression of the type III secretion (T3S) system encoded by the locus of enterocyte effacement (LEE). Deletion of O-island 51, a 14.93 kb cryptic prophage (CP-933C), resulted in a reduction in LEE expression and T3S. The deletion also had a reduced capacity to attach to epithelial cells and significantly reduced E. coli O157 excretion levels from sheep. Further characterization of O-island 51 identified a novel positive regulator of the LEE, encoded by ecs1581 in the E. coli O157:H7 strain Sakai genome and present but not annotated in the E. coli strain EDL933 sequence. Functionally important residues of ECs1581 were identified based on phenotypic variants present in sequenced E. coli strains and the regulator was termed RgdR based on a motif demonstrated to be important for stimulation of gene expression. While RgdR activated expression from the LEE1 promoter in the presence or absence of the LEE-encoded regulator (Ler), RgdR stimulation of T3S required ler and Ler autoregulation. RgdR also controlled the expression of other phenotypes, including motility, indicating that this new family of regulators may have a more global role in E. coli gene expression

The cAMP pathway is important for controlling the morphological switch to the pathogenic yeast form of Paracoccidioides brasiliensis

Paracoccidioides brasiliensis is a human pathogenic fungus that switches from a saprobic mycelium to a pathogenic yeast. Consistent with the morphological transition being regulated by the cAMP-signalling pathway, there is an increase in cellular cAMP levels both transiently at the onset (< 24 h) and progressively in the later stages (> 120 h) of the transition to the yeast form, and this transition can be modulated by exogenous cAMP. We have cloned the cyr1 gene encoding adenylate cyclase (AC) and established that its transcript levels correlate with cAMP levels. In addition, we have cloned the genes encoding three Gα (Gpa1–3), Gβ (Gpb1) and Gγ (Gpg1) G proteins. Gpa1 and Gpb1 interact with one another and the N-terminus of AC, but neither Gpa2 nor Gpa3 interacted with Gpb1 or AC. The interaction of Gpa1 with Gpb1 was blocked by GTP, but its interaction with AC was independent of bound nucleotide. The transcript levels for gpa1, gpb1 and gpg1 were similar in mycelium, but there was a transient excess of gpb1 during the transition, and an excess of gpa1 in yeast. We have interpreted our findings in terms of a novel signalling mechanism in which the activity of AC is differentially modulated by Gpa1 and Gpb1 to maintain the signal over the 10 days needed for the morphological switch

Elucidation of the RamA Regulon in Klebsiella pneumoniae Reveals a Role in LPS Regulation

Klebsiella pneumoniae is a significant human pathogen, in part due to high rates of multidrug resistance. RamA is an intrinsic regulator in K. pneumoniae established to be important for the bacterial response to antimicrobial challenge; however, little is known about its possible wider regulatory role in this organism during infection. In this work, we demonstrate that RamA is a global transcriptional regulator that significantly perturbs the transcriptional landscape of K. pneumoniae, resulting in altered microbe-drug or microbe-host response. This is largely due to the direct regulation of 68 genes associated with a myriad of cellular functions. Importantly, RamA directly binds and activates the lpxC, lpxL-2 and lpxO genes associated with lipid A biosynthesis, thus resulting in modifications within the lipid A moiety of the lipopolysaccharide. RamA-mediated alterations decrease susceptibility to colistin E, polymyxin B and human cationic antimicrobial peptide LL-37. Increased RamA levels reduce K. pneumoniae adhesion and uptake into macrophages, which is supported by in vivo infection studies, that demonstrate increased systemic dissemination of ramA overexpressing K. pneumoniae. These data establish that RamA-mediated regulation directly perturbs microbial surface properties, including lipid A biosynthesis, which facilitate evasion from the innate host response. This highlights RamA as a global regulator that confers pathoadaptive phenotypes with implications for our understanding of the pathogenesis of Enterobacter, Salmonella and Citrobacter spp. that express orthologous RamA proteins

Associations between cognitive-emotion regulation, social support and physical strength towards psychological well-being among graduate students

The research was conducted to examine the associations between cognitive-emotion regulation, social support and physical strength towards the psychological well-being of graduate students. Four instruments were used in this research namely Psychological Well-being by Ryff C. (1989), Cognitive-Emotion Regulation by Garnefsky N. and Kraaij V. (2006), Multidimensional Scale of Perceived Social Support by Greg Zimet (1988) and Exercise Habit Strength Questionnaire by Grove & Ortega (2005). A total of 3426graduate students (2124 females and 1302 males) were randomly selected in one Malaysian university. Data were analyzed using an independent t-test, Pearson correlation, and multiple regressions. The finding of this study revealed that the self-blame and negative consequences were the most significant factors influencing psychological well-being. The findings of the study also explained that students scored highest in the strategy of other-blame for cognitive-emotion regulation. With regard to social support, graduate students received support from significant others more than friends and family. With respect to exercise habit strength, strong stimulus-response scored the highest mean compared to other sub-factors

Human capital investment expenditures of women of female-headed household in Peninsular Malaysia

This study aims to investigate the human capital expenditure, expenditure share of human capital investment expenditure and the probability of having human capital investment among women of female-headed households. The data were obtained from a nationwide study on “Economic wellbeing and human capital investment of female-headed household” funded by the Ministry of Science, Technology and Innovation (MOSTI), government of Malaysia, under the e-Science Grant. Four states (Kedah, Pahang, Negeri Sembilan and Selangor) represents four zones were selected using simple random technique with 68% of response rate. The study found that women of female-headed household spent about 21% of their yearly income in reading material followed by health (18%) and personal care (15%). Similarly, expenditure share about 67% of their yearly income was spent on reading materials followed by health (63%) and personal care (58%) Further analysis revealed that those who have a higher household income (OR = 0.023; P<0.05) and smaller household size (OR = 0.028; P<0.05) were found to be significant invested part of their household expenses for their own human capital purposes