Fungal keratitis due to fusarium solani

A young man presented with swelling, congestion and lacrimation of right eye for one week. On examination, he had corneal ulcer. Corneal scrapings on lactophenol cotton blue stain revealed fungal hyphae. Culture on Sabouraud agar yielded Fusarium solani after 48 hours. Patient was treated with ketoconazole and miconazole and responded well.     

Closing the youth access gap: the projected health benefits and cost savings of a national policy to raise the legal smoking age to 21 in the United States

Current youth access laws, even if strictly enforced, do not prevent teenagers from obtaining cigarettes through social sources. To reduce the number of legal buyers a typical teenager routinely encounters, and to lessen ambiguity for vendors determining if a teen is of legal purchasing age, legislation raising the minimum legal purchase age (MLPA) for cigarettes to 21 has been discussed in several states. To estimate how a national law raising the smoking age to 21 would impact smoking prevalence, net costs (in terms of compliance enforcement, ID checking, and medical care) and health benefits (in terms of life years and QALYs) to the population over time, a dynamic computer simulation model was developed using publicly available secondary data. The model simulations were carried out for several scenarios assuming varying impacts of the policy change on smoking initiation probability over a 50-year period. One scenario assumes that smoking initiation probabilities for individuals under 21 shift by 3 years so a 18-year old in the simulation, for example, is as likely to initiate smoking as an 15-year old in the status quo. Under this assumption, raising the smoking age would reduce smoking prevalence for adults (age 18+) from the status quo level of 22.1-15.4% after 50 years. Prevalence would drop from 20 to 6.6% for 14-17-year olds, from 26.9 to 12.2% for 18-20-year olds, and from 21.8 to 15.5% for the 21+ group. The policy would produce a net cumulative savings to society of 212 billion US dollars (driven by reduced medical costs), and the accumulation of nearly 13 million additional QALYs over the period.     

Organization of rat vibrissa motor cortex and adjacent areas according to cytoarchitectonics, microstimulation, and intracellular stimulation of identified cells

The relationship between motor maps and cytoarchitectonic subdivisions in rat frontal cortex is not well understood. We use cytoarchitectonic analysis of microstimulation sites and intracellular stimulation of identified cells to develop a cell-based partitioning scheme of rat vibrissa motor cortex and adjacent areas. The results suggest that rat primary motor cortex (M1) is composed of three cytoarchitectonic areas, the agranular medial field (AGm), the agranular lateral field (AG1), and the cingulate area 1 (Cg1), each of which represents movements of different body parts. Vibrissa motor cortex corresponds entirely and for the most part exclusively to AGm. In area AG1 body/head movements can be evoked. In posterior area Cg1 periocular/eye movements and in anterior area Cg1 nose movements can be evoked. In all of these areas stimulation thresholds are very low, and together they form a complete representation of the rat's body surface. A strong myelinization and an expanded layer 5 characterize area AGm. We suggest that both the strong myelinization and the expanded layer 5 of area AGm may represent cytoarchitectonic specializations related to control of high-speed whisking behavior.     

Phosphodiesterase and thymidine phosphorylase-inhibiting salirepin derivatives from Symplocos racemosa

A re-investigation of the chemical constituents of the stem bark of Symplocos racemosa Roxb. led to the isolation of four new glycosides, symplocomoside (1), symponoside (2), symplososide (3) and symploveroside (4). Benzoylsalireposide (5) and salireposide (6) were re-isolated from this plant. The structures of the new compounds were determined by 1D and 2D-homonuclear and heteronuclear NMR spectroscopy, chemical evidence, and by comparison with the published data of the closely related compounds. The glycosides 1-4 displayed in vitro inhibitory activity against phosphodiesterase I with IC50 values of 122 +/- 0.017, 698 +/- 0.06, 722 +/- 0.03, 909 +/- 0.09 microM, respectively. The compounds 1-6 also showed in vitro inhibitory activity against thymidine phosphorylase with IC50 values of 189.96 +/- 1.02, 195.56 +/- 2.36, 207.61 +/- 1.06, 488.89 +/- 4.10, 427.20 +/- 5.36, 354.2 +/- 5.69 microM, respectively while 1 was also found to be a urease inhibitor with an IC50 value of 54.13 +/- 0.71 microM.     

