A probable case of sodium valproate monotherapy induced drug reaction with eosinophilia and systemic symptoms syndrome: a case report in Indian population

Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome is a drug-induced hypersensitivity syndrome most commonly caused by anti-epileptics like carbamazepine, phenytoin. It usually manifests as maculopapular rash, fever, eosinophilia, generalized lymphadenopathy, hepatitis, atypical lymphocytosis, and leucocytosis with the involvement of other organs. Valproate, a broad-spectrum antiepileptic, also used in bipolar disorders and migraine prophylaxis, is generally well tolerated. To date, very few cases of valproate monotherapy induced DRESS syndrome have been reported worldwide and here we are reporting one such rare case in a 72 years old Indian woman with a history of generalised tonic convulsions. The patient was classified as a ‘probable’ case of DRESS syndrome using the WHO-UMC criteria and Naranjo scale. Discontinuation of the offending medication and treatment with intravenous (IV) fluids, antihistamines, and steroids helped in recovery of the patient. Healthcare practitioners must be aware of valproate monotherapy induced DRESS syndrome and take effective measures to avoid severe side effects.

Awareness of order of blood draw among nurses in tertiary care hospital

Background: Phlebotomy or drawing of blood sample is one of the initial steps in processing of samples for various investigations of the patients in clinical laboratory. The sample for various investigation has to follow certain protocol or order of blood draw into different vacutainers by phlebotomist or the clinical person drawing the blood to avoid errors in test results. Hence awareness of order of blood draw among them is very essential.Methods: It is a cross sectional and observational study. Based on CLSI H3-A6 (clinical and laboratory standards institute) guidelines, a questionnaire consisting of 13 multiple choice questions was prepared after validation and distributed amongst the nurses, who were on duty during the study. The answers to the questionnaire were analysed using SPSS version 23. Descriptive statistics was done for all the data collected.Results: Total 120 nurses participated in this study in a tertiary care hospital. Nurses who were able to identify Color of the vacutainer with respective to additives (90%), correct order of draw (52%), volume of blood sample collected in vacutainer (62.9%), sample collected directly into vacutainer with vacuum suction (61.7%) was incomplete. Nurses also had wrong practices, where sample was transferred from one vacutainer to other (3.3%), collected the blood sample from the arm which had IV line (28%).Conclusions: In this study, it was found that awareness on the level of order of blood draw among nurses was found unsatisfactory. Frequent training and monitoring of work practices should be developed for nurses to reduce the errors in sample collection

Rabconnectin-3α/DMXL2 Is Locally Enriched at the Synaptic Ribbon of Rod Photoreceptor Synapses

Ribbon synapses reliably transmit synaptic signals over a broad signalling range. Rod photoreceptor ribbon synapses are capable of transmitting signals generated by the absorption of single photons. The high precision of ribbon synapses emphasizes the need for particularly efficient signalling mechanisms. Synaptic ribbons are presynaptic specializations of ribbon synapses and are anchored to the active zone. Synaptic ribbons bind many synaptic vesicles that are delivered to the active zone for continuous and faithful signalling. In the present study we demonstrate with independent antibodies at the light- and electron microscopic level that rabconnectin-3α (RC3α)—alternative name Dmx-like 2 (DMXL2)—is localized to the synaptic ribbons of rod photoreceptor synapses in the mouse retina. In the brain, RC3α-containing complexes are known to interact with important components of synaptic vesicles, including Rab3-activating/inactivating enzymes, priming proteins and the vesicular H+ -ATPase that acidifies the synaptic vesicle lumen to promote full neurotransmitter loading. The association of RC3α/DMXL2 with rod synaptic ribbons of the mouse retina could enable these structures to deliver only fully signalling-competent synaptic vesicles to the active zone thus contributing to reliable synaptic communication

Bone hydatid disease of distal femur and diaphysis of tibia: report of two cases with review of literature

Cystic echinococcus or hydatidosis is a parasitic infection of humans and animals. In this we are reporting 2 cases. one is hydatid disease at distal femur left side and other patient having hydatid disease at shaft tibia rt side. both cases investigated and definitive surgery was done as arthrodesis with long tibio-femoral nail for distal femoral hydatidosis and curettage for tibial hydatidosis. Both patient given albendazole and followed up. in recent follow-up both cases do not have signs of recurrence. hence case report of these two cases is discussed along with review of literature

Anomaly Extraction Using Histogram-Based Detector

Now a day’s network traffic monitoring and performance of the network are more important aspect in the computer science. Anomaly Extraction is a method of detecting in large set of flow observed during an anomalous time interval, the flows associated with the one or more anomalous event. Anomaly extraction is important problem that essential for application ranging from root cause analysis and attack mitigation and anomaly extraction is also important problem for several application of testing anomaly detector. In this paper, use a meta-data provided by histogram detector for detect and identify the suspicious flow after successfully detection suspicious flow then applying the association rule mining for finding the anomalous flow. By using the rich traffic data from the meta-data of the histogram-based detector we can reduce the classification cost. In this paper, Anomaly extraction method reduce the working time which is required for analyzing alarm, its make system more practically. DOI: 10.17762/ijritcc2321-8169.15011

Effect of post harvest treatments and harvesting stage on vase life and flower quality of cut Oriental lily

An investigation was carried out to study the effect of post harvest treatments and harvesting stage on vase life and flower quality of cut Oriental lily cv. Avocado. The results showed that highest vase life (15.83 days) and vase solution uptake (49.17 ml) was recorded with sucrose (2%) + 5-SSA (200ppm), whereas maximum flower diameter (15.17 cm) was recorded in vase solution containing sucrose (2%) + 5-SSA (100ppm). Earliest opening of florets (4.42 days) reported under sucrose (2%) + 5-SSA (200ppm). Effect of treatments was found non-significant in respect to opening of florets. Harvesting at green bud stage exhibited extended vase life (14.33 days) and higher vase solution uptake (40.43 ml), whereas maximum flower diameter (14.25 cm) recorded at 75% colour development stage. Based on the results it is concluded that 5-SSA could be an inexpensive and potential chemical for delaying senescence and for extending the keeping quality of cut liliums commercially