International Medical Publishing Group(IMPG), India
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Antibiogram, ESBL Production and Carbapenemase Detectionof Klebsiella Spp. in Hospital Acquired Infection
Get PDFnfections with ESBL K. pneumoniae are increasing, particularly among patients in ICUs. This pathogen is usually multidrug-resistant and there are limited treatment options available. Active surveillance for ESBLproducingpathogens in high-risk populations should be performed using appropriate antimicrobial techniques. Disease progression has occurred while on treatment with antibiotics to which there is in vitro susceptibility. The carbapenems, that is, imipenem and Meropenam, are safe and effective antibiotics for the treatment of severe ESBL-producing K. pneumoniae infection in preterm infants
Synergistic Effect of Supercritical CO Extract of Mango Ginger (Curcuma amada- 2Roxb.) With Glycolytic Inhibitors in Human Glioblastoma Cells In Vitro
Get PDFBackground: Cancer cells, unlike normal cells, principally use aerobic glycolysis with reduced mitochondrial oxidative phosphorylation for glucose metabolism, a phenomenon referred to as the Warburg effect. Glioblastoma, one of the most aggressive, lethal and incurable human tumors with a survival rate of 12-15 months in patients undergoing standard of care treatment involving surgery, chemotherapy and radiation therapy, has been shown to have a preferential metabolism of glucosethrough aerobic glycolysis. The cytotoxic effects of a previously described supercritical CO extract of 2 mango ginger (Curcuma amada-CA) with two glycolytic inhibitors [2-deoxy-D-glucose (2-DG) and sodium oxamate (SO)] was investigated in the U-87MG human glioblastoma cell line. Methods: Cytotoxicity assay was performed with increasing concentrations of CA, 2-DG and SO as single agents and in combinations in U-87MG glioblastoma cells by the MTT assay. The cytotoxicity data was analyzed using CompuSyn software to determine the synergism/additive effect/antagonism between drugs. The effect of CA and glycolytic inhibitors on ATP and lactate synthesis was analyzed to establish the inhibitory effects of individual drugs as well as their combinations on glycolysis pathway. The modulatory effect of CA, 2-DG and SO as single agents or combinations on mRNA and protein expression of apoptotic and metastasis genes were also analyzed by RT-PCR and western blot hybridization, respectively. Results: The hexokinase inhibitor 2-DG and the lactate dehydrogenase-A inhibitor SO, both inhibiting the glycolysis pathway, showed synergistic cytotoxic effects with CA in the glioblastoma cell line with combination index values of <1 in the CompuSyn analysis. CA inhibits cellular ATP synthesis in a dosedependent manner and it has better inhibition profile than 2-DG and SO. CA inhibits cellular lactate synthesis significantly better than 2-DG and SO at low concentrations, and CA+2-DG combination appears to be better than single agents at low doses for lactate inhibition in glioblastoma cells. Gene expression analysis by RT-PCR and western blot hybridization showed that CA, 2-DG and SO as well as their combinations up regulate the ratio of Bax/Bcl-2, p21, TIMP1 and caspase-3 expression and down regulate mutant p53 and MMP2 expression that may increase apoptosis and inhibit cell proliferation as well as metastasis of tumor cells. Conclusion: The combination of CA with glycolytic inhibitors like 2-DG and SO is beneficial for inhibition of growth, proliferation and migration of glioblastoma cells. These in vitro results support the rationale for conducting in vivo studies combining CA with 2-DG and SO in human glioblastoma
LI-FRAUMENI SYNDROME IN A PATIENT WITH FAMILIALHYPERLIPIDEMIA FROM WESTERN IRAN, A CASE REPORT
Get PDFMutations of germ-cell line TP53 gene are mainly reported in Li–Fraumeni syndrome(LFS). LFS-associated breast cancers are both hormone receptor and human epidermal growth factor receptor 2 positive. The purpose of this study is presentation of one case of LFS, associated with familial hyperlipidemias. A 52-year-old woman referred to clinic of oncology with a pain in the left breast. Her pathology report showed that she had breast cancer and computed tomography scan showed no evidence of metastasis. Markers of estrogen receptor, progesterone receptor and p53 were positive, IHC3 + and Ki67 in 20% of cells. We report the first case of a LFS patient with breast cancer and familial hyperlipidemias in Iran who ER, PR, P53 and HER-2 markers for her are positive. Also it is probably that LFS-associated cancer and atherosclerosis diseases are related to each other
HEALTH RELATED QUALITY OF LIFE ASSESSMENT INPATIENTS WITH DHS SURGICALLY TREATEDPERTROCHANTERIC KYLE FRACTURE TYPE I, II
