Antibiotic Use in Sore Throat: Are We Judicious?

Introduction Sore throat (acute tonsillitis/pharyngitis) is one of the most common clinical diagnosis encountered in ENT practice. It is a common practice to advice antibiotics in patients of sore throat not only in otolaryngology practice but also in pediatricians, GP’s and internists. This is now becoming a matter of concern for two reasons, for the side effects of antibiotics and bacterial drug resistance. Methods To analyse patients on their symptoms and rapid streptococcal test for group A Stretococcus and determine antibiotic use. A prospective study was done in 600 patients who were clinically diagnosed as acute tonsillitis or acute pharyngitis and results analysed. Discussion Results showed that 24 % patients needed antibiotics while the rest did well without antibiotics. Results Rapid streptococcal test is a useful test in determining whether the patient needs antibiotic and help is reducing irrational use of antibiotics.     

Identifying the location of Cu ions in nanostructured SAPO-5 molecular sieves and its impact on the redox properties

Combining X-ray Absorption Fine Spectroscopy (XAFS) with Anomalous Small-Angle X-ray Scattering (ASAXS) determines the location of Cu²⁺ ions in silicoaluminophosphate (SAPO-5) frameworks prepared by hydrothermal crystallization or impregnation. As expected, for the hydrothermally prepared sample, incorporation in the SAPO-5 framework was observed. For the first time preferential location of Cu²⁺ ions at the inner and outer surfaces of the framework is determined. Temperature-Programmed Reduction (TPR) and X-ray Photoelectron Spectroscopy (XPS) investigations demonstrated that such Cu²⁺ is stable in an argon (Ar) atmosphere up to 550 °C and can only be reduced under a hydrogen atmosphere. In contrast, Cu²⁺ deposited by impregnation on the pure SAPO-5 framework can be easily reduced to Cu⁺ in an Ar atmosphere. At lower Cu amounts, mononuclear tetrahedrally coordinated Cu species were formed which are relatively stable in the monovalent form. In contrast, at higher Cu amounts, CuO particles were found which change easily between the mono- and bivalent species.

Where is the Cu located? Combining X-ray Absorption Fine Spectroscopy (XAFS) with Anomalous Small-Angle X-ray Scattering (ASAXS) can answer this question for Cu loaded molecular sieves.     

A simple approach for enhanced immune response using engineered dendritic cell targeted nanoparticles

In this study, we demonstrate a simple strategy for enhanced immune response using a two-component dendritic cell (DC) targeted antigen delivery system. One component consists of a recombinant bifunctional fusion protein (bfFp) used for DC targeting, whereas, the other component is made of biotinylated PLGA nanoparticles that encapsulate the antigen. The fusion protein (bfFp) made of a truncated core-streptavidin fused to anti-DEC-205 single chain antibody (scFv) was mixed with ovalbumin-loaded biotinylated NPs that were formulated using biotin–PEG (2000)–PLGA, and the combination, bfFp functionalized NPs was used for DC targeted antigen delivery. In vitro DC uptake studies revealed a 2-fold higher receptor-mediated uptake of bfFp functionalized NPs when compared to non-targeted NPs. Immunization of the mice with the bfFp functionalized NPs in conjunction with DC maturation stimulus (anti-CD40 mAb) enhanced OVA-specific IgG and IgG subclass responses. Splenocytes of these mice secreted significantly higher levels of Th1 (IFN-γ and IL-2) cytokines upon ex vivo restimulation with OVA. The promising outcomes of the bfFp functionalized DC targeted system support its use as a versatile vaccine delivery system for the design of monovalent or polyvalent vaccines.     

Use of Clonidine as an Adjuvant to Infiltration Anaesthesia in Tympanoplasty: A Randomized Double Blind Study

This prospective double blind randomized study evaluated the effect of clonidine when used as an adjuvant to local anaesthetic agents for infiltration block and measured its impact on the quality of anaesthesia, intraoperative bleeding and post-operative pain. We recruited 60 patients needing tympanoplasty, which were randomized them into two groups; group A patients received local infiltration of 12 ml 2 % xylocaine with adrenaline (1:200,000 dilution), while group B received 12 ml 2 % xylocaine with adrenaline with 30 μg of clonidine. Duration of block was significantly prolonged in group B (group A 53.66 ± 7.7 vs. group B 177.13 ± 48.9, p < 0.005). Mean pain scores were significantly lower in group B during the first hour following the block (3.43 in group A vs. 1.2 in group B, p < 0.005). Total number of analgesic doses over 24 h showed no significant difference (3.1 in group B vs. 3.26 in group A, p > 0.05). 93.3 % patients in group A required sedation with midazolam, compared to 10 % in group B. Grade of bleeding was significantly lower in group B. Patient and surgeon satisfaction scores were better in group B. It could be concluded that 30 μg clonidine added to lidocaine 2 % has a significant impact in decreasing the bleeding in the operative field and improving the quality of intraoperative anesthesia as well as prolonging the duration of postoperative analgesia without significant side effects.     

