Outcomes of Primary Repair in Typhoid Perforation

Objective: To determine the outcomes of primary repair in patients with typhoid perforation.Study Design: Case series studyStudy Duration: Study was conducted for 3 year from 15th January 2014 to 15th January 2017.Methodology: 280 Patients presenting to the emergency department were included according to the inclusion and exclusion criteria via nonprobability consecutive sampling. Written informed consent was taken. The surgical procedure was performed by a senior surgeon having experience of more than 5 years. Postoperatively patient was followed up for ten days and final outcomes (wound infection, anastomotic leakage, wound dehiscence and intra-abdominal collection were assessed clinically and by ultrasound abdomen and was recorded on prescribed Performa. Data was entered and analyzed by using SPSS version 17Results: The age range was from 15 to 50 years (average age of 25.9 + 9.87 years). Out 280 patients, 108(38.6%) were male and 172 (61.1%) were female. Intra-abdominal collection occurred in 18(6.4%), wound dehiscence in 14(5%), wound infection in 74(26.4%) and anastomotic leakage in 12(4.3%). Conclusion: The primary repair of perforation is the treatment of choice for typhoid perforation. Early surgery and adequate resuscitation is necessary for successful management of patients with typhoid perforation

ANALYSIS OF PARENT TEACHER COUNCIL COLLABORATION FOR THE DEVELOPMENT OF EDUCATIONAL INSTITUTIONS

Purpose: Parent Teacher Council (PTC) is a school community which has the role in educational institutions to develop schools academically and financially. Methods: In this study, the output analysis of school communities for the schools’ development and educational enhancement were investigated. The tool of the study was a questionnaire which was administered to the school community secretaries and chairpersons. The tool of the study was already validated by sending to the panel of experts and its reliability was tested on Cronbach’s alpha (0.83) and factor analysis (0.56). It was a descriptive and non-experimental survey research. In this study, the collected data were analyzed on Chi square as statistical test. Results: The findings of the study revealed that PTC as school communities were established and had not put into account their tasks as they were asked to perform. The problem with these communities that they were not functional and did not know what was their role in schools which they had to perform. Their role was suffered owing to illiterate parents and due to that, the vacuum was found in the schools and school community collaboration

Study of Gc-ms And Hplc Characterized Metabolic Compounds in Guava (Psidium Guajava L.) Leaves

Psidium guajava leaves are rich source of nutrients, antioxidants, phytoconstituents and biological active compounds. The study was designed to elucidate secondary metabolites like alkaloids, saponins, flavonoids, tannins and glycosides in extracts of guava leaves through Gas chromatography-mass spectrometry (GC-MS) and high-performance liquid chromatography (HPLC) by qualitative as well as quantitative procedures. These metabolites were further tested for their antimicrobial potential against two-gram positive (Bacillus subtilis and Staphylococcus aureus) and two-gram negative (Escherichia coli and Pasteurella multocida) bacteria and three pathogenic fungal strains (Asprrgillus niger, Fusarium solani and Aspergillus flavus). GC-MS analysis revealed the presence of major constituents like Ca- Caryophyllene (22.70%), α cubebene (11.2%) and alpha Humulene (5.91%). The ethyl-acetate, methanol, n-hexane and chloroform extracts were tested for antibacterial and antifungal activities against above mentioned microbes. Among all the tested solvent extracts, Chloroform and ethyl acetate extracts of P. guajava demonstrated more sensitivity towards the growth of B. subtilis and P. multocida with MIC of 230±3.02, 316. ±6.2 and 237±5.09 and 288±1.55 μg/ml, respectively. Methanolic extracts showed higher MIC against S. aureus (233±5.51 μg/ml) and E. coli (192±2.05 μg/ml), respectively. The findings of this current study would provide the way to use guava as a potential therapeutic agent to combat antimicrobial and antifungal resistance

Role of Hypogonadotropic Hypogonadism in Psychosocial Deprivation among Females Patients

Background: Patients with rare diseases such as congenital hypogonadotropic hypogonadism (CHH) are often challenged to be isolated, lack proper medical care and face negative social consequences. Furthermore, pubertal development is the period of rapid and nearly simultaneous transformation of biological, physical, social, and psychological domains of an individual. Hence, the process of personal transformation is also affected in children with pubertal delay. Due to delay in the growth process, the individual looks different from her or his peers and may have negative consequences on the psychological and social interactions. Objective: The disparities in the growth and development may cause an increase in psychosocial problems and negative peer relationship. Hence, this study was designed to observe psychosocial consequences of delayed puberty in female with CHH. Design: Cross sectional study. Place & duration of study: The data were collected from CHH patients visiting public sector hospitals over a period of 18 months. Patients & Methods: The demographic information, complete medical history, psychological and psychosocial symptoms of the 52 female CHH patients were recorded on the questionnaire. Results: The present study demonstrated that most of the patients were frustrated due to poor body image, low self-esteem, feeling themselves behind the peers, and were with complaints of depression and anxiety. The other psychological symptoms include anger, irritability, loneliness, eating and sleeping disturbances. Conclusion: It was concluded that the delayed sexual maturation has resulted in frustration, low self-esteem and increased anxiety and depression in cohort of local females with CHH

