Complicated to operate case of appendicitis: A rare incident

Introduction: Appendicitis is an appendix inflammation that’s severe. It affects people of all ages but is most common between the ages of 10 to 30, and both men and women are afflicted equally. Appendicitis is substantially less common in developing nations, particularly regions of Africa, and among lower socioeconomic levels. Clinical Findings: Pain in the right iliac fossa, nausea, vomiting. Diagnostic Evaluation: Blood test: Hb-14.5 gm%, Total RBC count-4.5 millions/cu mm, Total WBC count-8000/cu mm, Total Platelet count-2.5 lac/cu mm, Albumin-4.1 gm%, Bilirubin (conjugated)-0.4 gm%, Bilirubin(unconjugated)-1.1 gm%. On a CT scan of the abdomen and pelvis, an abnormal appendix (diameter >6 mm) was discovered, or a calcified appendices eolith was discovered in conjunction with peri appendiceal inflammation and fat stranding. Therapeutic Intervention: Inj. Amoxicillin 500 mg x OD, Tab. Emset 4mg x TDS, Inj. Tramadol 100 mg x TDS, Tab. Limcee 500 mg x OD, Tab. Pantoprazole 40 mg x OD. Outcome: After treatment, the patient’s condition improved. His pain is relieved, and now the patient is good. Conclusion: My patient was admitted with the complaint of pain in the right iliac fossa, nausea and vomiting. Diagnosis confirmed the case of Appendicitis. After getting the proper treatment, the patient’s condition got improved

CORPORATE SOCIAL RESPONSIBILITY (CSR) ACTIVITIES OF SELECTED COMPANIES AT SOHAR PORT, OMAN

Purpose The objective of the study is to investigate into the roles of Corporate Social Responsibility towards the community development of Sohar.  This study critically analyzes the current practices of CSR in the selected companies at Sohar Port area, Oman. Design/methodology/approach The study was carried out with ten selected companies from Sohar Industrial Port area selected on a random sampling basis.   Findings The study has thrown light on the various activities of CSR carried out by the selected companies in the Al Batinah region of Sultanate of Oman.  The study reveals that the manufacturing companies have high inclination towards CSR programs than the other. Practical Implications Further the study shows that the selection of CSR activities by one company does not have any impact on any other company from the same area.  This will induce every company to come up with new CSR activities in to their manifold. Social Implications The study confirms that the selected companies play significant role through involving them in social responsibility activities resulting in sustained development of Sultanate of Oman. Originality/value No prior study has examined the CSR activities of the companies at Sohar Port, Oman. This study will pave a way to further scope of study on CSR activities of the companies of Oman

Field evaluation of a simple fluorescence method for detection of viable Mycobacterium tuberculosis in sputum specimens during treatment follow-up.

Simple tuberculosis (TB) treatment monitoring tools are needed. We assessed the performance of fluorescein-diacetate (FDA) smear microscopy for detection of viable Mycobacterium tuberculosis in sputum specimens (n = 288) of TB cases under treatment compared to culture (17.4% culture positivity). FDA sensitivity was moderate (83.7% [95% confidence interval {CI}, 70.3 to 92.6]), and specificity was low (66.1% [59.5 to 72.2]). The good negative predictive value (94.8% [90.1 to 97.8]) and negative likelihood ratio (0.2) suggest using this method to rule out treatment failure in settings without access to culture

UK primary care survey of venous leg ulceration management and referral - Post-EVRA trial

Objective Determine standards of referral and management of patients with venous leg ulceration in primary care after the release of the EVRA (A Randomized Trial of Early Endovenous Ablation in Venous Ulceration) study results. Methods An online questionnaire was disseminated over four months to professionals working within primary care. Results The survey received 643 responses. Of respondents, 90 (14%) had heard of the EVRA trial and 51 (8%) were familiar with the results. Of those who answered the following questions, 410 (69.1%) stated that referral to a vascular specialist must be made by the General Practitioner and 13 (2.2%) reported that they would always refer patients for secondary care assessment before the publication of EVRA. Considering the EVRA results, 128 (29%) reported that they would change practice regarding referral and would experience no barriers and 198 (45%) reported that they would like to refer earlier but is not their decision. Barriers to changing practice included local referral policies, training and time restrictions, 266 (59%) had heard of the NICE guideline (CG168) and 194 (43%) were aware of the recommendations for referral to a vascular service within two weeks for patients with an open or healed ulcer. Conclusion There is a considerable variation in local referral pathways for venous leg ulceration, and despite clinicians wanting to refer promptly, many primary care professionals are unable to. Unfortunately, the EVRA study alone may not change the overall practice, and work is needed to overcome barriers faced by primary care professionals

