A catastrophic case of venous air embolism in a patient undergoing posterior fossa surgery

Posterior cranial fossa surgeries pose increased risk of venous air embolism (VAE) due the associated pressure gradient. Early detection of VAE is of paramount importance to avoid the disastrous consequences. We, hereby report a case of catastrophic VAE in a 47-year-old male undergoing surgery for glioblastoma

Evaluation of preventable causes and risk factors of maternal mortality

Background: The primary objective was to evaluate preventable causes of maternal deaths at tertiary, second and primary care in Patiala district, Punjab. Secondary objective was to determine impact of socio-demographic characteristics, anemia and three delays on maternal death.Methods: This is a retrospective observational study carried out between 1. 7. 2013 till 30. 6. 2014, for period of one year in department of a tertiary care hospital and district health authorities catering to secondary and primary care deaths for evaluation of preventable causes and risk factors for maternal deaths at tertiary, secondary and primary level.Results: A total of 54 maternal deaths with MMR of 170.42/100000 live births, occurred in stipulated period, 87.03% at tertiary care, one at second care, 7.41% at home and 3.7% on the way to tertiary care. Majority of maternal deaths (92.6%) were unbooked, between 21-30 years (64.82%) of age, primi or second gravida (35.18%), para 1 or 2 (37.03%), illiterate (40.74%), low income group (57.41%) with rural background (59.26%). Majority of maternal deaths (77.7%) occurred in postpartum period. Most of maternal deaths (75.93%) were due to direct causes, pre-eclampsia 25.93% followed by sepsis (22.2%) and haemorrhage (20.3%). Anemia was contributory factor in 79.63% maternal deaths. 7.4% maternal deaths occurred at home with delay in seeking care while 29.62% died due to delay in reaching care. In 40.42% maternal deaths, it took more than two hours to reach tertiary care hospital.Conclusions: Skilled antenatal, intranatal and postnatal care, women empowerment, counseling, early diagnosis and referral of pre-eclampsia and other high-risk cases with curbing anemia at grass root level is need of millennium. Preventing delay in seeking care or reaching care-a step towards sustainable development goals (SDG) to reduce MMR

Mapping of IgE-binding regions on recombinant Cyn d 1, a major allergen from Bermuda Grass Pollen (BGP)

<p>Abstract</p> <p>Background</p> <p>Bermuda grass (<it>Cynodon dactylon</it>; subfamily Chloridoideae) is an important source of seasonal aeroallergens in warm tropical and sub-tropical areas worldwide. Improved approaches to diagnosis and therapy of allergic diseases require a thorough understanding of the structure and epitopes on the allergen molecule that are crucial for the antigen-antibody interaction. This study describes the localization of the human IgE-binding regions of the major group 1 pollen allergen Cyn d 1 from Bermuda grass.</p> <p>Methods</p> <p>A cDNA library was constructed from Bermuda grass pollen (BGP) using a Lambda gt11 expression vector. The gene encoding the Cyn d 1 allergen was isolated by screening the library with a mouse monoclonal antibody raised against grass group 1 allergen. In order to characterize the IgE epitopes on Cyn d 1, seven overlapping fragments and three deletion mutants were cloned and over-expressed in E. coli. The recombinant fragments and deletion mutants were evaluated for their comparative IgE reactivity with sera of non atopic individuals and grass pollen allergic patients by ELISA and a dot-blot assay.</p> <p>Results</p> <p>Analysis of IgE binding regions by overlapping fragments and deletion mutants identified two major allergenic regions corresponding to amino acids 120–170 and 224–244. Deletion of either or both regions led to a significant reduction in IgE binding, emphasizing the importance of the C-terminal region on Cyn d 1 in epitope-IgE interaction.</p> <p>Conclusion</p> <p>Anti-Cyn d 1 IgE antibodies from allergic human sera recognize two epitopes located at the C-terminal end of the molecule. These data will enable the design of improved diagnostic and therapeutic approaches for BGP hypersensitivity.</p

Aggressive angiomyxoma of vagina: a rare entity

Aggressive angiomyxoma a soft tissue tumor arising in the pelvis and perineal regions of women in reproductive age group is a rare entity. It is slow growing locally aggressive myxoid mesenchymal tumor, with a marked tendency to local recurrence. Preoperative clinical diagnosis is usually difficult due to absence of diagnostic features as well as rarity of the disease. We describe a case of aggressive angiomyxoma of vagina in a 47-year-old para 4 woman with multiple fibromyoma (upto 22-week size of pregnant uterus) with 10*10 cms posterior vaginal cyst. Total abdominal hystrectomy with surgical excision of vaginal wall cyst done. A retrospective diagnosis-Aggressive Angiomyxoma of the vagina was made after histological confirmation. Surgical excision with wide margins and long term follow up remains treatment of choice

FORMULATION DEVELOPMENT AND EVALUATION OF NOVEL FIXED DOSE COMBINATION OF S (-) PANTOPRAZOLE AND MOSAPRIDE CITRATE BY TABLET IN CAPSULE APPROACH