Get PDFTreatment of hip fractures is a major challenge to the health care system and society. Proper treatment of hip fractures in theelderly is still controversial.Objectives: To assess health-related quality of life and to demonstrate any difference following a rehabilitation treatmentwith kinesitherapy, magnetic therapy, and interferential currents.Material and methods: A quantitative analytical study of 28 patients, all females older than 65. Subjects were divided intotwo cohorts: 14 patients were treated with kinesitherapy and magnetic therapy, and 14 patients were treated withkinesitherapy and interferential currents. Standardized questionnaires, Score and Rand SF-36 with a total of 36 questionsgrouped into eight sections, were used for the health-related quality of life assessment.Results: In terms of ‘physical functioning’, the average score indicated a very poor physical functioning. The average scorefor ‘role limitations due to physical health’ indicated major role limitations due to physical health. The average score for‘role limitations due to emotional health’ indicated major role limitations due to emotional health. In terms of the ‘energy /fatigue’ parameter results indicated that patients felt a lack of energy which translated as a feeling of fatigue. The averagescore in ‘emotional wellbeing’ indicated that patients faced lack of emotional wellbeing. The ‘social functioning’ parametersuggested that patients faced problems in their social functioning. The average score in terms of ‘pain’ indicated theexistence of pain. And in terms of ‘general health’, the patients considered themselves to be in poor health.Conclusion: The results, although preliminary, indicate the importance of physical therapy in the postoperative period andits impact on the health-related quality of life, as well as the opportunity for a more efficient manner of restoring patient’scondition as it was prior to the fracture
CLINICAL OUTCOMES IN ANGIOGRAPHIC DOCUMENTEDCORONARY ARTERY DISEASE MANAGED WITH OPTIMALMEDICAL THERAPY IN CURRENT ERA - ONE YEAR FOLLOW UP
Get PDFBackgroundThe management of patients with coronary artery disease (CAD) is complex. There is no study from India showingclinical outcomes in angiographically documented coronary artery disease in ACS and stable coronary arterydisease in the current era. In most of previous studies only stable CAD patients were enrolled. Therefore the studyis planned in view of above points to assess the outcome in patients with angiographically proven CAD on optimal medicaltherapy.MethodsWe conducted Hospital based observational descriptive prospective study involving 106 patients who had objectiveevidence of myocardial ischemia and significant coronary artery disease in at least one major epicardial vessel and notwilling for either CABG or PCI, presenting to department of Cardiology, SMS Medical College from march 2013 to nov.2013 and one year follow up was done till nov.2014. The clinical outcomes were recorded at six month and 12 monthsfollow up.ResultsMost of the patients were male with a mean age of total patients’ 58.93±11.49 years (range 32 to 83 years). Of these patients,72 had diagnosis of previously stabilized ACS and 34 had stable coronary artery disease. The baseline characteristics of thepatients were similar in the two groups. 45.28% of patients were symptomatic due to angina at 6 months. At 12 months,only 24.46% of patients had angina. There were no significant differences between the stabilized ACS group and non-ACSgroup in death (overall death 6.6%; 8.3% vs. 2.9%; P = 0.52); hospitalization for acute coronary syndrome (19.4% vs.11.8%; P = 0.48); or myocardial infarction (overall MI 10.4%; 11.1% vs. 8.8%; P = 0.98), overall hospitalization rates(27.7%vs. 11.8% P=0.09).www.advancejournals.orgOpen Access Scientific PublisherInternational Journal of Medicine & Health ResearchIJMHR 46|Volume 1|Issue 2|2015 |2ConclusionsPreviously stabilized ACS as well as patients with stable coronary artery disease had similar outcomes with OMT so aninitial management approach; optimal medical therapy can be implemented safely in the patients with previously StabilizedACS as in patients with stable coronary artery diseas
Long Bone Metastasis in a Case of Medulloblastoma - Arare case report
Get PDFWe reported a case of medulloblastoma with upper end of tibia and lower end of femur metastasis. This was treated with CSI (craniospinal irradiation) two years back. After two year of follow-up he presented with pain over knee joint which was confirmed as metastasis to lower end of femur and upper end of tibia and then treated with palliative radiotherapy. Patient brain MRI shows thalamus mass suggestive of metastasis which was treated with palliative chemotherapy. Our case is unique in presentation because itpresented with long bone metastasi
