A comparative study of mebeverine and synbiotic combination in patients with diarrhoea predominant Irritable Bowel Syndrome in a Medical College in South India

Background: Irritable bowel syndrome (IBS) is a chronic, episodic functional gastrointestinal disorder characterized by abdominal pain / discomfort and altered bowel habits. Though it is considered as a functional disorder, the burden of the disease to the patients is very high and the quality of life becomes miserable. Currently available IBS therapies are mainly symptom oriented and have limited efficacy. Various studies had done so far which provide a clear rationale for the use of Synbiotic in this disorder. The objective of the study includes, this study was planned to compare the efficacy of Mebeverine + Synbiotic combination with Mebeverine and Synbiotic monotherapy in patients with diarrhoea predominant irritable bowel syndrome.Methods: The study was done in Department of Medical Gastroenterology, Rajiv Gandhi Government Hospital, Chennai for duration of one year. Patients with Irritable Bowel Syndrome (diarrhea predominant type), diagnosed within 1 year and attending outpatient department were taken. A randomized, Phase III, prospective, interventional, open label, outpatient, comparative study design was done. A total of 60 patients divided into 3 groups were finally selected for the study purpose.Results: Twelve weeks after completion of active drug therapy, the Mebeverine + Synbiotic combination improved all the symptoms of IBS except abdominal pain. Further it was evident that combination therapy had significant remission in stool frequency and consistency when compared with other groups.Conclusions: Combination of Mebeverine + Synbiotic is more effective in improving most of the troublesome symptoms in patients with diarrhea predominant irritable bowel syndrome than other therapies and also in maintaining remission, in terms of frequency and consistency of stools

Effect of vitamin A supplementation in category-I Pulmonary Tuberculosis patients in a Medical College in India: a rapid assessment analysis

Background: Tuberculosis is one of the major health problems affecting the global population causing immense morbidity and mortality. Studies have shown that a good antioxidant status of the body has immune protective role against tuberculosis and may be associated with a decreased risk of the disease and slower rate of progression. Objective of the study was planned to evaluate the beneficial effects of Vitamin A as add on therapy to the standard drug therapy in patients with sputum positive pulmonary tuberculosis.Methods: The study was done in a Tuberculosis clinic, Department of Internal Medicine, Stanley Medical College for duration of 6 months. All the newly diagnosed sputum positive pulmonary tuberculosis patients (18-55 years) attending the outpatient were taken for the study purpose. A Phase III, prospective, open, two arm parallel group, outpatient, randomized, active controlled study was done.Results: After two weeks of therapy, the number of patients with negative sputum smear was higher in the study group than the control group. Vitamin A supplementation resulted in an earlier elimination of tubercle bacilli from the sputum.Conclusions: This study shows that vitamin A as add on therapy to the existing standard therapy improves the clinical response and decreases the disease activity to a greater extent than with routine standard therapy alone

Alterations in cathepsin H activity and protein patterns in human colorectal carcinomas

Our analyses of cathepsin H activity levels and protein forms in human colorectal cancers compared to matched control mucosa support the concept that altered proteinase expression patterns may reflect both cancer stage and site. Cathepsin H-specific activity was significantly increased in colorectal cancers compared to control mucosa (P = 0.003;n = 77). Highest specific activities and cancer/normal ratios (C/N) for activity were measured in Dukes' B and C stage carcinomas, cancers involved in local spread and invasion to lymph nodes. In contrast, cathepsin B and L activities analysed in the same paired extracts had been shown to be most frequently elevated in earlier stage carcinomas (Dukes' A and B), confirming that cathepsin H demonstrates a distinct pattern of expression during colorectal cancer progression. Although cathepsin H activities were most commonly elevated in Dukes' C cancers at all colon sites, both specific activity and C/N ratios were significantly higher for cancers of the left colon compared to other colon locations. A subset of 43 paired extracts analysed on Western blots also revealed consistent changes in cathepsin H protein forms in cancers. Normal mucosa typically showed a strong protein doublet at 31 and 29 kDa while cancers demonstrated decreased expression or total loss of the 31 kDa protein (90% of cases), equal or increased expression of the 29-kDa protein (67% of cases) and the new appearance or up-regulation of a cathepsin H band at 22 kDa (78% of cases). C/N ratios for cathepsin H enzyme activity correlated significantly with C/N ratios for the 29 kDa mature single-chain protein form (P< 0.001), with increased activity most commonly associated with elevated expression of 29-kDa cathepsin H but also with up-regulation of the 22-kDa band, suggesting a shift to more fully processed, mature active cathepsin H protein forms in cancers. Changes in cathepsin H expression were also detected by immunohistochemistry as elevated cathepsin H staining in tumour epithelial cells. © 2000 Cancer Research Campaig

Hybrid Repair Strategies for Acute Type B Aortic Dissection Complicating Prior Standard and Complex Endovascular Aortic Repair

Type B aortic dissection (TBAD) in the presence of an existing aortic endograft is a rare, but potentially catastrophic, event. False lumen pressurization and propagation leads to several failure modes. Endograft collapse can lead to spinal cord, visceral, or lower extremity ischemia, and rupture of a previously sealed aneurysm sac is often fatal. A successful treatment strategy must incorporate the patient\u27s symptoms, urgency of intervention, extent of dissection, and the location and status of the existing graft. In this series, we present three cases of TBAD complicating prior endovascular aortic repairs-infrarenal, iliac branched, and thoracoabdominal branched endografts-successfully treated with tailored, hybrid interventions

Assessment the association between liver cancer incidence and mortality rate with human development index in the European countries in 2012

