Cardiac Functions in Alcoholic and Non-Alcoholic Cirrhosis

Cirrhosis is a chronic liver disease with systemic complications. Cardiac involvement in cirrhosis is less studied and rarely reported. Here an attempt was made to design a prospective analytical observational study to find out the functional status of the heart in established alcoholic (n=32) and non - alcoholic (n=68) cirrhosis patients compared with asymptomatic healthy controls. Rigid criteria was adopted in the selection of cases in order to exclude co morbid conditions and other contributing factors. This study was confined among males as women alcoholics could not be identified in this area. The data was analysed statistically. Left ventricular systolic function parameters (LVIDs, LVIDd, IVSd, LVPWd and ejection fraction) were comparable between alcoholics, non alcoholics and controls (p>0.05). Pulmonary artery systolic pressure (PASP) in cirrhosis patients and controls ranged from 12.5 to 56 mm Hg and 13 to 29 mm Hg respectively. The mean among the two groups were 28.2+9.06 and 20.4+4.21 mm Hg respectively. The difference among cirrhotics and controls with reference to PASP were statistically highly significant (p=0.0001). 54 The LV mass in cirrhotics patients and controls ranged from 74 to 271 gms and 90 to 120 gms respectively. The mean among the two groups were 162.26+50.65 and 159.33+41.77 grams respectively. But the difference was not statistically significant (p=0.8917). 48 cirrhotic patients (48%) had diastolic dysfunction compared to 10 persons (25%) in the control group which was significant (p<0.05). This significance persisted in both alcoholic and non alcoholic groups. Majority of patients in both subsets of cirrhotic with diastolic dysfunction showed LV relaxation abnormality pattern. (68% in alcoholic and 52% in non alcoholic group respectively) There was no significant difference in cardiac functions parameters when alcoholic cirrhotics were compared with non alcoholic cirrhotics (p>0.05). The present study has brought out the pattern of cardiac involvement and the comparability of observations with published series. More molecular and clinical studies are required to design effective therapeutic measures to prevent the progression of cirrhosis and its systemic complications

Drug utilization pattern in Schizophrenia

Background: Pharmacotherapy is the mainstay of treatment in schizophrenia. The economic impact of this illness is wide ranging, long lasting and huge. The emergence of newer antipsychotics has changed the prescribing pattern. Purpose of this study is to determine the prescription pattern of antipsychotic drugs and to analyse the drug utilization in patients with schizophrenia based on WHO prescribing indicators.Methods: A descriptive study was conducted for a period of 1-year duration at inpatient Department of Psychiatry of a Government Medical College in Kerala, India among 230 schizophrenic patients. The case sheets of patients meeting inclusion criteria were scrutinised to find out the antipsychotic prescription pattern and drug utilization was analysed using WHO prescribing indicators. Analysis was done using descriptive statistics.Results: Newer antipsychotics (55.2%) were prescribed slightly more in preference to older antipsychotic (44.8%) drugs. Out of the newer drugs prescribed olanzapine (20.9%) was prescribed the most followed by risperidone (18%). Haloperidol (22.9%) was the most frequently prescribed older antipsychotic. Majority (71.3%) of the patients were given more than one antipsychotics during the hospital stay. Trihexyphenidyl (27.9%) was the most frequently co-prescribed drug with antipsychotics. Average number of drugs per encounter was 4.19, 73.4% of the drugs were prescribed in their generic name, 50.4% of the encounters were with an injection prescribed. 44.4%of the drugs were prescribed from the EDL (WHO-19th edition). Average drug cost per encounter was Rs.45.43. Percentage of drug cost spent on injections was 8.44%.Conclusions: Newer antipsychotics were more prescribed for schizophrenia of which olanzapine was the commonest. Newer antipsychotics are preferred because of their propensity to cause less side effects and more efficacy. Study of pattern of drug utilization is useful for measuring the economic impact of drug use among patients thereby facilitating rational prescribing

DC-DC Converter with Reduced Stress Using Switched Inductor Technique with Feedback Control

ABSTRACT: Conventional DC-DC converters are unable to provide high step up voltage gain due to reverse recovery problem of diodes. In this paper, DC-DC converter using switched inductor technique with feedback control is introduced to achieve high voltage gain without high duty ratio. In the DC-DC converter using switched inductor technique, two inductors with same level of inductance are charged in parallel during the switch on period and are discharged in series during the switch off period. Simulation has been carried out to study the performance of the converter. Further performance comparison of this converter is done with transformer less high step up DC-DC converter

Folate-targeted immunotherapy effectively treats established adjuvant and collagen-induced arthritis

