Prognostic value of Hypocholesterolemia in sepsis

INTRODUCTION: Sepsis is the most common cause of death in Intensive Care Unit. It is an increasingly common cause of mortality and morbidity in elderly, Immunocompromised and critically ill patients. Approximately, 25–35% of patients with severe sepsis and 40–55% of patients with septic shock die within 30 days. AIMS OF THE STUDY: The aim of this study was to examine the difference and dynamic changes in serum lipid levels in ICU patients with sepsis and evaluate whether these lipids are associated with prognosis. MATERIALS AND METHODS: PLACE OF STUDY: Intensive Medical Care Unit, Department of General Medicine, Govt. Stanley Medical College & Hospital. STUDY DESIGN: Cross sectional observational study. STUDY POPULATION: 100 STUDY PERIOD: March 2016 to August 2016. INCLUSION CRITERIA: 1. Age ≥ 18 years, 2. Patients admitted to the ICU with sepsis between March and August 2016. EXCLUSION CRITERIA: 1. age less than 18 years, 2. pregnancy, 3. ICU readmission, and a need for primary cardiac care. 5. Patients with liver disease (hepatitis B, hepatitis C, immune hepatitis, liver cirrhosis, and hepatocellular carcinoma), 6. Dyslipidemia 7. history of statin or steroid (≥15_mg/day) use within the previous 7 days. METHODOLOGY: For each patient, data on age, gender, comorbidity, administration of vasoactive drugs, length of ICU stay, and 28-day mortality were collected. In addition, Sequential Organ Failure Assessment (SOFA) scores, and laboratory data, including cholesterol, TG, HDL, LDL were collected on days 0 (ICU admission) and day 3. CONCLUSION: In this study we can safely conclude that a significant decrease in systolic blood pressure is associated with hypocholesterolemia among patients admitted in ICU with sepsis, lowered systolic blood pressure levels were 1.14 times more common when patients admitted in ICU with sepsis present with hypocholesterolemia. • A significant decrease in diastolic blood pressure is associated with hypocholesterolemia among patients admitted in ICU with sepsis,lowered diastolic blood pressure levels were 1.14 times more common when patients admitted in ICU with sepsis present with hypocholesterolemia. • A significant increase in respiratory rate is associated with hypocholesterolemia among patients admitted in ICU with sepsis, elevated respiratory rate levels were 1.10 times more common when patients admitted in ICU with sepsis present with hypocholesterolemia. • A significant increase in respiratory rate is associated with hypocholesterolemia among patients admitted in ICU with sepsis, elevated respiratory rate levels were 1.15 times more common when patients admitted in ICU with sepsis present with hypocholesterolemia. • A significant increase in blood urea is associated with hypocholesterolemia among patients admitted in ICU with sepsis, elevated blood urea levels were 1.41 times more common when patients admitted in ICU with sepsis present with hypocholesterolemia. • A significant increase in serum creatinine is associated with hypocholesterolemia among patients admitted in ICU with sepsis, elevated serum creatinine levels were 1.41 times more common when patients admitted in ICU with sepsis present with hypocholesterolemia. • In this study we can safely conclude that a significant increase in TLC (WBC) is associated with hypocholesterolemia among patients admitted in ICU with sepsis, elevated TLC (WBC) levels were 1.38 times more common when patients admitted in ICU with sepsis present with hypocholesterolemia. • A significant increase in total bilirubin is associated with hypocholesterolemia among patients admitted in ICU with sepsis,elevated total bilirubin levels were 1.12 times more common when patients admitted in ICU with sepsis present with hypocholesterolemia. • A significant increase in SGOT is associated with hypocholesterolemia among patients admitted in ICU with sepsis, elevated SGOT levels were 1.50 times more common when patients admitted in ICU with sepsis present with hypocholesterolemia. • A significant increase in SGPT is associated with hypocholesterolemia among patients admitted in ICU with sepsis, elevated SGPT levels were 1.82 times more common when patients admitted in ICU with sepsis present with hypocholesterolemia. • A significant increase in INR is associated with hypocholesterolemia among patients admitted in ICU with sepsis, elevated INR levels were 1.04 times more common when patients admitted in ICU with sepsis present with hypocholesterolemia. • A significant decrease in triglycerides is associated with hypocholesterolemia among patients admitted in ICU with sepsis, lowered triglycerides levels were 1.05 times more common when patients admitted in ICU with sepsis present with hypocholesterolemia. • A significant decrease in LDL is associated with hypocholesterolemia among patients admitted in ICU with sepsis, lowered LDL levels were 1.14 times more common when patients admitted in ICU with sepsis present with hypocholesterolemia. • A significant decrease in HDL is associated with hypocholesterolemia among patients admitted in ICU with sepsis, lowered HDL levels were 1.07 times more common when patients admitted in ICU with sepsis present with hypocholesterolemia. • A significant increase in day 1 SOFA score is associated with hypocholesterolemia among patients admitted in ICU with sepsis, elevated day 1 SOFA score levels were 1.40 times more common when patients admitted in ICU with sepsis present with hypocholesterolemia. • A significant increase in day 3 SOFA score is associated with hypocholesterolemia among patients admitted in ICU with sepsis, elevated day3 SOFA score levels were 2.11 times more common when patients admitted in ICU with sepsis present with hypocholesterolemia. • SOFA Score Day 1 and 3 ≥ 2 and hypocholesterolemia are significant and strong independent risk factors for predicting death in patients admitted in ICU with sepsis. patients admitted in ICU with sepsis have 3.5 to 5.0 times more chances of death if one of the above independent predictor variable also occurs. • A significant increase in death status of patient is associated with hypocholesterolemia among patients admitted in ICU with sepsis, death of patient was 2.27 times more common when patients admitted in ICU with sepsis present with hypocholesterolemia. • Hence we conclude that hypocholesterolemia can be used as a prognostic marker in patients with sepsis

