Clinical profile, treatment, and visual outcome of serpiginous choroiditis

The purpose of this study was to report the clinical profile and management of patients with serpiginous choroiditis in a tertiary care referral center in India. In a retrospective cohort study, 107 eyes of 70 patients with serpiginous choroiditis seen between January 1995 and December 2002 were analyzed. Systemic steroids and immunosuppressives were the mainstay of therapy. Antituberculous and antiviral drugs were used in selected cases. There was male preponderance (7:3). Age at presentation ranged from 11 years to 52 years (mean 30.3 +/- 9 years); 52.9% had bilateral involvement. Vision improved or maintained in 86% eyes and deteriorated in 15 eyes (14%). The main cause of decrease of vision was macular involvement. Improvement in vision and resolution of lesions in patients with serpiginous choroiditis can occur with combination therapy of systemic steroids and immunosuppressive agents. Serial examination at regular intervals is needed to monitor the disease progression, recurrences, and involvement of the other eye.     

Anti-urolithiatic effects of Punica granatum in male rats

Ethnopharmacological relevance

The traditional use of Punica granatum has been reported to regulate urine discharge and controls the burning sensation of urine.

Materials and methods

Animals model of calcium oxalate urolithiasis was developed in male rats by adding ethylene glycol 0.75% in drinking water. The Punica granatum chloroform extract (PGCE) and Punica grantum methanol extract (PGME) orally at 100, 200 and 400 mg/kg, respectively, were administered along with ethylene glycol for 28 days. On 28 day, 24 h urine was collected from individual rats and used for estimation of urine calcium, phosphate and oxalate. The serum creatinine, urea and uric acid levels were estimated in each animal. The kidney homogenate was used for the estimation of renal oxalate contents. The paraffin kidney sections were prepared to observe the CaOx deposits.

Results

The ethylene glycol control (Gr.-II) had significant (P < 0.001 vs. normal) increase in levels of urine oxalate, calcium and phosphate, serum creatinine, urea and uric acid and renal tissues oxalates, as compared to normal (Gr.-I). The paraffin kidney sections show significant histopathological changes. The treatment of PGCE and PGME at 100, 200 and 400 mg/kg doses, significantly (P < 0.001 vs. control) decreased the urine oxalate, calcium and phosphate, renal tissue oxalates and serum creatinine, urea and uric acid, in EG induced urolithiasis after 28 days.

Conclusions

The PGCE and PGME at the doses of 400 mg/kg, found to be more effective in decreasing the urolithiasis and regeneration of renal tissues in male rats.     

Structural elucidation of NASICON (Na3Al2P3O12) based glass electrolyte materials: effective influence of boron and gallium

Understanding the conductivity variations induced by compositional changes in sodium super ionic conducting (NASICON) glass materials is highly relevant for applications such as solid electrolytes for sodium (Na) ion batteries. In the research reported in this paper, NASICON-based NCAP glass (Na_2.8Ca_0.1Al₂P₃O₁₂) was selected as the parent glass. The present study demonstrates the changes in the Na⁺ ion conductivity of NCAP bulk glass with the substitution of boron (NCABP: Na_2.8Ca_0.1Al₂B_0.5P_2.7O₁₂) and gallium (NCAGP: Na_2.8Ca_0.1Al₂Ga_0.5P_2.7O₁₂) for phosphorus and the resulting structural variations found in the glass network. For a detailed structural analysis of NCAP, NCABP and NCAGP glasses, micro-Raman and magic angle spinning-nuclear magnetic resonance (MAS-NMR) spectroscopic techniques (for ³¹P, ²⁷Al, ²³Na, ¹¹B and ⁷¹Ga nuclei) were used. The Raman spectrum revealed that the NCAP glass structure is more analogous to the AlPO₄ mesoporous glass structure. The ³¹P MAS-NMR spectrum illustrated that the NCAP glass structure consists of a high concentration of Q⁰ (3Al) units, followed by Q⁰ (2Al) units. The ²⁷Al MAS-NMR spectrum indicates that alumina exists at five different sites, which include AlO₄ units surrounded by AlO₆ units, Al(OP)₄, Al(OP)₅, Al(OAl)₆ and Al(OP)₆, in the NCAP glass structure. The ³¹P, ²⁷Al and ¹¹B MAS-NMR spectra of the NCABP glass revealed the absence of B–O–Al linkages and the presence of B₃–O–B₄–O–P₄ linkages which further leads to the formation of borate and borophosphate domains. The ⁷¹Ga MAS-NMR spectrum suggests that gallium cations in the NCAGP glass compete with the alumina cations and occupy four (GaO₄), five (GaO₅) and six (GaO₆) coordinated sites. The Raman spectrum of NCAGP glass indicates that sodium cations have also been substituted by gallium cations in the NCAP glass structure. From impedance analysis, the dc conductivity of the NCAP glass (∼3.13 × 10⁻⁸ S cm⁻¹) is slightly decreased with the substitution of gallium (∼2.27 × 10⁻⁸ S cm⁻¹) but considerably decreased with the substitution of boron (∼1.46 × 10⁻⁸ S cm⁻¹). The variation in the conductivity values are described based on the structural changes of NCAP glass with the substitution of gallium and boron.

Understanding the conductivity variations induced by compositional changes in sodium super ionic conducting (NASICON) glass materials is highly relevant for applications such as solid electrolytes for sodium (Na) ion batteries.     

Extra-Aortic Mycotic Aneurysm Due to Group A Streptococcus after Pharyngitis

Mycotic aneurysms, especially outside the aorta, are uncommon, with group A Streptococcus a particularly rare cause. We report a case of extra-aortic mycotic aneurysm following a sore throat without demonstrable bacteremia where identification of the pathological organism was made by molecular diagnostic techniques after a standard laboratory culture was negative.     

A study of assessment of patient safety climate in tertiary care hospitals

Background

Medical errors are being detected with increasing frequency in healthcare environment, in many cases leading to patient harm. Measurement and improvement of patient safety climate has been identified as a strategic effort towards addressing this vital issue.

Method

Safety Attitude Questionnaire (SAQ), validated by previous research was administered to 300 respondents in three tertiary care hospitals of India, the respondents representing various categories of healthcare workers and variations in safety scale score was analyzed by various statistical tools.

Results

No variation was observed in the Patient Safety Index score among the study hospitals. However, significant variations were observed among different categories of healthcare workers across dimensions of Teamwork, Perception of Management and Stress Recognition. Multiple Regression models identified Teamwork and Perception of Management to have significant correlation with Patient Safety Index Score.

Conclusion

Patient Safety Climate can be effectively assessed and such assessment utilized for focused improvement efforts towards safety in healthcare organizations.