The use of medicinal plants in health care practices by Rohingya refugees in a degraded forest and conservation area of Bangladesh

People in developing countries traditionally rely on plants for their primary healthcare. This dependence is relatively higher in forests in remote areas due to the lack of access to modern health facilities and easy availability of the plant products.We carried out an ethno-medicinal survey in Teknaf Game Reserve (TGR), a heavily degraded forest and conservation area in southern Bangladesh, to explore the diversity of plants used by Rohingya refugees for treating various ailments. The study also documented the traditional utilization, collection and perceptions of medicinal plants by the Rohingyas residing on the edges of this conservation area. We collected primary information through direct observation and by interviewing older respondents using a semi-structured questionnaire. A total of 34 plant species in 28 families were frequently used by the Rohingyas to treat 45 ailments, ranging from simple headaches to highly complex eye and heart diseases. For medicinal preparations and treating various ailments, aboveground plant parts were used more than belowground parts. The collection of medicinal plants was mostly from the TGR. © 2009 Taylor & Francis

Pengaruh Regulasi Perbankan, Regulasi Perpajakan, Kinerja, Inklusi Keuangan dan Tanggung Jawab Sosial Terhadap Keberhasilam Usaha (Studi pada: Usaha Kecil dan Menengah Desa Wisata Batik Wijirejo Kecamatan Pandak, Kabupaten Bantul Yogyakarta)

Tujuan penelitian ini untuk menganalisis pengaruh regulasi perbankan dan regulasi perpajakan yang dimediasi kinerja dan inklusi keuangan pelaku usaha serta dimoderasi tanggung jawab sosial terhadap keberhasilan usaha. Sampel yang digunakan dalam penelitian ini adalah pelaku Usaha Kecil dan Menengah batik Desa Wijirejo Kecamatan Pandak Kabupaten Bantul Yogyakarta. Teknik pengambilan sampel menggunakan metode sensus yaitu seluruh populasi berjumlah 76 pelaku usaha batik menjadi sampel penelitian. Metode analisis data menggunakan WrapPLS 5.0. Hasil penelitian menunjukkan bahwa: 1) pelaksanaan regulasi perbankan dan regulasi perpajakan bagi pelaku usaha kecil dan menengah bukan merupakan faktor penentu meningkatnya keberhasilan usaha; 2) Jika didukung dengan kinerja dan inklusi keuangan pelaku usaha yang baik, maka regulasi perbankan dan regulasi perpajakan merupakan faktor penentu meningkatnya keberhasilan usaha; 3) Penerapan visi misi yang tegas, kemampuan manajemen yang baik dan motivasi kerja yang tinggi dari pelaku usaha menjadi faktor penentu untuk meningkatkan pengetahuan pelaku usaha tentang perbankan khususnya bidang keuangan (melek keuangan); 4) Regulasi perbankan melalui penetapan suku bunga kredit, kemudahan pengajuan kredit dan kecepatan proses kredit didukung dengan pengelolaan usaha yang baik serta pengetahuan keuangan (melek keuangan) yang baik menjadi faktor penentu dalam meningkatkan modal, skala usaha, laba dan pengelolaan usaha; 5) Regulasi perpajakan melalui penetapan besaran pajak, kemudahan akses pajak, penyederhanaan prosedur pajak dan transparansi mengenai pajak didukung dengan pengelolaan usaha yang baik serta pengetahuan keuangan (melek keuangan) yang baik menjadi faktor penentu dalam meningkatkan modal, skala usaha, laba dan pengelolaan usaha; 6) Adanya kemitraan atau pembinaan dari perusahaan besar terhadap pelaku usaha mampu meningkatkan penerapan visi misi yang tegas, kemampuan manajemen yang baik dan motivasi kerja yang tinggi yang menjadi faktor penentu untuk meningkatkan keberhasilan usaha

