Prevalence,pattern, sensitivity and resistance to antibiotics of different bacteria isolated from port site infection in low risk patients after elective laparoscopic cholecystectomy for symptomatic cholelithiasis at tertiary care hospital of Kashmir

The aim of this study was to determine specific pattern of port site microbial colonisation, sensitivity and resistance to different antibiotics of bacteria isolated from port site infection (PSI) in low risk patients after elective laparoscopic cholecystectomy in surgical wards at tertiary care hospital of Kashmir. This is a prospective study. The study included 675 consecutive patients of postoperative PSI after elective laparoscopic cholecystectomy for symptomatic cholelithiasis over a period of 12 months. Culture swabs were taken from port sites with signs of PSI and transported to the microbiology laboratory. The positive swab cultures were subjected to antibiotic susceptibility test. The data obtained was analysed by using appropriate statistical analytical tests. The incidence of PSI after elective laparoscopic cholecystectomy is 6·7%. The commonest organism responsible for PSI is pseudomonas, 19 (42·2%) cases. Most of the strains of organisms isolated were resistant to commonly used antibiotics in the hospital,pseudomonas was found 100% resistant to the combination of ampicillin + sulbactum and ceftriaxone and it was sensitive to imipenem, amikacin and vancomycin in 89·47,57 and 52·63% of cases respectively. Our study will be helpful in choosing effective empirical prophylactic antibiotic therapy in cases of elective laparoscopiccholecystectomy and will have a great impact on morbidity and mortality in them because of PSI.     

Anti‐neutrophil cytoplasmic antibody‐positive neutrophilic dermatosis of the dorsal hands

Neutrophilic dermatosis of the hands is a localized variant of Sweet syndrome (SS). It was first reported in 1995, and is an uncommon condition, with < 100 cases reported to date. The female preponderance, morphological and histological features, and response to treatment are similar to SS, but it differs in its distribution on the body. There may also be a lack of systemic features and inconsistent laboratory findings. Significantly, about half of all cases are associated with haematological problems, i.e. myelodysplasia and leukaemia. Other cases may be associated with ulcerative colitis or solid tumours. We describe a case of a 71‐year‐old man with neutrophilic dermatoses of the hands, who also had involvement of the lips. There was an associated rise in his anti‐neutrophil cytoplasmic antibody level, which corresponded with the activity of the disease.     

Pilot study of salivary butyrylcholinesterase,phosphodiesterase, thiols and cerulopalsmin in auditory neuropathy

ObjectiveTo estimate butyrylcholinesterase (BChE), phosphodiesterase (PDE), thiols and cerulopalsmin by non – invasive means in saliva a of subjects (both cases and controls) and correlated to their hearing sensitivity.MethodsTotal of 13 subjects participated in this study. Among them 7 were having auditory neuropathy and 6 were healthy controls. Unstimulated saliva (10 ml) was collected from each participant. Ceruloplasmin, thiols, phosphodiesterase and pseudocholinesterase were estimated by colorimetric method in the salivary samples.ResultsSalivary BChE and PDE levels were marginally elevated and protein thiols were marginally decreased in cases as compared to that of controls. Salivary ceruloplasmin was significantly decreased (p = 0.022) in cases as compared to that of controls.ConclusionsSaliva can be used as a potential noninvasive tool for evaluation of disorders.     

Validation of Spectrophotometric Method for Determination of Thiamazole in Liquids by Dissolution Test for the Transdermal Form

Pharmaceutical Chemistry Journal - The purpose of this work was to validate the method of UV absorption spectrophotometry for the determination of thiamazole in transdermal patches during their...     

Scalene Muscle Injections for Neurogenic Thoracic Outlet Syndrome: Case Series

Abstract: Scalene muscle injections are used to confirm the diagnosis of neurogenic thoracic outlet syndrome and predict the response of patients to surgery. We performed a retrospective study to determine if relief of pain was related to brachial plexus blockade in these patients. Methods: We reviewed the charts of 12 patients who had anterior and middle scalene muscle injections, for neurogenic thoracic outlet syndrome, between April 2009 and September 2010. The injections were performed under ultrasound guidance wherein 2 to 5 mL of 0.25% bupivacaine was injected into the belly of the anterior and scalene muscles. The following were noted: (1) sites of preprocedure pain; (2) volume injected into each of the anterior and middle scalene muscles; (3) presence of numbness after injection; and (4) presence and duration of pain relief. Results: All 12 patients had relief of their pain. Six of the twelve patients developed numbness, which ranged from blockade of the C4‐5, C6‐7, and C4‐T1 dermatomes. In the patients who developed numbness, there was no relationship between the duration of numbness and the duration of pain relief or the location of numbness and the location of pain relief. Conclusions: The relief from scalene muscle injections in patients with neurogenic thoracic outlet syndrome is not related to blockade of the brachial plexus. ?     

