A prospective assessment of antimicrobial agents utilization pattern in a tertiary care hospital

Background: The antimicrobial resistance is increasing globally and, concurrently, downward trend in development of newer antibiotics is leading to a serious public health problem and economic consequences.Methods: Prescriptions with at least one antimicrobial were included in the study. A total of 242 prescriptions were included in the study. The antimicrobials were classified into different classes based on WHO-ATC classification.Results: A total of 281 antimicrobials prescribed in 242 prescriptions with an average of 1.16 per prescription. In most of the prescriptions, 1 antimicrobial were prescribed (88.43%). The routes of the antimicrobial administration were mostly oral 268 (95.37%) followed by injectable 13 (4.63%). The most commonly prescribed classes of antimicrobial in this study were antibacterials for systemic use (J01) (74.02%) followed by antimycobacterials (J04) (13.88%), antiparasitic drugs (P) (8.19%), antimycotics for systemic use (J02) (2.49%) and antivirals for systemic use (J05) (1.42%). Among antibacterials, the most commonly prescribed classes of antibacterial was various antibacterial FDCs (19.22%), followed by quinolones (18.86%), macrolides (18.15%), β-lactams (11.03%) cephalosporins (6.76%), penicillins (4.27%), aminoglycosides (2.84%), metronidazole (1.78%), clindamycin (1.78%) and tetracycline (0.36%). The total percentage of antimicrobials prescribed as Fixed Dose Combinations (FDCs) were 32.38%.Conclusions: The present study has reported that most commonly prescribed antimicrobials were quinolones followed by macrolides and β-lactams. Recommendations to change the ongoing prescribing practices should be based on the Standard Treatment Guidelines, EDL and Antibiotic policy or by following the information, education, and communication (IEC) interventions

Upper Gastrointestinal Endoscopy in Lumbini Medical College and Teaching Hospital

Introduction: Upper gastrointestinal (UGI) endoscopy includes visualization of the oropharynx, esophagus, stomach, and proximal duodenum, with real time assessment and interpretation of the findings encountered. An upper endoscopy is indicated in the diagnostic evaluation of signs and symptoms of a wide variety of gastrointestinal disorders. Besides there are some therapeutic implication of the endoscopy. This study was conducted to study the spectrum of diseases found during the upper gastrointestinal endoscopy in patient presenting in Lumbini Medical College and Teaching Hospital (LMCTH).   Methods: This was a retrospective observational study carried out in LMCTH. The endoscopic record book of the patients who underwent UGI endoscopy for various reasons from February 2011 to 2013 was analysed. The risk factor of smoking and alcohol was also included and analysed in the study.   Results: All together 550 upper GI endoscopy was performed in the two years. There were 290 males (52.72%) and females were 260 (47.38%). The mean age was 45.7 years (SD=17.9). Most of the patient belonged to the age group 41 to 80 years (71%). Among total patients, 209 (38%) of them were found to be macroscopically normal. Of those who had positive endoscopic findings; 165 (48.4%) had gastritis and 36 (10.6%) had duodenal ulcer, esophageal varices was in 30 (8.8%), gastric carcinoma in nine (2.6%) of cases. Cigarette smoking was significantly associated with the presence of peptic ulcer disease (p=0.01) and malignancy of gastrointestinal tract (p=0.03). Alcohol intake was non-significantly related to peptic ulceration (p=0.07) and malignancy of gastrointestinal tract (p=0.09).   Conclusion: Upper gastrointestinal endoscopy is a safe and useful procedure for investigating patients with gastrointestinal complains. Gastritis was the most common finding among the patients who had abnormal endoscopy followed by duodenal ulcer and esophageal varices

Upper Gastrointestinal Endoscopy in Lumbini Medical College and Teaching Hospital

  Introduction: Upper gastrointestinal (UGI) endoscopy includes visualization of the oropharynx, esophagus, stomach, and proximal duodenum, with real time assessment and interpretation of the findings encountered. An upper endoscopy is indicated in the diagnostic evaluation of signs and symptoms of a wide variety of gastrointestinal disorders. Besides there are some therapeutic implication of the endoscopy. This study was conducted to study the spectrum of diseases found during the upper gastrointestinal endoscopy in patient presenting in Lumbini Medical College and Teaching Hospital (LMCTH).   Methods: This was a retrospective observational study carried out in LMCTH. The endoscopic record book of the patients who underwent UGI endoscopy for various reasons from February 2011 to 2013 was analysed. The risk factor of smoking and alcohol was also included and analysed in the study.   Results: All together 550 upper GI endoscopy was performed in the two years. There were 290 males (52.72%) and females were 260 (47.38%). The mean age was 45.7 years (SD=17.9). Most of the patient belonged to the age group 41 to 80 years (71%). Among total patients, 209 (38%) of them were found to be macroscopically normal. Of those who had positive endoscopic findings; 165 (48.4%) had gastritis and 36 (10.6%) had duodenal ulcer, esophageal varices was in 30 (8.8%), gastric carcinoma in nine (2.6%) of cases. Cigarette smoking was significantly associated with the presence of peptic ulcer disease (p=0.01) and malignancy of gastrointestinal tract (p=0.03). Alcohol intake was non-significantly related to peptic ulceration (p=0.07) and malignancy of gastrointestinal tract (p=0.09).   Conclusion: Upper gastrointestinal endoscopy is a safe and useful procedure for investigating patients with gastrointestinal complains. Gastritis was the most common finding among the patients who had abnormal endoscopy followed by duodenal ulcer and esophageal varices

