Utility of urine reagent strips in rapid bedside diagnosis of bacterial meningitis

Background: Bacterial meningitis is a medical emergency and late diagnosis and treatment can lead to neurological damage and death. For definitive diagnosis of meningitis, laboratory based CSF analysis is required which is based on microscopy, protein and sugar estimation. This requires laboratory set up with experienced pathologist and long turn around time. Hence urinary reagent strips as a semiquantitative method can be applied for CSF analysis. This method can be used where laboratory set up is not available as well as bedside test for early diagnosis of bacterial meningitis. The present prospective study was undertaken to evaluate the utility of urine reagent strips in rapid diagnosis of bacterial meningitis. The aim of the present was to evaluate the role of urine reagent strips in the analysis of cerebrospinal fluid in suspected cases of meningitis.Methods: The prospective study was carried out in the department of pathology in a tertiary care centre for a period of 6 months from September 2018 to February 2019. CSF analysis of suspected cases of meningitis was done with urine reagent strip as well as with standard laboratory method. The results of both were compared.Results: Out of 79 cases of meningitis, 68.35% cases were of bacterial meningitis. The specificity and sensitivity of CSF analysis with reagent strip was 93.33% and 82.35% respectively, for cell count, 94.4% and 88.2% respectively for proteins and 91.3% and 60.2% respectively for glucose.Conclusions: Semiquantitative analysis of CSF sample with urine reagent strips helps in rapid diagnosis of bacterial meningitis and can be useful to facilitate therapeutic decisions in resource constrained settings

Parachordoma: a rare recurring case at a rare site

Parachordoma is an uncommon tumor of soft tissue and the orign is not clear. This soft tissue tumor resembles chordomas as well as extraskeletal myxoid chondrosarcomas and has only recently been fully characterized. Although it is considered a benign lesion, its behavior tends to be locally aggressive, with reports of a recurrence rate of up to 20% and of several cases of metastasis. In this article, we report a case of parachordoma in the neck with recurrence that we met in clinical works

Single bath enzymatic scouring and bleaching process for preparation of absorbent cotton

This study aims at developing an enzyme based single bath scouring and bleaching process for the preparation of absorbent cotton using short staple cotton fibre with high micronaire. Neutral pectinase and cellulase enzymes individually and also in combination for scouring and hydrogen peroxide for bleaching have been used. The enzymatic process has been optimized to get the desired absorbency of less than 10 s as prescribed by pharmacopeia. An attempt has also been made to explore the possibility of combining the enzyme treatment with peroxide bleaching in a single bath. The result indicates that like conventional scouring and bleaching processes the enzymatic process with a mixture of pectinase and cellulase followed by bleaching produces required qualities for the cotton to be used as absorbent cotton. The absorbent cotton thus produced by the above process shows sinking time of 1.8 s, water holding capacity of 24 grams per gram fibre and less than 0.5% sulphated ash. The weight loss for the single bath scouring and bleaching process is found 18% less as compared to conventional process without any significant difference in the whiteness index and absorbency. The carboxyl content of the treated fibres shows that the formation of oxycellulose is lesser in enzymatic process as compared to conventional treatment. The relative crystallinity index obtained from FTIR spectra shows that the change in proportion of crystalline and amorphous regions is lesser in enzyme treated fibres. The developed process is ecofriendly with savings in energy, time and water along with minimum physical and chemical changes in the fibre

A clinical study to evaluate the effect of Dashamoola Trivrit Taila Paana in Kashtartava w.s.r. Dysmenorrhoea

Dysmenorrhoea means difficult menstruation but the term is used to mean painful menstruation, but a more practical definition includes cases of painful menstruation of sufficient magnitude so as to incapacitate day to day activities.[1] Kashtartava is Pratyama Laxana of various Yonivyapads like - Vatala, Paripluta, Udavartini, Mahayoni, Antarmukhi, Sukimukki and also in Vataja Artava Dhushti, Khsina Artava Dhushuti, Asrgdara that affects approximately 50% of menstruating women. It is common reason for losing time at school or work or for visiting the family doctor. Pain is the biggest problem since the beginning of mankind. Morbid Vata Dosha especially Apana Vata is causative factor of Kashtartava. Drugs which have Vatahara Artava Doshahara properties are beneficial. Considering the morbidity and the complications that are caused by Kashtartava, combination of above herbal preparation has been tried here. Here, in this study Dashmoola Trivrit Taila having property of Shula Prashamana Vatanulomana and Vatashamaka is indicated in the form of Paana

Alcohol Detection and Engine Locking of Vehicle using Embedded Model

This paper proposes making vehicle driving safer than before. We have designed an embedded model which is implemented using Atmel AT89S52 microcontroller. We have derived the driver’s condition in real time environment and we propose the detection of alcohol using MQ-3 alcohol detector connected to microcontroller such that when the level of alcohol crosses a permissible limit, the vehicle ignition system will be turned off

Exonerations in the United States 1989 Through 2003

On August 14, 1989, the Cook County Circuit Court in Chicago, Illinois, vacated Gary Dotson\u27s 1979 rape conviction and dismissed the charges.1 Mr. Dotson-who had spent ten years in and out of prison and on parole for this conviction-was not the first innocent prisoner to be exonerated and released in America. But his case was a breakthrough nonetheless: he was the first who was cleared by DNA identification technology. It was the beginning of a revolution in the American criminal justice system. Until then, exonerations of falsely convicted defendants were seen as aberrational. Since 1989, these once-rare events have become disturbingly commonplace

