Indication of laser in ENT and head & neck surgery

Indication of LASER in E.N.T. and Head—Neck surgery have been discussed along with some basic knowledge of LASER.     

Age-Wise Variation in Haematological and Cytomorphometrical Analysis of Naked-Neck Chicken

The present study aims at the evaluation of haematological and cytomorphometrical parameters of naked neck chicken being maintained at Central Poultry Development Organisation, Eastern Region, Bhubaneswar, Odisha. For haematological analysis, a total of five age groups (4th, 7th, 8th, 25th and 60th weeks) and for morphometry of blood cells, 2nd week individuals along with others are also considered. Haemoglobin and total erythrocyte count in adult birds are significantly (p < 0.01) different from other such groups. Irrespective of all age groups, haematocrit differs significantly at p < 0.01. Mean corpuscular volume differs at p < 0.01 between and among groups, except, 7th, 8th and 25th week. In case of mean corpuscular haemoglobin, no difference is observed in 4th and 7th week age and except adults, others do not show significant difference with respect to their sex. Mean corpuscular haemoglobin concentration is not significantly different among or between chicks and adults. Total leukocyte count reflects significant difference (p < 0.01) between and among the age-groups. But, monocytes and heterophils reflect significant difference (p < 0.01) with respect to different ages. Unlike basophils, all other blood cells reflect significant difference (p < 0.01) with respect to age and sexual dimorphism.     

The emergence of zoonotic Fusarium oxysporum infection in captive‐reared fingerlings of golden mahseer,Tor putitora (Hamilton, 1822) from the central Himalayan region of India

Zoonotic Fusarium oxysporum infection was identified in captive‐reared fingerlings of golden mahseer, Tor putitora (Hamilton, 1822) from the central Himalayan regions, India. Initially, fingerlings of T. putitora (mean length 10.8 ± 0.002 and weight 18.58 ± 0.054 g) were observed with cottony mass like growth completely covering the dorsal and caudal fins. The infected fingerlings were showing clinical signs such as sluggish, erratic movement, gasping, flared operculum and settling at one corner of the rearing tanks. The microscopic observation of 8‐day old culture of cottony mass like growth showed the presence of septate macroconidia, randomly spread microconidia and chlamydospores in short‐chain. From sequence analysis of ITS amplified fragment, the isolate was identified as Fusarium oxysporum, TPFCF 214 (MH464266.1) and clustered with F. oxysporum, strain NRRL 43504 (EF453107.1) and F. oxysporum, strain 20736 (JX 270150.1) isolated from the human in phylogenetic tree. An experimental infection of healthy golden mahseer fingerlings with 20 µl of F. oxysporum spore suspension (2.5 × 10⁹ spore ml⁻¹) showed the development of lesion 6‐dpi at the site of injection. Experimental trial on EPC‐2 cell culture recorded detachment in the monolayer, clumping and shrinking of the cell line 6‐8 dpi with a spore suspension of F. oxysporum, TPFCF 214 (5.68 × 10² cell/ml). From the severity of its infection, there is a chance that F. oxysporum may emerge as pathogenically and pose a significant health risk on captive‐reared golden mahseer in other Asian countries and world. As Fusarium solani and F. oxysporum are known to cause invasive fusariosis in human especially in immunocompromised patients, localized infection in immunocompetent individuals as well as osteomyelitis, arthritis, otitis, sinusitis and brain abscess, the global fish farmers, handlers and aquaculturist need to be aware of possible health hazards caused by Fusarium spp. and should adopt proper fish health management and animal husbandry practice to control the infection of Fusarium in culture environment.     

In vitro and in vivo antibacterial evaluation of DRF 8417, a new oxazolidinone

OBJECTIVES AND METHODS: DRF 8417, a novel oxazolidinone, has been evaluated against Gram-positive and fastidious Gram-negative bacteria. In vitro activity of DRF 8417 was determined by broth microdilution method and in vivo efficacy studies were carried out in different murine systemic infection models. RESULTS: DRF 8417 exhibited potent activity against Gram-positive pathogens with MIC(50) and MIC(90) values ranging from 0.06 to 1 mg/L. MICs against Haemophilus influenzae and Moraxella catarrhalis were one to two dilutions lower than those of linezolid. The in vivo efficacy, by oral route, in different susceptible and resistant Gram-positive systemic bacterial infection models ranged from 2.0 to 2.9 mg/kg. CONCLUSIONS: These studies displayed the excellent in vitro and in vivo activity of DRF 8417 against Gram-positive pathogens and lower MICs when compared with linezolid against H. influenzae and M. catarrhalis.     

Medication Adherence and Discontinuation of Aripiprazole Once-Monthly 400 mg (AOM 400) Versus Oral Antipsychotics in Patients with Schizophrenia or Bipolar I Disorder: A Real-World Study Using US Claims Data

Introduction

Few studies have compared adherence between long-acting injectable antipsychotics, especially for newer agents like aripiprazole once-monthly 400 mg (AOM 400; aripiprazole monohydrate) and oral antipsychotics, in patients with schizophrenia or bipolar I disorder (BD-I) in a real-world setting.