Chemical composition and pharmacological bio-efficacy of Parrotiopsis jacquemontiana (Decne) Rehder for anticancer activity

Consistent STAT3 (Single transducer and activator of transcription 3) activation is observed in many tumors and promotes malignant cell transformation. In the present investigation, we evaluated the anticancer effects of Parrotiopsis jacquemontiana methanol fraction (PJM) on STAT3 inhibition in HCCLM3 and MDA-MB 231 cells. PJM suppressed the activation of upstream kinases i.e. JAK-1/2 (Janus kinase-1/2), and c-Src (Proto-oncogene tyrosine-protein kinase c-Src), and upregulated the expression levels of PIAS-1/3 (Protein Inhibitor of Activated STATs-1/3), SHP-1/2 (Src-homology region 2 domain-containing phosphatase-1/2), and PTP-1β (Protein tyrosine phosphatase 1 β) which negatively regulate STAT3 signaling pathway. PJM also decreased the levels of protein products conferring to various oncogenes, which in turn repressed the proliferation, migration, invasion, and induced apoptosis in cancer cell lines. The growth inhibitory effects of PJM on cell-cycle and metastasis were correlated with decreased expression levels of CyclinD1, CyclinE, MMP-2 (Matrix metalloproteinases-2), and MMP-9 (Matrix metalloproteinases-9). Induction of apoptosis was indicated by the cleavage and subsequent activation of Caspases (Cysteine-dependent Aspartate-directed Proteases) i.e. caspase-3, 7, 8, 9, and PARP (Poly (ADP-ribose) polymerase) as well as through the down-regulation of anti-apoptotic proteins. These apoptotic effects of PJM were preceded by inhibition of STAT3 cell-signaling pathway. STAT3 was needed for PJM-induced apoptosis, and inhibition of STAT3 via pharmacological inhibitor (Stattic; SC-203282) abolished the apoptotic effects. Conclusively, our results demonstrate the capability of PJM to inhibit cancer cell-proliferation and induce apoptosis by suppressing STAT3 via upregulation of STAT3 inhibitors and pro-apoptotic proteins whereas the down-regulation of upstream kinases and anti-apoptotic protein expression. In future, one-step advance studies of PHM regarding its role in metastatic inhibition, immune response modulation for reducing tumor, and inducing apoptosis in suitable animal models would be an interesting and promising research area

Effect of early tranexamic acid administration on mortality, hysterectomy, and other morbidities in women with post-partum haemorrhage (WOMAN): an international, randomised, double-blind, placebo-controlled trial

Background Post-partum haemorrhage is the leading cause of maternal death worldwide. Early administration of tranexamic acid reduces deaths due to bleeding in trauma patients. We aimed to assess the effects of early administration of tranexamic acid on death, hysterectomy, and other relevant outcomes in women with post-partum haemorrhage. Methods In this randomised, double-blind, placebo-controlled trial, we recruited women aged 16 years and older with a clinical diagnosis of post-partum haemorrhage after a vaginal birth or caesarean section from 193 hospitals in 21 countries. We randomly assigned women to receive either 1 g intravenous tranexamic acid or matching placebo in addition to usual care. If bleeding continued after 30 min, or stopped and restarted within 24 h of the first dose, a second dose of 1 g of tranexamic acid or placebo could be given. Patients were assigned by selection of a numbered treatment pack from a box containing eight numbered packs that were identical apart from the pack number. Participants, care givers, and those assessing outcomes were masked to allocation. We originally planned to enrol 15 000 women with a composite primary endpoint of death from all-causes or hysterectomy within 42 days of giving birth. However, during the trial it became apparent that the decision to conduct a hysterectomy was often made at the same time as randomisation. Although tranexamic acid could influence the risk of death in these cases, it could not affect the risk of hysterectomy. We therefore increased the sample size from 15 000 to 20 000 women in order to estimate the effect of tranexamic acid on the risk of death from post-partum haemorrhage. All analyses were done on an intention-to-treat basis. This trial is registered with ISRCTN76912190 (Dec 8, 2008); ClinicalTrials.gov, number NCT00872469; and PACTR201007000192283. Findings Between March, 2010, and April, 2016, 20 060 women were enrolled and randomly assigned to receive tranexamic acid (n=10 051) or placebo (n=10 009), of whom 10 036 and 9985, respectively, were included in the analysis. Death due to bleeding was significantly reduced in women given tranexamic acid (155 [1·5%] of 10 036 patients vs 191 [1·9%] of 9985 in the placebo group, risk ratio [RR] 0·81, 95% CI 0·65–1·00; p=0·045), especially in women given treatment within 3 h of giving birth (89 [1·2%] in the tranexamic acid group vs 127 [1·7%] in the placebo group, RR 0·69, 95% CI 0·52–0·91; p=0·008). All other causes of death did not differ significantly by group. Hysterectomy was not reduced with tranexamic acid (358 [3·6%] patients in the tranexamic acid group vs 351 [3·5%] in the placebo group, RR 1·02, 95% CI 0·88–1·07; p=0·84). The composite primary endpoint of death from all causes or hysterectomy was not reduced with tranexamic acid (534 [5·3%] deaths or hysterectomies in the tranexamic acid group vs 546 [5·5%] in the placebo group, RR 0·97, 95% CI 0·87-1·09; p=0·65). Adverse events (including thromboembolic events) did not differ significantly in the tranexamic acid versus placebo group. Interpretation Tranexamic acid reduces death due to bleeding in women with post-partum haemorrhage with no adverse effects. When used as a treatment for postpartum haemorrhage, tranexamic acid should be given as soon as possible after bleeding onset. Funding London School of Hygiene & Tropical Medicine, Pfizer, UK Department of Health, Wellcome Trust, and Bill & Melinda Gates Foundation