High-Throughput Screening of Australian Marine Organism Extracts for Bioactive Molecules Affecting the Cellular Storage of Neutral Lipids

Mammalian cells store excess fatty acids as neutral lipids in specialised organelles called lipid droplets (LDs). Using a simple cell-based assay and open-source software we established a high throughput screen for LD formation in A431 cells in order to identify small bioactive molecules affecting lipid storage. Screening an n-butanol extract library from Australian marine organisms we identified 114 extracts that produced either an increase or a decrease in LD formation in fatty acid-treated A431 cells with varying degrees of cytotoxicity. We selected for further analysis a non-cytotoxic extract derived from the genus Spongia (Heterofibria). Solvent partitioning, HPLC fractionation and spectroscopic analysis (NMR, MS) identified a family of related molecules within this extract with unique structural features, a subset of which reduced LD formation. We selected one of these molecules, heterofibrin A1, for more detailed cellular analysis. Inhibition of LD biogenesis by heterofibrin A1 was observed in both A431 cells and AML12 hepatocytes. The activity of heterofibrin A1 was dose dependent with 20 µM inhibiting LD formation and triglyceride accumulation by ∼50% in the presence of 50 µM oleic acid. Using a fluorescent fatty acid analogue we found that heterofibrin A1 significantly reduces the intracellular accumulation of fatty acids and results in the formation of distinct fatty acid metabolites in both cultured cells and in embryos of the zebrafish Danio rerio. In summary we have shown using readily accessible software and a relatively simple assay system that we can identify and isolate bioactive molecules from marine extracts, which affect the formation of LDs and the metabolism of fatty acids both in vitro and in vivo

Cardiovascular Disease Management With Sodium-Glucose Cotransporter-2 Inhibitors in Patients With Type 2 Diabetes: A Cardiology Primer

Patients with type 2 diabetes face an elevated risk of cardiovascular disease. This review centers on sodium-glucose cotransporter-2 (SGLT2) inhibitors, a class of drugs that, according to a growing body of evidence, may have major potential for managing cardiovascular disease in patients with type 2 diabetes. This review presents findings from multiple clinical trials suggesting that SGLT2 inhibitors can not only serve as preventive therapeutic agents but also play a role in the active management of heart failure. The discussion includes the mechanism of action of SGLT2 inhibitors, emphasizing that they enhance urinary glucose excretion, which could lead to improved glycemic control and contribute to metabolic shifts beneficial to cardiac function. Alongside these cardiometabolic effects, safety concerns and practical considerations for prescribing these agents are addressed, taking into account potential adverse effects such as genitourinary infections and diabetic ketoacidosis as well as the financial implications for patients. Despite these drawbacks, therapeutic indications for SGLT2 inhibitors continue to expand, including for kidney protection, although further research is necessary to fully understand the mechanisms driving the cardioprotective and kidney-protective effects of SGLT2 inhibitors. By synthesizing current knowledge, this review intends to inform and guide clinical decision-making, thereby enhancing cardiovascular disease outcomes in patients with type 2 diabetes

Selective and low temperature transition metal intercalation in layered tellurides

Layered materials embrace rich intercalation reactions to accommodate high concentrations of foreign species within their structures, and find many applications spanning from energy storage, ion exchange to secondary batteries. Light alkali metals are generally most easily intercalated due to their light mass, high charge/volume ratio and in many cases strong reducing properties. An evolving area of materials chemistry, however, is to capture metals selectively, which is of technological and environmental significance but rather unexplored. Here we show that the layered telluride T2PTe2 (T=Ti, Zr) displays exclusive insertion of transition metals (for example, Cd, Zn) as opposed to alkali cations, with tetrahedral coordination preference to tellurium. Interestingly, the intercalation reactions proceed in solid state and at surprisingly low temperatures (for example, 80?°C for cadmium in Ti2PTe2). The current method of controlling selectivity provides opportunities in the search for new materials for various applications that used to be possible only in a liquid