Methods

Two separate retrospective cohort analyses using Truven MarketScan data from January 1, 2012 to June 30, 2016 were conducted to compare medication adherence and discontinuation in patients with schizophrenia or BD-I who initiated treatment with AOM 400 vs. patients changed from one oral antipsychotic monotherapy to another. Adherence was defined as proportion of days covered (PDC) ≥?0.80 in the year following the index date. Linear regression models examined the association between AOM 400 and oral antipsychotic cohorts and medication adherence. Kaplan–Meier curves and Cox regression estimated time to and risk of discontinuation, while adjusting for baseline covariates. A sensitivity analysis was conducted using a combination of propensity score matching and exact matching to create matched cohorts.

Results

Final cohort sizes were as follows—Schizophrenia: AOM 400 n?=?408, oral antipsychotic n?=?3361; BD-I: AOM 400 n?=?413, oral antipsychotic n?=?15,534. In patients with schizophrenia, adjusted mean PDC was higher in patients in the AOM 400 cohort vs. the oral antipsychotic cohort (0.57 vs. 0.48 P?<?0.001), and patients in the oral antipsychotic cohort had a higher risk of discontinuing treatment vs. the AOM 400 cohort (HR 1.45, 95% CI 1.29–1.64). For patients with BD-I, adjusted mean PDC was higher for the AOM 400 cohort (0.59 vs. 0.44, P?<?0.001), and patients in the oral antipsychotic cohort had a higher risk of discontinuation (HR 1.71, 95% CI 1.53–1.92).

Conclusions

In a real-word setting, AOM 400 resulted in a significantly higher percentage of patients with a PDC?≥?0.80 and significantly longer time to treatment discontinuation compared to patients with schizophrenia or BD-I who received treatment with an oral antipsychotic.

Funding

Otsuka Pharmaceutical Development and Commercialization, Inc. and Lundbeck.

     

Brain-sparing holo-cranial radiotherapy: a unique application of helical tomotherapy

Aims

Diffuse and extensive involvement of the scalp/skull by malignancy mandates holo-cranial radiotherapy with the aim to deliver homogeneous doses to the planning target volume (PTV) while minimising the dose to surrounding organs at risk (OARs). Previously described techniques result in significant heterogeneity, suboptimal coverage or poor conformity and need complicated beam matching. Here we report our preliminary experience of planning and delivery of brain-sparing holo-cranial radiotherapy with helical tomotherapy.

Materials and methods

Three patients with extensive involvement of the scalp/skull by malignancy were planned and treated with image-guided intensity-modulated radiation therapy on helical tomotherapy. The plan evaluation was carried out using standardised dose metrics.

Results

Helical tomotherapy achieved highly conformal and homogeneous dose distributions with substantial OAR sparing in all three patients. The volume of PTV receiving ≥95% of prescribed dose (V_95%) was ≥98% in all three patients. The mean (standard deviation) homogeneity index and conformity index was 0.046 (0.006) and 0.783 (0.035), respectively. The mean dose to the brain parenchyma outside the PTV was 17.32 Gy (74%), 28.76 Gy (63.9%) and 26.7 Gy (59.3%) for the three patients. The mean (standard deviation) monitor units and beam-on time was 6939 (985) and 8.10 (1.137) min, respectively. Overall the treatment was very well tolerated with no significant acute toxicity. Early follow-up evaluation revealed a good clinicoradiological response and the absence of local disease progression with no significant sequelae, implying successful application of the treatment paradigm.

Conclusion

Helical tomotherapy is ideally suited for brain-sparing holo-cranial radiotherapy with its exceptional ability of tangential beam delivery resulting in highly conformal and homogenous dose distribution across large, complex target volumes with substantial OAR sparing.     

Molecular analysis of neocortical layer structure in the ferret

Molecular markers that distinguish specific layers of rodent neocortex are increasingly employed to study cortical development and the physiology of cortical circuits. The extent to which these markers represent general features of neocortical cell type identity across mammals, however, is unknown. To assess the conservation of layer markers more broadly, we isolated orthologs for 15 layer‐enriched genes in the ferret, a carnivore with a large, gyrencephalic brain, and analyzed their patterns of neocortical gene expression. Our major findings are: 1) Many but not all layer markers tested show similar patterns of layer‐specific gene expression between mouse and ferret cortex, supporting the view that layer‐specific cell type identity is conserved at a molecular level across mammalian superorders; 2) Our panel of deep layer markers (ER81/ETV1, SULF2, PCP4, FEZF2/ZNF312, CACNA1H, KCNN2/SK2, SYT6, FOXP2, CTGF) provides molecular evidence that the specific stratifications of layers 5 and 6 into 5a, 5b, 6a, and 6b are also conserved between rodents and carnivores; 3) Variations in layer‐specific gene expression are more pronounced across areas of ferret cortex than between homologous areas of mouse and ferret cortex; 4) This variation of area gene expression was clearest with the superficial layer markers studied (SERPINE2, MDGA1, CUX1, UNC5D, RORB/NR1F2, EAG2/KCNH5). Most dramatically, the layer 4 markers RORB and EAG2 disclosed a molecular sublamination to ferret visual cortex and demonstrated a molecular dissociation among the so‐called agranular areas of the neocortex. Our findings establish molecular markers as a powerful complement to cytoarchitecture for neocortical layer and cell‐type comparisons across mammals. J. Comp. Neurol. 518:3272–3289, 2010. © 2010 Wiley‐Liss, Inc.