Marine Virus Isolation for Use in Phage Templating of Nanoparticles

Over the course of the past year, we experimented with bacteriophage (phage) isolation from both fresh and marine water. We also tested two different chemical flocculation techniques, polyethylene glycol (PEG) and iron chloride. Furthermore, we tested different vesicles in which chemical flocculation occurs, such as separation funnels, centrifuge tubes, and Erlenmeyer flasks. We analyzed the effectiveness of flocculation via florescent microscopy. Each flocculated sample was visually compared to the original unconcentrated sample by staining the DNA with SYBR-Green. A successful concentrated viral sample yielded a \u3e10 fold increase in overall fluorescence. We found that both iron chloride and PEG were equally as effective in precipitating phage from water. Unfortunately, while the original protocols we read were designed for marine water, we had little success in precipitating phage from marine water. We tested samples of marine water from various locations, and used both methods of chemical flocculation. Despite this experimentation, we did not succeed in precipitating phage from sea water. Fresh water appeared to have a large viral load, as florescence microscopy showed large amounts of virus, even on the unconcentrated sample. Most experiments were done with fresh water since the viral load is high. We are now in the process of utilizing our library of phage pull-downs to isolate, classify and categorize phage by sequence analysis. In addition, we are exploring ways to expand our phage libraries through the isolation of host bacterial cells. Finally, we are developing strategies for screening a variety of panels of nanoparticles to determine phage-particle interaction strengths

Genomic DNA extraction from sapwood of Pinus roxburghii for polymerase chain reaction studies

A method for extraction of genomic DNA from sapwood tissues of mature tall trees of Pinus roxburghii, where collection of needle tissues is extremely difficult has been standardized. The extracted DNA was comparable to that obtained from the needle tissue in terms of yield and purity. The yield of extracted DNA ranged from 6.98 to 19.668 μg / 100 mg tissue and A260 / A280 ratio ranged from 1.70 to 1.87. The polymerase chain reaction (PCR) amplification of the DNA extracted from sapwood tissue using random amplification of polymorphic DNA (RAPD), inter simple sequence repeat (ISSR) and simple sequence repeat (SSR) markers was similar to that of DNA extracted from the needle tissues.Keywords: Pinus roxburghii, DNA extraction, sapwood, random amplification of polymorphic DNA (RAPD), inter simple sequence repeat (ISSR), simple sequence repeat (SSR)African Journal of Biotechnology Vol. 12(15), pp. 1732-173

Epstein Barr Virus negative Lymphoepithelial Carcinoma Involving the Maxillary Sinus: A Rare Case Report