Activated macrophages express a cell surface receptor for the vitamin folic acid. Because this receptor is inaccessible or not measurably expressed on other normal cells, folic acid has been recently exploited to selectively deliver attached radio-emitters to sites of activated macrophage accumulation, allowing scintigraphic imaging of inflamed joints and organs of arthritic rats. We demonstrate here that folate-linked haptens can also be targeted to activated macrophages, decorating their cell surfaces with highly immunogenic molecules. Under conditions in which the rodent has already been immunized against keyhole limpet hemocyanine-(fluorescein isothiocyanate) FITC, activated macrophages are eliminated. Administration of folate-FITC conjugates to rodents with experimental arthritis attenuates (a) systemic and peri-articular inflammation, (b) bone and cartilage degradation, and (c) arthritis-related body weight loss. Treatment with folate-hapten conjugates is comparable to methotrexate, etanercept, anakinra, and celecoxib at alleviating the symptoms of arthritis. We conclude that reduction of activated macrophages by folate-targeted immunotherapy can ameliorate the symptoms of arthritis in two rodent models of the disease

Audio files enhance class room learning among medical students in Oman

Oman Medical College a private Medical College in Sultanate of Oman offers a 7 year MD program with the medium of instruction being English. Students are mostly Omani nationals who are Arabic speaking. To enhance understanding and learning course materials offered in the lectures, we decided to record the lecture sessions in MP3 format and provide access to the audio files to the students of Pharmacology in year 5. At the end of 8 months of study the students completed a survey to assess the effectiveness of listening to the audio files of lectures. 80/103 students (77%) responded to the survey. 49 students out of the 80 (62%) agreed that they used the audio recordings. 80/103 students (77%) responded to the survey. 49 students out of the 80 (62%) agreed that they used the audio recordings. Most of the students listened to them from their laptops. 84% of the students agreed that listening to audio recordings helped them to understand and learn the lecture material in detail. 94% of the students recommended use of this tool in other courses also. 38% of students who attended lectures did not use this tool due to lack of time. To fully understand the potential value of audio recordings as a supplementary learning tool a more in-depth, detailed understanding of students' experiences of using audio recordings is required

Chemical transformations of self-assembled monolayers by low energy reactive ion beam bombardment

Reactions of low energy (500 eV) beams of CCl4+, O2+ and PCl3+ on hydrocarbon and fluorocarbon self-assembled monolayer surfaces are shown to produce chemically modified monolayers. The surfaces before and after the reaction have been characterised by X-ray photoelectron spectroscopy. It is suggested that the surface modification involves the substitution of the ion/ surface reaction sites with the appropriate reagent. It appears that the ion beam penetration is minimal and the extent of modification is limited to the top layers of the surface. It is found that the hydrocarbon surface is more reactive than the fluorocarbon surface towards oxygen ions. Upon prolonged bombardment, the alkyl chains desorb and the exposed substrate reacts with the ion beam. It is proposed that extremely thin molecular surfaces of distinct functionality can be made by low energy reactive ion beam bombardment on SAM surfaces

Cut-and-place technique of pterygium excision with autograft without using sutures or glue: Our experience

BACKGROUND: Conjunctival sutures used in pterygium surgery are not only time-consuming process but also may lead to local complications such as discomfort, scarring, granuloma, or infection. Plasma-derived products such as fibrin glue may produce possible hypersensitivity reactions whereas the risk of viral transmission remains theoretically possible. We describe a simple method of achieving conjunctival autograft adherence during pterygium surgery avoiding potential complications associated with the use of fibrin glue or sutures. MATERIALS AND METHODS: After pterygium excision and fashioning of the autologous conjunctival graft, the recipient bed is encouraged to achieve natural hemostasis and relative desiccation before graft placement. Excessive hemorrhage in the graft bed is tamponed. Graft adherence and positioning is examined 12–15 min after surgery. RESULTS: A total of 205 cases of pterygium underwent excision with conjunctival autograft without using sutures or glue. Mean follow-up time was 14.6 months. Cosmesis achieved was excellent in all cases. There were no intraoperative complications seen. Recurrence was seen in 6.8% of cases (14 cases). Nasal gaping was seen in 36% of cases (74 cases), which healed spontaneously without any surgical intervention. CONCLUSION: This simple technique for pterygium surgery is not only cost effective and quick but also may prevent potential adverse reactions encountered with the use of foreign materials and in this large series provided safe and comparable results to current methods

Not Available

Not AvailableAn antimicrobial packaging material was developed by uniformly embedding 1, 3 and 5% chitosan (w/w)in low density polyethylene matrix using maleic anhydride grafted LDPE as a compatible agent. The materials were mixed by compounding and blown into monolayer films via blown film extrusion. The developed films showed good barrier properties against oxygen. Characterization of the composite films with Fourier transform infrared spectroscopy revealed that chitosan and LDPE interacted well with eachother. Overall migration showed better release of chitosan adduct from the LDPE matrix which enhancedthe antibacterial properties of the films. The interaction between the LDPE/CS and maleic anhydride grafted LDPE had a decreasing effect on the tensile strength and heat sealing properties. Investigation on antimicrobial properties of LDPE/CS films showed 85–100% inhibition of Escherichia coli. Efficacy of LDPE/CS films was evaluated by using them as packaging material for chilled storage of Tilapia (Ore-ochromis mossambicus). Analysis of storage quality indices (peroxide value, free fatty acid, total volatile base nitrogen and aerobic plate count) revealed good antibacterial property and extension of shelf life of Tilapia in the chitosan incorporated novel composite films compared to virgin LDPE film.Not Availabl