Secretion of beta-human chorionic gonadotropin by non-small cell lung cancer: a case report

<p>Abstract</p> <p>Introduction</p> <p>We describe a case of non-small cell lung cancer that was found to stain positive for beta-human chorionic gonadotropin on immunohistochemistry. Only a few case reports have described lung cancers that secrete beta-human chorionic gonadotropin.</p> <p>Case presentation</p> <p>A 68-year-old Caucasian man presented with symptoms of weakness, fatigue and weight loss for the past two months. On examination, he was found to have generalized lymphadenopathy, and radiologic workup revealed numerous metastases in the lungs, liver and kidneys. Biopsy of the supraclavicular lymph node revealed metastatic large cell lung cancer with beta-human chorionic gonadotropin hormone positivity. The serum beta-human chorionic gonadotropin level was 11,286 mIU/ml (upper limit of normal, 0.5 mIU/ml in non-pregnant females). He was diagnosed with stage 4 lung non-small cell lung cancer. The patient refused chemotherapy. He was discharged home with hospice care.</p> <p>Conclusion</p> <p>The markedly elevated serum values of beta-human chorionic gonadotropin initially prompted the medical team to investigate germinal tumors. In the presence of a negative testicular ultrasound, workup was performed to find an extratesticular source of the tumor. Finally, the diagnosis was made with a tissue biopsy. This case illustrates that atypical markers can be seen in many cancers, emphasizing the role of immunohistochemistry and tissue biopsy in establishing the diagnosis.</p

Uklanjanje obostranog dermoida na bulbarnoj spojnici šteneta pasmine labrador retriver elektrokauterom - prikaz slučaja.

A Labrador retriever pup with a bilateral dermoid in the eyes was treated successfully by the use of a unipolar hand held electrocautery unit.Štene pasmine labrador retriver s obostranim dermoidom u očima bilo je uspješno izliječeno upotrebom jednostranog ručnog elektrokautera

Nature, prevalence and factors associated with depression among the elderly in a rural south Indian community

Background: Depression in old age is an important public health problem causing considerable morbidity and disability worldwide. There is a dearth of community studies from India investigating geriatric depression and its associated risk factors. This study aimed to establish the nature, prevalence and factors associated with geriatric depression in a rural south Indian community

Novel magnetite nanoparticles coated with waste sourced bio- based substances as sustainable and renewable adsorbing materials

This study examines the possibility of using bio-based product isolated from urban solid wastes as a material for environmental technological applications. To this end, Fe3O4 nanoparticles coated with different amounts of soluble bio-based products (SBO) were synthesized as low-cost nanoadsorbent for the removal of pollutants in wastewater. Particles of 10 nm diameter with Fe3O4 core and SBO shell were obtained. The concentration of SBO employed in the synthesis had no effect on the size and structure of the NPs, but ruled the pHPZC and aggregation of the nanoparticles in water. The cationic dye crystal violet (CV) was used as a model pollutant to test the adsorption capacity of the nanoparticles. The results indicated that both the medium pH and NP dosage were significant parameters to enhance the removal of CV. The results contribute to the studies which show how wastes can become a source of revenue through the industrial exploitation of their chemical value.Fil: Magnacca, Giuliana. Università di Torino; ItaliaFil: Allera, Alex. Università di Torino; ItaliaFil: Montoneri, Enzo. Università di Torino; ItaliaFil: Celi, Luisella. Università di Torino; ItaliaFil: Benito, Damián Ezequiel. Universidad Nacional de La Plata. Laboratorio de Investigación y Desarrollo de Métodos Analíticos; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - La Plata; ArgentinaFil: Gagliardi, Leonardo Gabriel. Universidad Nacional de La Plata. Laboratorio de Investigación y Desarrollo de Métodos Analíticos; ArgentinaFil: Martire, Daniel Osvaldo. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico la Plata. Instituto de Investigaciones Fisicoquímicas Teóricas y Aplicadas; ArgentinaFil: Gonzalez, Monica Cristina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico la Plata. Instituto de Investigaciones Fisicoquímicas Teóricas y Aplicadas; ArgentinaFil: Carlos, Luciano. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico la Plata. Instituto de Investigaciones Fisicoquímicas Teóricas y Aplicadas; Argentin

Negative Feedback Regulation of T Cells via Interleukin-2 and FOXP3 Reciprocity

As interleukin-2 (IL2) is central to the clonal expansion of antigen-selected T cells, we investigated the relationship between IL2 and the negative regulatory transcription factor FOXP3. We found IL2 to be responsible for T cell antigen receptor (TCR)-activated FOXP3 expression by both CD4+ and CD8+ human T cells, and as anticipated, FOXP3 expression restricted TCR-stimulated IL2 expression. However, no evidence could be found that FOXP3+ cells actively suppress IL2 expression by FOXP3- cells. These data are consistent with an IL2/FOXP3-dependent negative feedback loop that normally regulates the T cell immune response. It follows that a defect in this negative feedback loop as a result of a deficiency of either IL2 or FOXP3 will lead to a hyperproliferative autoimmune syndrome, without the necessity of invoking an active suppressive function for FOXP3+ T cells