Self injection of Dichlorvos, an Organophosphorus Compound

We report two patients who injected themselves a strong organophosphate compound, dichlorvas, and showed the typical clinical picture of organophosphate intoxication. There are very few case reports of parenteral organophosphorous poisoning. With the appropriate therapy, their symptoms disappeared in a few days. The cases are reported because of unusual and interesting way of intoxication

Cyto-histological correlation in diagnosis of gastrointestinal lesions- a prospective study in a tertiary care institute

Background: Gastrointestinal tract is involved by a large number of inflammatory, infectious and neoplastic diseases. There is a worldwide rising incidence of GIT lesions especially neoplasms.Methods: This study was planned to correlate endoscopic and colonoscopic brush cytology with histopathology of gastrointestinal lesions and to determine the spectrum of gastrointestinal lesions in patients subjected to endoscopic brushings and biopsy.Results: Sensitivity of upper GI brush cytology was 95.15% and specificity 90.41%. Sensitivity of colonoscopic brush cytology was 100% and specificity 86.79%. The accuracy of brush cytology came out to be 92.45% in upper GIT and 92.22% in lower GIT.Conclusions: Brush cytology is a non-invasive and cost-effective method to retrieve epithelial cells from a much larger surface area of the mucosa, thus allowing thorough sampling and increasing the diagnostic yield

Giant intra-abdominal hydatid cysts with multivisceral locations

The disseminated intra-peritoneal hydatid disease is a very rare finding. A case of disseminated intra abdominal hydatid disease is presented along with a review of literature and various therapeutic modalitie

Role of therapeutic drug monitoring of azathioprine and thiopurine methyltransferase enzyme status in patients with inflammatory bowel disease: Indian scenario

Inflammatory bowel disease is mainly caused by dysragulated immune system. Inflammatory bowel disease incidences are rising in Asian countries with difficulty in their diagnosis and managements. There is rising the incidences and prevalence rate in India. Inflammatory bowel disease has two major subtypes Ulcerative colitis and chron’s disease. In ulcerative colitis inflammation occurs in lower part of large intestine that extend from anal verge to proximal colon while in case of chron’s disease there is transmural inflammation of gastrointestinal tract. This review is to provide comprehensive review focused on the current status of therapeutic drug monitoring of azathioprine metabolites in patients of inflammatory bowel disease

Bioactivity guided isolation and characterization of antimicrobial principle from Hydrocotyle javanica Thunb.

Hydrocotyle javanica Thunb. (Family Araliaceae) has been used in traditional herbal medicine as a substitute of Centella asiatica (L.) Urban. Although, the latter has been studied extensively and various biologically active constituents have been reported, the former has not been studied for its active constituents. The current study followed activity guided isolation and identification of the fraction with antimicrobial activity from H. javanica. Plant extracts were prepared by extracting successively with petroleum ether, ethyl acetate and ethanol. Antimicrobial activity was evaluated using gram positive and gram negative bacteria and Candida albicans. Bioactivity-guided isolation was carried out by preparative thin layer chromatography and bioautography. Cytotoxicity of the most active antimicrobial principle was evaluated against Human embryonic kidney (HEK293) and Adenocarcinomic Human Alveolar Basal Epithelial (A549) cell lines. The tentative structure of the most active antimicrobial principle was constructed from the data obtained from FTIR, MS, H-NMR and C-NMR

The Bethesda system for reporting thyroid cytology: a prospective study in a tertiary care institute along with review of literature

Background: The Bethesda system for reporting thyroid cytology (TSBRTC) was devised by the National Cancer Institute (NCI) to obtain uniformity, reproducibility and a defined management protocol while dealing with thyroid lesions. This study was undertaken with the aim to see the benefits of adopting TBSRTC in the diagnosis of thyroid FNAC, and identify the malignancy risk of each category.Methods: This cross-sectional study was conducted in Indira Gandhi Medical College, Shimla, Himachal Pradesh from June 2016 to July 2017 on 181 thyroid FNACs which were reported according to the Bethesda system for reporting thyroid cytopathology (TBSRTC) under six categories: (I) non-diagnostic/unsatisfactory (II) benign (III) atypia of undetermined significance/follicular lesion of undetermined significance (IV) follicular neoplasm/suspicious for follicular neoplasm (specify if Hurthle cell (oncocytic) type (V) suspicious for malignancy (VI) malignant. Histopathological diagnosis was available for 65 cases where thyroidectomy was performed. Malignancy risk was calculated for each category. Sensitivity, specificity, positive and negative predictive values for TBSRCT were also calculated. All the data was analyzed in SPSS software version 22.0 (IBM, USA).Results: Benign lesions constituted the major bulk. After the use of TBSRTC, there was increased ability to look for follicular neoplasms, improvement in making definitive diagnosis of the cases, an improvement in diagnostic accuracy, and we were in line with the implied risk outlined by TBSRTC in most of the cases.Conclusions: Application of TBSRTC results in uniformity in reporting among pathologists and better interdisciplinary communication and patient management