Introduction: Lymphoepithelial carcinoma (LEC) is one of the rare malignancies involving the head and neck region. It is common in Eskimos and Chinese population with Epstein Barr virus association. Standard treatment protocol is not in place owing to the rarity of this tumor.Case Presentation: The present case is a LEC involving the right maxillary sinus not associated with Epstein Barr Virus (EBV) and first of its kind presentation in the Indian population. Lack of awareness, nonaffordability and poor patient compliance resulted in poor response to radiotherapy. The patient succumbed within fourteen months of diagnosis.Conclusion: Cancer treatment is still not at reach to the poor and the illiterate. Epidemiological studies targeted at genetic basis of origin will be beneficial in identifying rare, and unusual presentation of the disease. We believe that this case will highlight the importance of risk assessment and early diagnosis of cancer at mass level

2,4-Bis(4-fluoro­phen­yl)-3-aza­bicyclo­[3.3.1]nonan-9-one

In the title compound, C20H19F2NO, a crystallographic mirror plane bis­ects the mol­ecule, passing through the N, O and two C atoms of the central ring system. The mol­ecule exists in a twin-chair conformation with equatorial dispositions of the 4-fluoro­phenyl groups on both sides of the secondary amino groups; the dihedral angle between the aromatic ring planes is 28.67 (3)°

Efeito da adubação verde nos teores de matéria orgânica e fósforo em Vertissolo cultivado com meloeiro irrigado no Semiárido.

O uso dos coquetéis vegetais se tornou uma prática viável de manejo de solo no Semiárido tendo como benefícios acúmulo de matéria orgânica e ciclagem de nutrientes. Assim, este trabalho tem como objetivo monitorar as alterações nos teores de MO e P após o segundo ano de cultivo do melão em sucessão a coquetéis vegetais e vegetação espontânea com e sem revolvimento do solo. O experimento foi instalado em área de agricultor, localizado no Projeto Mandacaru, Juazeiro-BA, em março de 2011. O solo do local é classificado como Vertissolo Haplico Ortico salino. O delineamento experimental foi o de blocos ao acaso, com três sistemas de culturas intercalares (sem coquetel vegetal, coquetel vegetal 1 e coquetel vegetal 2) e dois sistemas de preparo (com revolvimento e sem revolvimento). Após a colheita foi realizada a amostragem do solo nas profundidades 0-20 e 20-40 cm. Foram determinados os teores de MO e P. Dois ciclos de coquetéis vegetais e o revolvimento do solo não alteram significativamente o teor de matéria orgânica e fosforo quando comparados a presença de vegetação espontânea