Exosome mediated differentiation of megakaryocytes: a study on TLR mediated effects

Journal of Thrombosis and Thrombolysis - Megakaryocytes are large polyploid bone marrow cells whose function is to produce circulatory platelets. Megakaryocytes are also known to release...     

Cochlear Implant in Prelingually Deaf Children: Our Experience

Retrospective study of the prelingual cochlear implantation programme under government scheme done at medical college hospital in central India. Forty-two prelingually deaf children screened and sent for cochlear implantation at our centre From March 2015 to Feb 2018 were reviewed with respect to their age, sex, preimplantation hearing aid use, surgical technique for cochlear implantation, type of FDA (USA) approved cochlear implant, post operative speech therapy and its outcome with respect to categories of auditory perception and speech intelligibility scoring were compared for children younger than 4 years and older than 4 years. For outcome measurement non parametric statistical method was used for any significance between the two groups. There was a wide range of children implanted ranging from 2 to 7 years. Both varia and mastoidectomy and posterior tympanotomy method of cochlear implantations were done with good rate complete insertion and electrode activation. There was no significant difference between the two group with regard to CAP and SIR outcomes after 1 year. In order to get better outcomes with respect to the speech language development, there is need to strengthen the early identification and cochlear implantation before 4 years of age in government approved schemes.     

Nasal glioma : A case report

Nasal glioma, also known as glial heterptopia or the occurrence of isolated non — leratomatous glial tissue is a rare and benign congenital defect. This condition is diagnosed usually at birth time and requires early treatment to prevent facial deformations. We report here a case of extranasal glioma that was diagnosed and treated at the department of ENT, Gandhi Medical College, Bhopal. We emphasize on the developmental theory proposed as the etiology and discuss the clinical aspects, treatment and follow up.     

Treatment of morbid obesity in inner-city women

OBJECTIVE: To explore the use of the very-low-calorie formula diet (VLCD) in the indigent population of Newark, NJ, with the goal of achieving 10% weight loss within a relatively short period of 10 weeks. RESEARCH METHODS AND PROCEDURES: We accepted 131 morbidly obese indigent women into our study program. The study was limited to women only and the average starting weight was 292.3 +/- 5.9 lbs (+/- SE; 50.3 +/- 0.9 body mass index [kg/m(2)]). We used three treatment paradigms: total cost-free program for 10 weeks; cost-free, but compliance requirements; and a weekly charge of $25. The results obtained were compared with two control populations: women enrolled during the same recruitment period in a comparable suburban VLCD program and a historical control population of suburban women treated from 1985 through 1995. RESULTS: In group A (total cost-free), 79% of patients completed the 10-week program, but only 18% of patients achieved the goal of 10% weight loss. In group B when attendance and weight loss requirements were imposed, the dropout rate accelerated such that only 37% of patients completed the 10-week course, and 16% of the women were successful with their weight loss. In group C, imposing $25/wk financial outlay also accelerated dropouts but had little effect on weight loss success, which was 10% of the starting group. By comparison, the suburban patients and the historical control group exhibited 67% and 76% attendance rates after 10 weeks, and 33% and 55% success rates, respectively, in achieving the weight loss goal. DISCUSSION: We conclude that inner-city patients exhibit great interest in weight loss when financial barriers are removed. Successful weight loss was achieved in 10% to 18% of patients using the VLCD approach, approximately one-half of that obtained in affluent suburban women. Imposing financial or compliance restrictions to the inner-city patients served only to enhance dropouts.     

Primary cardiac synovial sarcoma

Abstract Synovial sarcomas are rare tumors and account for only 3% of cardiac malignancies. In this report, we present a case of a primary synovial sarcoma of the left ventricle . (J Card Surg 2010;25:288‐290)