Human papilloma virus vaccination: practical guidelines

Cervical cancer has a long latency period and established role of HPV lead to interest in development of HPV vaccine. Main goal of HPV vaccination is to decrease cervical cancer incidence. There are two vaccines available, for the prevention of HPV infection - gardasil and cervarix. Gardasil is quadrivalent and cervarix is bivalent. The FDA has approved gardasil in 2006 and cervarix in 2009 based on their efficacy in phase 3 trails. When recommending HPV immunization of females, it should be offered to girls 11 to 12 years of age, but can be administered as early as nine years. Catch-up vaccination should be offered for females aged 13 to 26 years who have not been previously vaccinated. HPV immunization is not effective in clearing cytological evident disease or HPV infection that is already present and it does not provide immunization for serotypes other than included in vaccine. Cervical cancer screening is recommended to continue as per guidelines

Angioembolization of rectal stent induced inferior mesenteric artery pseudoaneurysm

Bleeding is a lesser-known complication of rectal self-expandable metal stents (SEMS). Most of these bleedings are self-limiting. Life threatening bleeding as a complication of SEMS reported only rarely. In the present paper, we are reporting a rare case of near fatal intraluminal bleeding from rectal SEMS. Traumatic pseudoaneurysm formed in superior rectal branch of the inferior mesenteric artery because of pressure induced by rectal stent. Severe bleeding leads to haemorrhagic shock. Patient was stabilized and angioembolization of pseudoaneurysm with superior rectal branch of inferior mesenteric artery was done. Bleeding stopped post procedure and patient discharged in stable condition. This case presentation highlights the fact that we should decide management strategy for a patient in multidisciplinary meeting and utilize the available resources in best possible ways. Though rectal stents are good alternatives, they have their own set of complications. These should be considered while deciding strategy for the upfront stoma versus rectal stent. For cases as in this article upfront stoma may have avoided the associated complication.

A comparison of buccal versus vaginal misoprostol administration for induction of first and second trimester abortion

Background: Aim of study was to compare effectiveness, adverse effects and patient’s acceptability of buccal and vaginal routes of administration of misoprostol in 1st and 2nd trimester abortion, type of study-randomized control trial Methods: A total of 200 women with indications for abortion up to 20 weeks of pregnancy were enrolled over a period of 1 year and received misoprostol either through buccal (Group A) or vaginal (Group B) route. Each group containing 50 patients of first trimester and second trimester. Results: Incomplete abortion rate (25%) was significantly higher in vaginal group while drug related side-effects (47%), patients’ satisfaction and acceptability (82%) was higher in buccal group respectively. Conclusions: Buccal route may be preferred owing to a better complete abortion rate, better patient satisfaction and acceptability as compared to vaginal route

In vitro antimicrobial activity of ten medicinal plants against clinical isolates of oral cancer cases

<p>Abstract</p> <p>Background</p> <p>Suppression of immune system in treated cancer patients may lead to secondary infections that obviate the need of antibiotics. In the present study, an attempt was made to understand the occurrence of secondary infections in immuno-suppressed patients along with herbal control of these infections with the following objectives to: (a) isolate the microbial species from the treated oral cancer patients along with the estimation of absolute neutrophile counts of patients (b) assess the in vitro antimicrobial activity medicinal plants against the above clinical isolates.</p> <p>Methods</p> <p>Blood and oral swab cultures were taken from 40 oral cancer patients undergoing treatment in the radiotherapy unit of Regional Cancer Institute, Pt. B.D.S. Health University,</p> <p>Rohtak, Haryana. Clinical isolates were identified by following general microbiological, staining and biochemical methods. The absolute neutrophile counts were done by following the standard methods. The medicinal plants selected for antimicrobial activity analysis were <it>Asphodelus tenuifolius Cav., Asparagus racemosus </it>Willd., <it>Balanites aegyptiaca </it>L.<it>, Cestrum diurnum </it>L., <it>Cordia dichotoma </it>G. Forst, <it>Eclipta alba </it>L., <it>Murraya koenigii </it>(L.) Spreng. <it>, Pedalium murex </it>L.<it>, Ricinus communis </it>L. and <it>Trigonella foenum graecum </it>L. The antimicrobial efficacy of medicinal plants was evaluated by modified Kirby-Bauer disc diffusion method. MIC and MFC were investigated by serial two fold microbroth dilution method.</p> <p>Results</p> <p>Prevalent bacterial pathogens isolated were <it>Staphylococcus aureus </it>(23.2%), <it>Escherichia coli </it>(15.62%), <it>Staphylococcus epidermidis </it>(12.5%), <it>Pseudomonas aeruginosa </it>(9.37%), <it>Klebsiella pneumonia </it>(7.81%), <it>Proteus mirabilis </it>(3.6%), <it>Proteus vulgaris </it>(4.2%) and the fungal pathogens were <it>Candida albicans </it>(14.6%), <it>Aspergillus fumigatus </it>(9.37%). Out of 40 cases, 35 (87.5%) were observed as neutropenic. Eight medicinal plants (<it>A. tenuifolius, A. racemosus, B. aegyptiaca, E. alba, M. koenigii, P. murex R. communis </it>and <it>T. foenum graecum</it>) showed significant antimicrobial activity (P < .05) against most of the isolates. The MIC and MFC values were ranged from 31 to 500 μg/ml. <it>P. aeruginosa </it>was observed highest susceptible bacteria (46.6%) on the basis of susceptible index.</p> <p>Conclusion</p> <p>It can be concluded that treated oral cancer patients were neutropenic and prone to secondary infection of microbes. The medicinal plant can prove as effective antimicrobial agent to check the secondary infections in treated cancer patients.</p