Urinary, Plasma, and Serum Biomarkers’ Utility for Predicting Acute Kidney Injury Associated With Cardiac Surgery in Adults: A Meta-analysis

BackgroundEarly accurate detection of acute kidney injury (AKI) occurring after cardiac surgery may improve morbidity and mortality. Although several novel biomarkers have been developed for the early detection of AKI, their clinical utility in the critical intraoperative and immediate postoperative period remains unclear.Study DesignSystematic review and meta-analysis.Setting & PopulationAdult patients having cardiac surgery.Selection Criteria for StudiesEMBASE, CINAHL, Cochrane Library, Scopus, and PubMed from January 1990 until January 2015 were systematically searched for cohort studies reporting the utility of novel biomarkers for the early diagnosis of AKI after adult cardiac surgery. Reviewers extracted data for study design, population, timing of biomarker measurement and AKI occurrence, biomarker performance (area under the receiver operating characteristic curve [AUROC]), and risk of bias.Index TestsNovel urine, plasma, and serum AKI biomarkers, measured intraoperatively and in the early postoperative period (<24 hours).Reference TestsAKI was defined according to the RIFLE, AKIN, or 2012 KDIGO criteria.ResultsWe found 28 studies reporting intraoperative and/or early postoperative measurement of urine (n=23 studies) or plasma or serum (n=12 studies) biomarkers. Only 4 of these studies measured biomarkers intraoperatively. Overall, intraoperative discrimination by the urine biomarkers neutrophil gelatinase-associated lipocalin (NGAL) and kidney injury marker 1 (KIM-1) demonstrated AUROCs<0.70, whereas N-acetyl-β-d-glucosaminidase (NAG) and cystatin C had AUROCs<0.75. In the immediate 24-hour postoperative period, the urine biomarkers NGAL (16 studies), KIM-1 (6 studies), and liver-type fatty acid binding protein (6 studies) exhibited composite AUROCs of 0.69 to 0.72. The composite AUROCs for postoperative urine cystatin C, NAG, and interleukin 18 were ≤0.70. Similarly, the composite AUROCs for postoperative plasma NGAL (6 studies) and cystatin-C (5 studies) were <0.70.LimitationsHeterogeneous AKI definitions.ConclusionsIn adults, known urinary, plasma, and serum biomarkers of AKI possess modest discrimination at best when measured within 24 hours of cardiac surgery

Bioactivity guided isolation and characterization of antimicrobial principle from Hydrocotyle javanica Thunb.

913-919Hydrocotyle javanica Thunb. (Family Araliaceae) has been used in traditional herbal medicine as a substitute of Centella asiatica (L.) Urban. Although, the latter has been studied extensively and various biologically active constituents have been reported, the former has not been studied for its active constituents. The current study followed activity guided isolation and identification of the fraction with antimicrobial activity from H. javanica. Plant extracts were prepared by extracting successively with petroleum ether, ethyl acetate and ethanol. Antimicrobial activity was evaluated using gram positive and gram negative bacteria and Candida albicans. Bioactivity-guided isolation was carried out by preparative thin layer chromatography and bioautography. Cytotoxicity of the most active antimicrobial principle was evaluated against Human embryonic kidney (HEK293) and Adenocarcinomic Human Alveolar Basal Epithelial (A549) cell lines. The tentative structure of the most active antimicrobial principle was constructed from the data obtained from FTIR, MS, H-NMR and C-NMR

Probiotics from Fermented Fish

The term ‘Probiotics’ is used to describe live microorganisms, which, when administered in adequate quantities, confer health benefits. The term probiotics was first introduced in 1965 by Lilly and Stillwell, who defined it to be microorganisms acting as growth promoters for other microorganisms. These microorganisms may include Lactobacillus, Streptococcus, Bifidobacterium, Saccharomyces, Aspergillus, Enterococcus etc., as well as a mixture of other microorganisms. The chapter focuses on providing a comprehensive and up-to-date review of probiotics that have been isolated from fermented fish-based products