Upper-extremity deep vein thrombosis and downhill esophageal varices caused by long-term pacemaker implantation

Upper-extremity deep vein thrombosis is common after pacemaker or cardioverter-defibrillator implantation. Only 1% to 3% of patients with upper-extremity deep vein thrombosis become symptomatic. Downhill esophageal varices develop in the upper third of the esophagus as a result of the obstruction of the superior vena cava. Herein, we report the case of a 54-year-old man--a recipient of multiple implanted cardiac pacemakers--who presented with bilateral upper-extremity deep vein thrombosis. This severely symptomatic condition was complicated by very rare and life-threatening downhill varices of the upper esophagus, but without bleeding. To the best of our knowledge, this is the 1st report of this array of conditions.     

Video capsule endoscopy: what is the future?

Video capsule endoscopy (VCE) that was launched 10 years ago has become a first-line procedure for examining the small bowel, especially in the case of obscure gastrointestinal bleeding. Other major indications include Crohn disease (CD), celiac disease, and intestinal polyposis syndrome. In the case of small bowel diseases, the use of VCE must be integrated in?a?global diagnostic and therapeutic approach. More recently, wireless endoscopy has been adapted for examining the colon, opening up larger perspectives for colorectal cancer screening or colon examination. Technologic modifications of the second-generation colon capsule increase the sensitivity of this method for detecting polyps. Other new developments, including remote magnetic manipulation, power management, drug delivery capsule, microbiopsy capsule, and adaptation of technologies such as chromoendoscopy, are sure to enhance the capabilities of wireless endoscopy in gastrointestinal disorders.     

Unintended Pregnancy Influences Racial Disparity in Tubal Sterilization Rates

BACKGROUND  

Minority women are more likely than white women to choose tubal sterilization as a contraceptive method. Disparities in rates of unintended pregnancy may help explain observed racial/ethnic differences in sterilization, but this association has not been investigated.     

Synthesis and anti-candida potential of certain novel 1-[(3-Substituted-3-phenyl)propyl]-1H-imidazoles

The synthesis and anti-Candida activity of 1-[(3-aroyloxy-3-phenyl)propyl]-1H-imidazoles 5a-f and 1-[(3-alkyl/aralkyl/phenyl-3-phenyl)propan-3-ol]-1H-imidazoles 5g-j are reported. The influence of the ester formation and different substitutions on the anti-Candida activity of the alcohol 4 was investigated. Among the newly developed bioactive chemical entities, compounds 5b and 5c displayed minimum inhibitory concentrations (MICs) against Candida albicans and Candida pseudotropicales comparable to that of tioconazole and more potent than miconazole.     

Zerumbone inhibits interleukin-6 and induces apoptosis and cell cycle arrest in ovarian and cervical cancer cells

Interleukin-6 is one of the factors affecting sensitivity to cytotoxic agents. Therefore, the current study was designed to investigate the role of IL-6 and IL6 receptors in the cytotoxic effects of zerumbone in ovarian and cervical cancer cell lines (Caov-3 and HeLa, respectively). Exposure of both cancer cells to zerumbone or cisplatin demonstrated growth inhibition at a dose-dependent manner as determined by the MTT (3-[4,5-dimethylthiazol-2-yl]-2,Sdiphenyltetrazolium bromide) reduction assay. Both laser scanning confocal microscopy and TUNEL assay showed typical apoptotic features in treated cells. The studies conducted seems to suggest that zerumbone induces cell death by stimulating apoptosis better than cisplatin, based on the significantly higher percentage of apoptotic cells in zerumbone's treated cancer cells as compared to cisplatin. In addition, zerumbone and cisplatin arrest cancer cells at G2/M phase as analyzed by flow cytometry. Our results indicated that zerumbone significantly decreased the levels of IL-6 secreted by both cancer cells. In contrast, HeLa and Caov-3 cells were still sensitive to cisplatin and zerumbone, even in the presence of exogenous IL-6. However, membrane-bound IL-6 receptor is still intact after zerumbone treatment as demonstrated using an immune-fluorescence technique. This study concludes that the compound, zerumbone inhibits both cancer cell growth through the induction of apoptosis, arrests cell cycle at G2/M phase and inhibits the secretion levels of IL-6 in both cancer cells. Therefore, zerumbone is a potential candidate as a useful chemotherapeutic agent in treating both cervical and ovarian cancers in future.     

The efficacy of intramuscular loading dose of MgSO4 in severe pre-eclampsia/ eclampsia at a tertiary referral centre in Northwest Nigeria

Aims and Objectives: The efficacy of 10g intramuscular loading dose of magnesium sulphate in women with severe preeclampsia/eclampsia was assessed at a tertiary health centre for potential use at primary health level. Subjects and Methods: Intramuscular 10g loading dose and 14g loading dose of Pritchard were compared in women with severe preeclampsia/eclampsia. Primary outcome measures were the occurrence of fits in women with severe preeclampsia, further fits in those with eclampsia and maternal death. Other outcome measures were mode of delivery and severe birth asphyxia at 5 minutes of life. Results: One hundred and three women were enrolled; 54 and 49 women had 10g and 14g loading dose respectively. No significant convulsions (p= 0.1424) occurred in women with severe preeclampsia who had 10g intramuscular loading dose and repeat convulsion was averted in 93% of women with eclampsia. 10g loading dose did not increase the likelihood of caesarean section in women with preeclampsia (p=0.2832) or eclampsia (p=0.9112). The mean Apgar score at 5 minutes of life of neonates whose mothers had 10g and 14g loading dose for preeclampsia was 8 and 8.46 respectively, and 8.9 and 8.8 respectively for eclampsia. There was no statistically significant difference in maternal death between the two groups for severe preeclampsia (p= 0.2020) and eclampsia (p=0.3496). Conclusion: This study suggests a potential use of intramuscular 10 gram loading dose of MgSO4 at the primary health care level in Nigeria.