ЭТАПЫ ВНЕДРЕНИЯ НАЦИОНАЛЬНОГО РЕГИСТРА ПО ТУБЕРКУЛЕЗУ В РЕСПУБЛИКЕ ТАДЖИКИСТАН

The implementation of the National TB Registry in the Republic of Tajikistan ensured the high-quality collection, storage and transmission of statistical information from all regions of the country to the State Institution “Republican Center for the Protection of the Population from Tuberculosis”. The National TB Registry has significantly improved the reporting process, including obtaining timely information on various requests: Ensured the collection, storage, processing of data on TB patients with drug-sensitive and resistant forms; Contributed to the generation of standard statistical reports and ensuring the timely exchange of data on TB patients between TB institutions at various levels; Improved information reliability control; Provided a stable mechanism for the exchange of information between laboratories and clinical service; Provided analysis of information for management decisions and in scientific research.The National TB Registry allows timely receipt of laboratory test results, which, in particular, significantly reduces the time interval from the moment of diagnosis to admission for treatment, and contributes to an increase in the reliability of registration of chemotherapy outcomes. The national TB registry has sufficient potential for further improvement.Introducerea Registrului Național al tuberculozei (TB) în Republica Tadjikistan a asigurat colectarea, stocarea și transmiterea de înaltă calitate a informațiilor statistice din toate regiunile țării către Instituția de Stat „Centrul Republican pentru Protecția Populației împotriva Tuberculozei”. Registrul Național al TB a făcut posibilă îmbunătățirea semnificativă a procesului de întocmire a rapoartelor, inclusiv obținerea de informații în timp util cu privire la diverse solicitări: prevăzut pentru colectarea, stocarea, prelucrarea datelor privind bolnavii de TBC cu forme susceptibile și rezistente la medicamente; a contribuit la generarea de rapoarte statistice standard și asigurarea schimbului la timp de date privind pacienții cu TB între instituțiile anti-TB de diferite niveluri; control îmbunătățit al fiabilității informațiilor; a asigurat unmecanism stabil pentru schimbul de informații între laboratoare și serviciul clinic; a asigurat analiza informațiilor pentru deciziile de management și în desfășurarea cercetării științifice.Registrul Național al TBC permite obținerea în timp util a rezultatelor testelor de laborator, ceea ce, în special, reduce semnificativ intervalul de timp de la momentul diagnosticării până la administrarea tratamentului și contribuie la creșterea fiabilității înregistrării rezultatelor chimioterapiei. Registrul național al TB are un potențial suficient pentru îmbunătățiri suplimentare.Внедрение Национального ТБ регистра в Республике Таджикистан обеспечило качественный сбор, хранение и передачу статистической информации из всех регионов страны в ГУ «Республиканский центр по защите населения от туберкулеза». Национальный ТБ регистр позволил значительно улучшить процесс подготовки отчетов, включая получение своевременной информации по различным запросам: Обеспечил сбор, хранение, обработку данных по больным туберкулезом с лекарственно-чувствительными и устойчивыми формами; Способствовал генерации стандартных статистических отчетов и обеспечение своевременного обмена данными по больным туберкулезом между противотуберкулезными учреждениями различных уровней; Улучшил контроль достоверности информации; Обеспечил устойчивый механизм обмена информацией между лабораториями и клинической службой; Обеспечил проведение анализа информации для управляющих решений и при проведении научных исследований.Национальный ТБ регистр позволяет своевременно получать результаты лабораторных исследований, что, в частности, значительно сокращает интервал времени от момента диагностики до взятия на лечение, и способствует повышению достоверности регистрации исходов химиотерапии. Национальный ТB регистр имеет достаточный потенциал для дальнейшего совершенствования

O processo de ensino e aprendizagem na alfabetização: reflexões sobre práticas de leitura e escrita

This article seeks to reflect on reading and writing practices in a third grade class at a public elementary school to understand the factors that interfere with student learning. It is a qualitative research that used a semi-structured interview with the teacher, a focus group with the students, observation, reflective diary and documentary analysis. The results indicate that the teacher uses diverse and contextualized reading practices and the students attribute a positive value to reading and writing. And although the PNAIC states that the pupil must be literate at 8 years of age, many children of this age are not literate. Another point to emphasize, in relation to this program, is that a good part of the students is in age / grade gap. One of the possible factors that may influence this learning is the lack of support from some parents, perhaps because they are not literate, or because of the social context in which they are inserted. This certainly makes it difficult for parents to link to school, which can also reflect the learners' learning. However, it is necessary not to disregard the social, political and structural conditions that interfere in the school life of the students, since the educational phenomenon is very complex and goes beyond the walls of the school.Este artigo busca refletir sobre práticas de leitura e de escrita numa turma do terceiro ano do Ensino Fundamental de uma escola pública, para compreender os fatores que interferem na aprendizagem dos alunos. Trata-se de uma pesquisa qualitativa que utilizou de entrevista semiestruturada com a professora, grupo focal com os educandos, observação, diário reflexivo e análise documental. Os resultados apontam que a professora utiliza práticas de leitura diversificadas e contextualizadas e os educandos atribuem um valor positivo à leitura e à escrita. E apesar do PNAIC explicitar que o educando deve estar alfabetizado aos 8 anos de idade, muitas crianças com esta idade não estão alfabetizadas. Outro ponto a destacar, em relação a esse programa, é que boa parte dos educandos se encontra em defasagem idade/série. Um dos possíveis fatores que pode influenciar nesta aprendizagem, é a falta de apoio de alguns pais, talvez por não serem alfabetizados, ou pelo contexto social em que estão inseridos. Isso certamente dificulta o vínculo dos pais com a escola, o que também pode refletir na aprendizagem dos educandos. Todavia, é preciso não desconsiderar os condicionantes sociais, políticos e estruturais que interferem na vida escolar do educandos, pois o fenômeno educativo é muito complexo e extrapola os muros da escola