Breeding Strategies for Improving Fodder Security in Semi-Arid Tropics (SAT)

Semi-Arid Tropic region extends in 55 countries of the world mostly developing nations which extend from Asia to Africa and provides home for 38 % of total poor of the world (Thornton et al., 2000). South Asia holds maximum areas under SAT which is followed by the countries from African continent and South America. The region is under tremendous change and facing acute problem of water, land degradation and soil health and loss of biodiversity. Demand for livestock product in the region is growing much more rapidly than the demand for food grains. Livestock numbers have increased significantly in all SAT regions for all categories of livestock over the last three decades. Increasing population of livestock in the region has created huge pressure on the available fodder resources. To meet the deficit in all components of fodder, dry crop residues and feed has to be met from either increasing productivity, utilizing untapped feed resources or increasing land area under fodder crops. The region primarily depends on annual dual purpose fodder crops viz., sorghum, pearlmillet, maize, oats, cowpea, clovers and perennial crops like lucerne and range grasses and legumes. The present paper deals about the current status, recent research and development and opportunities which can be effectively utilized for ensuring feed and fodder security in the region

Assessment of adverse event following immunization and its co-relates among COVID-19 vaccine recipient in Bundelkhand region of Uttar Pradesh: A cross-sectional study

Background: The COVID-19 pandemic is a global emergency. AEFIs reporting and assessment should be done with high priority as they could change the benefit-risk profile of the vaccine. Objective: To assess adverse effects after COVID-19 vaccination. Methods: This cross-sectional study conducted among 605 heath functionaries taken part from January 2021 to March 2021. Results: The most common AEFI reported was pain at injection site (51.9%). Gender, previous COVID status and perception before vaccination were significantly associated with AEFI. Conclusion: There was no serious adverse event after vaccination. COVID vaccine has a good safety profile

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

Aggressiveness of esthesioneuroblastoma: a rare case report and review of literature

Introduction. Esthesioneuroblastoma, also known as olfactory neuroblastoma, is a rare malignant neuroectodermal nasal tumor with distinctive clinical, histopathological, radiological, and molecular features. It arises from olfactory receptors in the nasal mucosa or the cribriform plate of the ethmoid bone. It is generally slow-growing; fast-growing tumors may lead to widespread metastasis. Here, we present an atypical case of aggressive esthesioneuroblastoma treated with a multimodality approach.  Case description. A 28-year male, presented with a painful swelling over the right cheek lasting for 5 months. The patient underwent surgery, and histopathology of the surgical specimen revealed a small round blue cell tumor with widespread positivity for synaptophysin and CD 56. The histopathological appearance and immunohistochemical profile of the biopsy tissue confirmed esthesioneuroblastoma. Owing to subtotal resection, the patient received adjuvant radical radiotherapy to the local site and lymph nodes. Three months post-radiotherapy, a CECT scan showed a partial response, so the patient received intravenous chemotherapy. However, the patient had local disease progression; establishing the aggressivness of esthesioneuroblastoma in our patient. The patient is alive with residual stable disease after 2.5 years from the initial diagnosis and is follow up.  Conclusion. Esthesioneuroblastomas are uncommon tumors and owing to their slow-growing nature, the patient may neglect them. There is a wide spectrum of clinical presentations and outcomes in such patients, and as the literature on esthesioneuroblastoma is scarce due to its rarity, this case report seeks to contribute to a better understanding of such uncommon malignancy in terms of its clinical presentation, behavior, and outcomes