Exonerations in the United States 1989 through 2003

On August 14, 1989, the Cook County Circuit Court in Chicago, Illinois, vacated Gary Dotson\u27s 1979 rape conviction and dismissed the charges.1 Mr. Dotson-who had spent ten years in and out of prison and on parole for this conviction-was not the first innocent prisoner to be exonerated and released in America. But his case was a breakthrough nonetheless: he was the first who was cleared by DNA identification technology. It was the beginning of a revolution in the American criminal justice system. Until then, exonerations of falsely convicted defendants were seen as aberrational. Since 1989, these once-rare events have become disturbingly commonplace

Comparing outcomes of robotic versus open mesorectal excision for rectal cancer

Background: The outcomes of robot-assisted mesorectal excision for rectal cancer, compared with open resection, have not been fully characterized. Methods: A retrospective analysis of pathologic, short-term, and long-term outcomes in patients with rectal adenocarcinoma who underwent total or tumour-specific mesorectal excision at a high-volume cancer centre between 2008 and 2017 was conducted. Outcomes after robotic and open surgery were compared on an intention-to-treat basis. Results: Out of 1048 resections performed, 1018 patients were reviewed, with 638 who underwent robotic surgery and 380 open surgery. Robotic surgery was converted to the open approach in 17 (2.7 per cent) patients. Patients who underwent robotic surgery were younger (median 54 (range 22–91) years versus median 58 (range 18–97) years; P < 0.001), had higher tumours (median 80 (range 0–150) mm from the anal verge versus median 70 (0–150) mm; P ¼ 0.001), and were less likely to have received neoadjuvant therapy (64 per cent versus 73 per cent; P ¼ 0.003). For patients who underwent a robotic total mesorectal excision, the operating time was longer (median 283.5 (range 117–712) min versus median 249 (range 70–661) min; P < 0.001). However, the rate of complications was lower (29 per cent versus 45 per cent; P < 0.001) and length of hospital stay was shorter (median 5 (range 1–32) days versus median 7 (range 0–137) days; P < 0.001). Median follow-up of survivors was 2.9 years. The proportion of patients with a positive circumferential resection margin did not differ between the groups, nor did the rate of local recurrence (robotic versus open: 3.7 per cent, 95 per cent c.i. 1.9 to 5.6 versus 2.8 per cent, 95 per cent c.i. 1.0 to 4.6; P ¼ 0.400), systemic recurrence (ro- botic versus open: 11.7 per cent, 95 per cent c.i. 8.5 to 14.8 versus 13.0 per cent, 95 per cent c.i. 9.2 to 16.5; P ¼ 0.300), or overall sur- vival (robotic versus open: 97.8 per cent, 95 per cent c.i. 96.3 to 99.3 versus 93.5 per cent, 95 per cent c.i. 90.8 to 96.2; P ¼ 0.050). The same results were documented in a subanalysis of 370 matched patients, including 185 who underwent robotic surgery and 185 open surgery, for the overall incidence of any postoperative complications, overall survival, disease-free survival, local recur- rence, and systemic recurrence. Conclusion: In patients with rectal cancer who are candidates for curative resection, robotic mesorectal excision is associated with lower complication rates, shorter length of stay, and equivalent oncologic outcomes, compared with open mesorectal excisio

Assessing fracture risk in early stage breast cancer patients treated with aromatase-inhibitors: An enhanced screening approach incorporating trabecular bone score

AbstractIntroductionAromatase-inhibitors (AIs) are commonly used for treatment of patients with hormone-receptor positive breast carcinoma, and are known to induce bone density loss and increase the risk of fractures. The current standard-of-care screening tool for fracture risk is bone mineral density (BMD) by dual-energy X-ray absorptiometry (DXA). The fracture risk assessment tool (FRAX®) may be used in conjunction with BMD to identify additional osteopenic patients at risk of fracture who may benefit from a bone-modifying agent (BMA). The trabecular bone score (TBS), a novel method of measuring bone microarchitecture by DXA, has been shown to be an independent indicator of increased fracture risk. We report how the addition of TBS and FRAX®, respectively, to BMD contribute to identification of elevated fracture risk (EFR) in postmenopausal breast cancer patients treated with AIs.Methods100 patients with early stage hormone-positive breast cancer treated with AIs, no prior BMAs, and with serial DXAs were identified. BMD and TBS were measured from DXA images before and following initiation of AIs, and FRAX® scores were calculated from review of clinical records. EFR was defined as either: BMD ≤−2.5 or BMD between −2.5 and −1 plus either increased risk by FRAX® or degraded microstructure by TBS.ResultsAt baseline, BMD alone identified 4% of patients with EFR. The addition of FRAX® increased detection to 13%, whereas the combination of BMD, FRAX® and TBS identified 20% of patients with EFR. Following AIs, changes in TBS were independent of changes in BMD. On follow-up DXA, BMD alone detected an additional 1 patient at EFR (1%), whereas BMD+ FRAX® identified 3 additional patients (3%), and BMD+FRAX®+TBS identified 7 additional patients (7%).ConclusionsThe combination of FRAX®, TBS, and BMD maximized the identification of patients with EFR. TBS is a novel assessment that enhances the detection of patients who may benefit from BMAs