Involving children and young people in clinical research through the forum of a European Young Persons’ Advisory Group: needs and challenges

Children and young people are seen as fundamental to the design and delivery of clinical research as active and reflective participants. In Europe, involvement of children and young people in clinical research is promoted extensively in order to engage young people in research as partners and to give them a voice to raise their own issues or opinions and for their involvement in planning and decision making in addition to learning research skills. Children and young people can be trained in clinical research through participation in young person advisory groups (YPAGs). Members of YPAGs assist other children and young people to learn about clinical research and share their experience and point of view with researchers, thereby possibly influencing all phases of research including the development and prioritization of research questions, design and methods, recruitment plans, and strategies for results dissemination. In the long term, the expansion of YPAGs in Europe will serve as a driving force for refining pediatric clinical research. It will help in a better definition of research projects according to the patients’ needs. Furthermore, direct engagement of children and young people in research will be favorable to both researchers and young people.     

RAGE: a new frontier in chronic airways disease

Asthma and chronic obstructive pulmonary disease (COPD) are heterogeneous inflammatory disorders of the respiratory tract characterized by airflow obstruction. It is now clear that the environmental factors that drive airway pathology in asthma and COPD, including allergens, viruses, ozone and cigarette smoke, activate innate immune receptors known as pattern-recognition receptors, either directly or indirectly by causing the release of endogenous ligands. Thus, there is now intense research activity focused around understanding the mechanisms by which pattern-recognition receptors sustain the airway inflammatory response, and how these mechanisms might be targeted therapeutically. One pattern-recognition receptor that has recently come to attention in chronic airways disease is the receptor for advanced glycation end products (RAGE). RAGE is a member of the immunoglobulin superfamily of cell surface receptors that recognizes pathogen- and host-derived endogenous ligands to initiate the immune response to tissue injury, infection and inflammation. Although the role of RAGE in lung physiology and pathophysiology is not well understood, recent genome-wide association studies have linked RAGE gene polymorphisms with airflow obstruction. In addition, accumulating data from animal and clinical investigations reveal increased expression of RAGE and its ligands, together with reduced expression of soluble RAGE, an endogenous inhibitor of RAGE signalling, in chronic airways disease. In this review, we discuss recent studies of the ligand–RAGE axis in asthma and COPD, highlight important areas for future research and discuss how this axis might potentially be harnessed for therapeutic benefit in these conditions.     

<Emphasis Type="Bold">9</Emphasis><Superscript><Emphasis Type="Bold">th</Emphasis></Superscript><Emphasis Type="Bold">International Conference On Homocysteine and One-Carbon Metabolism - HCY2013</Emphasis>

Canavan disease (CD) is a fatal neurological disorder caused by defects in the gene that encodes for a critical metabolic enzyme. The enzyme aspartoacylase catalyzes the deacetylation of N-acetylaspartate to produce acetate required for fatty acid biosynthesis in the brain. The loss of aspartoacylase activity leads to the demyelination and disrupted brain development that is found in CD patients. Sixteen different clinical mutants of aspartoacylase have been cloned, expressed and purified to examine their properties and the relationship between enzyme properties and disease phenotype. In contrast to numerous cell culture studies that reported virtually complete loss of function, each of these purified mutant enzymes was found to have measureable catalytic activity. However, the activities of these mutants are diminished, by as little as three-fold to greater than 100-fold when compared to the native enzyme. Many of these mutated enzyme forms show decreased thermal stability and an increased propensity for denaturation upon exposure to urea, but only four of the 16 mutants examined showed both diminished thermal and diminished conformational stability. Significantly, each of these lower stability mutants are responsible for the more severe phenotypes of CD, while patients with milder forms of CD have aspartoacylase mutants with generally high catalytic activity and with either good thermal or good conformational stability. These results suggest that the loss of catalytic function and the accumulation of N-acetylaspartate in Canavan disease is at least partially a consequence of the decreased protein stability caused by these mutations.     

Comparison of efficacy and safety of intralesional triamcinolone and combination of triamcinolone with 5-fluorouracil in the treatment of keloids and hypertrophic scars: Randomised control trial

The treatment of keloid and hypertrophic scar is challenging with no universally accepted mode for permanent ablation. Conventional therapies yield unpredictable results, significant complications and require elaborate hardware.