Pena-Shokeir Syndrome: A Case Report
Get PDFIntroduction: Pena-Shokeir syndrome (fetal akinesia deformation sequence, FADS) is an autosomal recessivelethal disorder characterized by combination of abnormal limb position, facial anomalies (micrognathia),camptodactyly, restrictive fetal movement with reduced or absent response to acoustic stimulation, growth restriction, polyhydramnios, and pulmonary hypoplasia. Limb defects like rocker bottom foot and clubfoot are other prominents of the syndrome. Case report: Obstetric ultrasonographic examination of a 24-year-old pregnant woman, consanguineous with her husband, revealed a single female fetus with contractures of the lower limbs, persistent flexion of the bilateralwrist, elbow joints and the knee joints consistent with Pena Shokeir syndrome phenotype. The parents were informed about the diagnosis and its poor prognosis. Fetus had no viability, therefore the termination of thepregnancy was offered to the parents and they accepted. We report the prenatal ultrasonographic and postnatal clinical findings suggestive of Pena-Shokeir syndrome case. Conclusion: Pena–Shokeir syndrome is a potentially lethal condition and most cases are diagnosed prenatally byultrasound
COMPARISON OF PLASMA PROTEINS IN TYPE 2 DIABETES MELLITUS AND NON-DIABETICS
Get PDFIntroduction: Insulin resistance in type 2 diabetes mellitus is known to alter fractional synthetic rates of different plasma proteins. Objective of the study was to compare plasma total proteins and albumin in type 2 diabetics with that of non-diabetic controls.Methodology: This retrospective study was conducted in Adarsha Superspeciality Hospital, Udupi, Karnataka. Data of plasma proteins and demographic profiles of 173 type 2 diabetes mellitus patients was compared with that of 121 healthy non-diabetics. Mann Whitney U test was used to compare the data.Results: A significantly low albumin (p= 0.0080) , significantly high globulin levels (p = 0.0246) were observed in type 2 DM. However differences in total protein levels were insignificant. Albumin/globulin ratio was found to be low very significantly (p=0.0006) in patients.Conclusion: We conclude that hypoalbuminemia and hyper gamma globulinemia were observed in patients of type 2 DM as compared to non-diabetic
STATE KALLIKREIN-KININ SYSTEM IN PREGNANT WOMEN GROUPS INFECTIOUS RISK
Get PDFThis article describes the performance of enzymes KKS infectious risk during pregnancy. A significant reduction of prekallikrein and kallikrein, and increase of TATA (total antitriptic activity), BAEE (N-benzoyl-1-arginine ethyl ether) kininase is shown that can be used as a marker of inflammation in pregnant women infectious risk
IMPROVEMENT OF VITAMIN-D DEFICIENT RACHITISTREATMENT IN CHILDREN
Get PDFIntroduction:Significant changes of the highest fatty acids content were revealed in the blood serum in children ill withrachitis. The depth of changes of the highest fatty acids content depended on the degree of the pathologic process severity.The revealed disturbances of the highest fatty acids content was corrected by means of apricot oil and the results of therapywere presented. Efficacy of the presented method of treatment in children with rachitis was shown in optimal doses ofapricot oil.Methods: 67 patients ill with Vitamin-D deficient rachitis and 10 practically healthy children of the control group wereenrolled in the study. The 1stdegree of the disease was diagnosed in 30 (44,8%) and the 2nddegree in 37 (55,2%)children.The content of the highest fatty acids in blood serum of the studied patients was determined by means of gas- liquidchromatography. For identification of separated methyl aether fatty acids the method of “witness” and “sorbentsorbat”method based on structural group contents were used.Results:67 babies were studied. In children with Vitamin-D deficient rachitis the content of such fatty acids as palmitinic,strearic and linolic acids increases and palmitoleinic, oleic, linoleic and arachidonic acids decreases and that is the evidenceof lipid exchange disturbance in rachitis. It motivates the necessity to correct lipid exchange in this pathology and to addvegetable oils. In order to eliminate dysmetabolism of the highest fatty acids in children with rachitis it is recommended toadminister apricot oil as therapeutic agent.Conclusion:In order to eliminate the highest fatty acids dysmetabolism in children ill with rachitis it is recommended toadminister apricot oil that results in restoration of the highest fatty acids metabolism and provides high therapeutic effect