As múltiplas faces da desigualdade de gênero no Oriente Médio : uma análise comparativa entre a Arábia Saudita, o Líbano, os Emirados Árabes Unidos e o Catar

Trabalho de Conclusão de Curso (graduação)—Universidade de Brasília, Instituto de Relações Internacionais, 2017.A desigualdade de gênero no Oriente Médio é muito intensa e preocupante, atingindo as mais baixas classificações nos índices internacionais sobre o tema. Compreender as causas dessa desigualdade e a sua relação com os elementos culturais e internacionais são essenciais para mudar essa triste realidade. Nesse sentido, este trabalho busca apresentar um panorama geral da situação das mulheres em quatro países árabes da região. Serão analisados quatro aspectos da desigualdade de gênero: a educação; o mercado de trabalho; a religião; e a política e cidadania. Ademais, será apresentado as teorias de desigualdade de gênero, de justiça e o contexto histórico dessa localidade

ANALYSIS OF PARENT TEACHER COUNCIL COLLABORATION FOR THE DEVELOPMENT OF EDUCATIONAL INSTITUTIONS

Purpose: Parent Teacher Council (PTC) is a school community which has the role in educational institutions to develop schools academically and financially. Methods: In this study, the output analysis of school communities for the schools’ development and educational enhancement were investigated. The tool of the study was a questionnaire which was administered to the school community secretaries and chairpersons. The tool of the study was already validated by sending to the panel of experts and its reliability was tested on Cronbach’s alpha (0.83) and factor analysis (0.56). It was a descriptive and non-experimental survey research. In this study, the collected data were analyzed on Chi square as statistical test. Results: The findings of the study revealed that PTC as school communities were established and had not put into account their tasks as they were asked to perform. The problem with these communities that they were not functional and did not know what was their role in schools which they had to perform. Their role was suffered owing to illiterate parents and due to that, the vacuum was found in the schools and school community collaboration

Susceptibility of NPPA and IL6 with Type 2 Diabetes and Hypertension in Punjab, Pakistan

Type 2 Diabetes (T2D) and Hypertension are the major health issues affecting quality of life of young ages throughout the world, especially the third world countries facing more complications with diabetes due to poor disease management. The present study was conducted to explore the association of genetic polymorphism with T2D and hypertension in the Punjabi population. The case control study was conducted comprising of 288 patients (118 male, 170 female) and 170 controls (104 male, 66 female). The selected genes along SNPs were NPPA (rs5064 G\u3eA, rs5063 C\u3eT) and IL6 (rs1800796 C\u3eG). DNA was amplified by Nested PCR and sequencing was performed for genotyping. The rs5063 and rs5064 from NPPA was not associated with hypertension and not involved in the predisposition of diabetes (p \u3c 0.05). Moreover, rs1800796 (IL6) showed an association (p \u3c 0.001) with diabetes (OR = 0.394 (0.265, 0.584). SNPs analysis with demographic data confirmed that rs1800796-CC (p = 0.008) is significantly associated with positive family history of T2D. Risk of T2D development associated with IL6 was confirmed, whereas NPPA was not associated with hypertension