Background: Liver Cancer (LC) is one of the most common cancers in the worldwide. This cancer is considered as the fifth most common cancer in male and the ninth most common cancer in female. However, socioeconomic factors and morbidity and mortality of cancer are linked by sophisticated and flexible pathways. We were investigated the association between incidence and mortality of LC with the Human Development Index (HDI) in European countries in 2012. Methods: This study was an ecologic study in European countries for assessment the correlation between Age-Specific Incidence Rate (ASIR) and Age-Specific Mortality Rate (ASMR) of LC with HDI and its details including: Life expectancy at birth, Mean years of schooling and Gross National Income (GNI) per capita. We used of Pearson correlation method for appraisement the association between HDI and its components with ASIR and ASMR. Data of study was analyzed by SPSS15 statistical analysis software; the significance level of the tests was considered P<0.05. Results: Generally in 2012, European countries have recorded 63,462 new cases of LC, crude rate was 8.6 and ASIR was 4.3 per 100,000. On the other hand in Europe countries in 2012, 62,191 cases of deaths were occurred due to LC, crude rate was 8.4 and ASMR was 3.9 per 100,000. Strong positive Correlation was observed between ASIR and ASMR (r = 0.848; P <= 0.001). HDI have weak negative correlation with ASIR of LC (r = -0.194; P = 0.230), and strong negative correlation with ASMR of LC(r= -0.515; P = 0.001). Conclusion: Increase in the human development index was associated with reduce in incidence and mortality of LC

DEKCS: a dynamic clustering protocol to prolong underwater sensor networks

Energy consumption is a critical issue in the design of wireless underwater sensor networks (WUSNs). Data transfer in the harsh underwater channel requires higher transmission powers compared to an equivalent terrestrial-based network to achieve the same range. However, battery-operated underwater sensor nodes are energy-constrained and require that they transmit with low power to conserve power. Clustering is a technique for partitioning wireless networks into groups where a local base station (cluster head) is only one hop away. Due to the proximity to the cluster head, sensor nodes can lower their transmitting power, thereby improving the network energy efficiency. This paper describes the implementation of a new clustering algorithm to prolong the lifetime of WUSNs. We propose a new protocol called distance- and energy-constrained k-means clustering scheme (DEKCS) for cluster head selection. A potential cluster head is selected based on its position in the cluster and based on its residual battery level. We dynamically update the residual energy thresholds set for potential cluster heads to ensure that the network fully runs out of energy before it becomes disconnected. Also, we leverage the elbow method to dynamically select the optimal number of clusters according to the network size, thereby making the network scalable. Our evaluations show that the proposed scheme outperforms the conventional low-energy adaptive clustering hierarchy (LEACH) protocol by over 90% and an optimised version of LEACH based on k-means clustering by 42%

Thermomechanical modelling of laser surface glazing for H13 tool steel

A two-dimensional thermomechanical finite element (FE) model of laser surface glazing (LSG) has been developed for H13 tool steel. The direct coupling technique of ANSYS 17.2 (APDL) has been utilised to solve the transient thermomechanical process. A H13 tool steel cylindrical cross-section has been modelled for laser power 200 W and 300 W at constant 0.2 mm beam width and 0.15 ms residence time. The model can predict temperature distribution, stress–strain increments in elastic and plastic region with time and space. The crack formation tendency also can be assumed by analysing the von Mises stress in the heat-concentrated zone. Isotropic and kinematic hardening models have been applied separately to predict the after-yield phenomena. At 200 W laser power, the peak surface temperature achieved is 1520 K which is below the melting point (1727 K) of H13 tool steel. For laser power 300 W, the peak surface temperature is 2523 K. Tensile residual stresses on surface have been found after cooling, which are in agreement with literature. Isotropic model shows higher residual stress that increases with laser power. Conversely, kinematic model gives lower residual stress which decreases with laser power. Therefore, both plasticity models could work in LSG for H13 tool steel

The Outcome of Bicolumnar Acetabular Fracture Treated by Single Anterior Ilioinguinal Approach

Background: Acetabular fracture therapy, being complicated, is generally treated by non-operative methods due to a lack of surgeons’ expertise in pelvis surgery. The surgical exposure and reduction of acetabular fractures may become more direct and practical with the altered technique since it is closer to the acetabular quadrilateral plate. This study aimed to determine the efficacy of a single anterior illio-inguinal approach for the management of a Bi-columnar acetabulum fracture. Methods: Sixty patients, fulfilling the selection criteria were selected for descriptive case series from Orthopedic Surgery Department at Lahore General Hospital, from 02-12-2020 to 02-06-2021. After informed consent, surgery was performed on all patients under general anesthesia. Patients were followed-up and evaluated for efficacy in OPD after 12 weeks of surgery with a Harris hip score. All demographic and other information was recorded on a Proforma. SPSS 22 was used to assess data. Post-stratification, efficacy was compared by using chi-square, p-value ≤0.05 was considered significant. Results: Out of 60 patients, 45(75 %) were male, whereas 15(25%) were female (Mean age 52.71±10.50yrs). The Mean of duration fracture (in days) and Harris score are 11.03±5.29 and 2.83±0.45 respectively. The efficacy concerning lateral side was 60% for left side and 26.7% for right side. Efficacy was higher in less than 10 days old fractures at 55.0% while after 10 days it was 31.7%. We found that the percentage of efficacy was 86.7%. Conclusion: The current study concluded that the anterior illio-inguinal approach is highly effective (p=0.001) in the management of acetabular fractures. Keywords: Acetabulum; Pelvic; Fracture; General Surgery