Objective: The main objective of the present study was to formulate a fixed dose combination of chirally pure S (-) Pantoprazole and Mosapride citrate tablets. Since no systematic studies on design and development of S (-) Pantoprazole and Mosapride citrate tablets in capsule approach are available in literature, we propose to develop a suitable formulation to characterize in-vitro release profile of both the tablets in capsules. Chirally pure S (-) Pantoprazole tablets were prepared as delayed release and Mosapride citrate tablets were prepared as immediate release tablets.Methods: Enteric coating was done on S (-) Pantoprazole tablets to modify its release in 6.8 phosphate buffer. In-vitro dissolution of capsule containing both the tablets was performed in two different media, 0.1N HCl and 6.8 phosphate buffer respectively. All Physico-chemical parameters for both the tablets as well as capsules were evaluated individually and were found well within the specified limits.Result: Initially dissolution was performed in 0.1 N HCl in which immediate release tablet of Mosapride dissolve completely and pantoprazole tablets remains as it is due to enteric coating. Further tablet was placed in 6.8 phosphate buffer in which delayed release tablets of S (-) Pantoprazole gives complete release. Drug product was found stable during accelerated stability studies for 6 month at 40°C/75% RH.Conclusion: A stable and robust formulation of S (-) Pantoprazole and Mosapride citrate as fixed dose combination was developed and evaluated. Tablet in capsule approach was developed and results were well within the specified limits.Keywords: S (-) pantoprazole, Mosapride citrate, Modified release, Fixed-dose combination, Delayed release

Linking Illness to Food: Summary of a Workshop on Food Attribution

To identify and prioritize effective food safety interventions, it is critical not only to identify the pathogens responsible for illness, but also to attribute cases of foodborne disease to the specific food vehicle responsible. A wide variety of such “food attribution” approaches and data are used around the world, including the analysis of and extrapolation from outbreak and other surveillance data, case-control studies, microbial subtyping and source-tracking methods, and expert judgment, among others. The Food Safety Research Consortium sponsored the Food Attribution Data Workshop in October 2003 to discuss the virtues and limitations of these approaches and to identify future options for the collection of food attribution data in the United States. This discussion paper summarizes workshop discussions and identifies challenges that affect progress in this critical component of a risk-based approach to improving food safety.foodborne illness, food attribution, outbreaks, case-control studies, microbial fingerprinting, microbial subtyping, FoodNet

Mortality and morbidity associated with illegal use of abortion pill: a prospective study in tertiary care center

Background: In India, medical method of abortion is allowed for first 7 weeks of intra uterine pregnancy. As per WHO it is safe and effective method for termination of early pregnancy under medical supervision. It is done by using mifepristone (200mg) and misoprostol (800mcg). These drugs are not for contraception but are abortion pills. Women use the abortion pills for unintended pregnancy inspite of using various method of contraception due to lack of knowledge, apprehension, poverty, denial, and ignorance of contraceptive use without any medical supervision (illegal use) and become victim of unsafe abortion. The main aim of this study was to find out mortality and morbidity associated with illegal use of abortion pill.Methods: A prospective observational study was carried out in the department of obstetrics and gynaecology, TMMC and RC Moradabad, a tertiary care center with history of intake of abortion pill (mifepristone and misoprostol) for 1 year from 1st May 2015 to 1st April 2016 on 120 patients. Data was collected and analysed by percentage and proportions.Results: Illegal use of abortion pill was more common among 30-39 years (55%) group of women and mostly were grand multiparous (81.67%). In most of the cases husband brought the pills (85%) from advice of chemist (70%).The most common presenting complaint was excessive bleeding per vaginum (66.3%). Most common complication was moderate anemia (38.3%).Conclusions: The present study recommends medical method of abortion is safe and effective under medical supervision. Illegal use of abortion pills without supervision results in serious complications. 

A new antibacterial imidazole from the marine sponge Iricinia fusca

A new imidazole alkaloid (1) along with two known compounds, variabilin (2) and iricinialactam A (3) have been isolated from the Arabian marine sponge Ircinia fusca. The structure of the new compound was established as 4-((1, 2-dihydroxy-5-(methyl (1-methyl-1H-imidazol-4-yl) amino) pentan-3-yl) oxy)-3, 5-dimethoxy-1-methylpyrrolidin-2-one (1) by 1D and 2D NMR, and high-resolution electrospray ionization mass spectrometry (HRESIMS). Compound 1 exhibited selective growth inhibitory activity against gram-positive bacteria S. aureus at 100 µg/mL

Sociodemographic and seroprevalence profile of sexually transmitted infections (HIV, Hepatitis B, Hepatitis C and Syphilis) in asymptomatic pregnant females

Background: Globally 499 million new episodes of curable STIs occur in the age group of 15-49 years, 80% in developing countries and 79 million in India alone. There is an increasing trend for viral STIs while bacterial STIs are on decline. Number of pregnant women with STIs is increasing by about 250 million a year in developed world and double that number in developing countries. The objective of the study was to estimate seroprevalence of STIs (Hepatitis C, Hepatitis B, HIV and Syphilis) and to evaluate impact of sociodemographic profile and sexual behaviour on STIsMethods: This observational study was carried out on 1000 asymptomatic pregnant females attending antenatal clinics, Department of Obstetrics and Gynecology, Government Medical College Patiala, Punjab.Results: Seroprevalence for STIs in asymptomatic pregnant females was 22.5%. Hepatitis C-9%, Hepatitis B-6.3%, HIV-5.5%, and Syphilis 1.7%. Illiteracy, low socio economic status, homemakers, rural background with multiple sex partners in the 21-30 years age group is associated with increasing trends of STIs in pregnancy.Conclusions: Screening asymptomatic pregnant women for STIs remains a key programme strategy for quadruple (Hepatitis C, Hepatitis B, HIV and Syphilis) prevention. Mandatory screening for STIs to reduce perinatal transmission is need of the millennium– a step toward ending STI epidemics as a global priority.