Simplified [correction of Simlified] calculation of mean QRS vector (mean electrical axis of heart) of electrocardiogram

In clinical practice assessment of the mean QRS axis (MQRSA) provides information related either with hypertrophy of the ventricles or conduction blocks. The method adopted by clinicians i.e. the inspection of the QRS voltage in six of the limb leads has inherent element of subjectivity of approximately 10degrees. Moreover, in certain condition, when there is ambiguity about differentiation of left axis deviation assessed by inspection method in to either hypertrophy of left ventricles or complete/hemi block of the left bundle branches, accurate measurement of the axis becomes necessary to arrive at the correct diagnosis. Though a formula based on area under R wave and S-wave of the same QRS complex has been derived for accurate measurement of axis, considering its use in the computer software, working with ordinary electrocardiograph the only method for accurate measurement of the QRS axis is plotting method i. e. the net voltages in Lead-I, and III on their respective axes which is not practicable in clinical settings. Although, calculation of MQRSA by area method gives an accurate assessment of MQRSA, some authors prefer measurement of axis by voltage method, as in cases of the right ventricular hypertrophy with a broad S-wave calculation of axis by area method may give erroneous results. Hence, to obtain correct measurement of MQRSA, we have derived a simplified formula based on the net voltage of QRS complexes in Lead-I and Lead-III. The formula derived is as follows, Tan(theta) =(I + 2III) divided by sqrt [3I], where I and III represent net voltage in Lead-I and III, theta = angle subtended with the axis Lead-I. The value of theta can be found by using scientific calculator or the table. In case net voltage of QRS complex in Lead-I being negative, the value of the theta should be subtracted from 180degrees to find the angle of mean QRS vector.     

Current practice in the management of vasectomy reversal and unobstructive azoospermia in Merseyside & North Wales: a questionnaire-based survey

OBJECTIVE: To investigate the current incidence of vasectomy reversal procedures, the techniques used and which practitioners use them. PATIENTS AND METHODS: Using a questionnaire, 130 general surgeons and urologists practising in Merseyside and North Wales were surveyed. RESULTS: The response rate was 74%, with 24 urological surgeons and 14 general surgeons undertaking vasectomy reversal. Annually, urological surgeons carried out significantly more procedures than did general surgeons, at 8.5 and 5.3 (P = 0.029), respectively. They were also more likely to use double-layer closure and microsurgical techniques, whilst significantly less likely to use stents. Urologists reported significantly greater patency rates, at 76% and 52% (P = 0.017), respectively, with no significant differences in subsequent pregnancy rates (30% vs 25%). Only one practitioner checked tubal patency in the female partner before vasectomy reversal. CONCLUSIONS: The use of vasectomy reversal is a cost-effective treatment for men wanting paternity after vasectomy. The technique used by the clinician and proper audit of the results require close attention; it would also appear to be obvious that all the partners of men seeking a vasectomy reversal should have their fertility status established before reversal, something that is clearly not done at present.     

The effect of vagus nerve stimulation on migraines

Vagus nerve stimulation (VNS) inhibits nociceptive behavior in animals. VNS might reduce pain in patients with VNS device implanted for intractable seizures. One case report described possible benefits on migraines. We contacted all patients who received VNS therapy for intractable epilepsy between 1993 and 1999 at Southern Illinois University, Springfield, Illinois. Patients who had concomitant chronic pain were subsequently interviewed. Pain intensity before and after VNS implantation was rated by the patient as average, worst, and least and on numeric rating scale from 1 to 10. Current pain measurements were compared to preimplantation by using Global Pain Relief Rating Scale. Of 62 patients who received VNS, 27 patients were interviewed; 4 patients had common migraine, and no other chronic pain syndromes were identified. All patients with migraine reported reductions in headache frequency and numeric rating scale score for average and least headache intensity. One patient reported complete relief of headaches. Improvement was reported to start 1 to 3 months after initiation of therapy. On Global Pain Relief Rating Scale, 1 patient reported complete pain relief, 2 reported a lot of pain relief, and 1 reported slight pain relief. Concomitant antiepileptic drugs were decreased in 3 patients and slightly increased in 1. VNS might be beneficial for prophylactic therapy of migraine.