Clinical Manifestations and Role of Proton Pump Inhibitors in the Management of Laryngopharyngeal Reflux

Laryngopharyngeal reflux (LPR) refers to the backflow of stomach contents into the throat that is into the hypopharynx. LPR is different from classical Gastroesophageal reflux disease (GERD) in many ways. Proton pump inhibitors have become the treatment of choice even though conflicting results exists in their response. Treatment requires acid suppression to be as complete as possible and treatment failure is not uncommon. In this article we present here our prospective study of 50 patients diagnosed as a case of LPR on the basis of reflux finding score and reflux symptom index. We tried to evaluate the role of PPI in LPR management by observing the effect of PPI on reflux finding score (RFS) and reflux symptom index (RFI) during the follow up period of 16 weeks.     

Intracystic breast carcinoma: case study and review

Breast carcinoma is the most common cancer in women, the second leading cause of cancer-related mortality in women, and the leading cause of death from cancer in women between the ages of 40 and 44. While cystic breast disease is the most frequent cause of benign breast masses, intracystic breast cancers are rare. We present a case of a postmenopausal woman with a large cystic breast carcinoma with its interesting radiologic and cytopathologic findings and review the literature.     

Reducing the toll of inflammatory lung disease

Toll-like receptors (TLRs) are pivotal in human response to microbial stimuli. Their activation and signaling underpin much of the observed epidemiologic data generated by the hygiene hypothesis, and their contribution to infectious exacerbations of airways disease is likely to be highly important. Our growing knowledge in this field will have a significant impact on the understanding of the pathogenesis of inflammatory diseases, and TLR-based therapies are already in early clinical trials to modify atopic disease severity.     

Infiltrating syringomatous adenoma of nipple

Infiltrating syringomatous adenoma of the nipple is a rare, benign lesion with distinct clinical and histological features. Origin from ducts of dermal sweat glands has been postulated. Important differential diagnosis include nipple adenoma, tubular carcinoma and adenosquamous carcinoma. Appropriate local management includes accurate diagnosis and complete excision to avoid local recurrences. This report describes the condition in a 39-year-old parous lady.     

Flavonoid glycosides from<Emphasis Type="Italic">Prunus armeniaca</Emphasis> and the antibacterial activity of a crude extract

Investigations on the chemical constituents of the fruits of Prunus armeniaca have led to the isolation of two new flavonoid glycosides, 4',5,7-trihydroxy flavone-7-O-[beta-D-mannopyranosyl (1'-->2")]-beta-D-allopyranoside (1) and 3,4',5,7-tetrahydroxy-3',5'-di-methoxy flavone 3-O-[alpha-L-rhamnopyranosyl (1'-->6")]-beta-D-galactopyranoside (2), from the butanolic fraction of the fruits. The butanolic extract exhibited antibacterial activity against both Gram positive and Gram negative bacteria. The structures of these compounds were elucidated through spectral studies, including 2D-NMR (COSY, NOESY, J-resolved), HMQC and HMBC experiments.     

Widespread distribution of tetracycline resistance genes in a confined animal feeding facility

We sought to determine the distribution of resistance and the tetracycline resistance genes among bacteria isolated from a swine confined animal feeding facility where tetracycline-containing feed had been in use for over 20 years. Samples collected from feed, hogs, hog houses, waste lagoon, soil, surface water and well water were screened for the presence of (a) resistant Escherichia coli and enterococci and (b) tetracycline-resistant strains of all species. Genomic DNA was extracted from the latter strain collection and fragments from 16S rDNA and ten tetracycline resistance genes (tetA, tetB, tetC, tetE, tetH, tetL, tetM, tetS, tetT and rumB) were polymerase chain reaction-amplified and a partial nucleotide sequence was obtained. In this environment, 77% of E. coli and 68% of enterococci isolated were tetracycline resistant. Tetracycline resistance was found in 26 different bacterial genera and in 60 species. Single resistance gene alleles (as defined by nucleotide sequence) were present in multiple species. There was evidence of gene recombination and multiple different tetracycline resistance genes were present in single bacterial isolates. These data provide further evidence for the widespread distribution of resistance genes in microbial populations in settings in which there is ongoing subtherapeutic antimicrobial use.     

A cross-cultural comparison of British and Pakistani medical students' understanding of schizophrenia

This study aimed to compare British, British Pakistani and Native Pakistani (from Pakistan) medical students' beliefs about the manifestation, causes and cures of schizophrenia, prior to any psychiatric training. A total of 305 participants completed a questionnaire on general beliefs about people with schizophrenia, causal explanations concerning the aetiology of schizophrenia and the role of hospitals and society in treating people with schizophrenia. It was predicted that compared with the British and British Pakistanis, the Pakistanis would have more negative beliefs and attitudes, considering people with schizophrenia to be more dangerous and unpredictable; they were also expected to use more superstitious beliefs to explain the cause of schizophrenia and its symptoms; as well as believe more in seeking help from God and faith healers. There was strong evidence to suggest that Pakistanis possessed more negative beliefs and attitudes about people with schizophrenia, but there was no evidence to indicate that Pakistanis believed more in superstitious causal explanations. Pakistanis were more likely to consider seeking help from faith healers, but not God, compared with British Pakistanis and the British. Results confirm previous European-Asian difference in the understanding of the cause, manifestation and cure of schizophrenia. The impact of traditional and Western cultural influences on British Pakistanis is considered.