ABSTRACT
A number of biological molecules such as inflammatory enzymes and cytokines are altered during dengue virus (DENV) infection, many of which are attributed to the pathogenesis of the DENV infection. Papaya (Carica papaya) based extracts (PBE) and certain vitamins have been proven beneficial for dengue fever (DF) patients. The extract of papaya leaves were shown to improve platelet count in dengue patients. Extracts of papaya pulp based was also shown to induce in vitro IL-6 and stem cell factor in human peripheral blood mononuclear cells and stem cells of mesenchymal origin. Different vitamins such as D, E, and C have shown promise to treat dengue disease when taken in small supplementation trials. However, the exact molecular mechanisms on the beneficial roles of either PBE or vitamins are yet to be defined. Hence, the aim of this review is to link the cellular and molecular responses of DENV pathogenesis and pharmacological actions of the bio-active components of PBE or vitamins. It has also been shown that the beneficial roles of PBE and vitamins in DF are linked to thrombopoiesis, prevention of the viral entry and replication, decrease in oxidative damage assisted thrombocytopenia, and the reduction in vascular leakage. The DENV mediated fatalities are expected to expand it’s geographic boundary whilst an efficient drug and the most likely candidate vaccine against DENV are still in progress. Findings on the molecular mechanisms of food and nutrient supplement might reinforce ongoing research to treat the increasing number of DENV infected patients using natural products while waiting for the right drug and vaccine.
ABSTRACT
ADPKD presenting as congestive cardiac failure due to dilated cardiomyopathy is rare. ADPKD is an inherited systemic disorder with major renal manifestation and in some cases extrarenal manifestation or combination of both. In this report 45 year male patient presented with complains of dyspnoea, abdominal distension, pain right hypochondriac region. He was hospitalized, examined clinically and advised various bio-chemical and imaging tests. The finding was suggestive of ADPKD with dilated cardiomyopathy with congestive cardiac failure. He was managed with diuretics, ACE inhibitors, digoxin, Moist oxygen inhalation and he responded to the treatment.
ABSTRACT
With decreasing incidence of cervical pathology in western world due to increasing awareness and screening programme. Contrary to it in India and developing countries cervical lesion, particularly cervical carcinoma is the leading cause of increasing morbidity, mortality and financial burden on society. The present study is an insight into the epidemiological profile of cervical lesion on Pap smear and histopathology finding in Kosi region of Bihar. The study was carried over the period of 2 years 8 months. Total 154 patients were enrolled in this study and were analysed for age, socio-economic status, parity, age at first pregnancy and symptoms using Pap smear with histopathological finding of cervical lesions. Data were analysed of which 79.23% (122) patients were in age groups 21-40 years, 72.08% (111) were from low socio-economic status, and 70.78% (109) were with parity 4 and more. 66.88% (103) patients delivered their first child below 20 years of age. 69.49% (107) patients presented with foul smelling vaginal discharge and pelvic pain. On pap smear and histopathological findings preinvasive (dysplasia, LGSIL, HGSIL) and invasive stage (carcinoma) constituted 26.61% (41) cases. The epidemiological pattern of cervical lesion in kosi region of Bihar is different from other study with presentation in younger age groups, high parity and markedly increased incidence of premalignant and malignant lesion on pap smear and histopathology findings.
ABSTRACT
Background: In recent years, high thoracic anaesthesia (HTEA) combined with general anaesthesia has been extensively studied in patients undergoing coronary artery bypass graft surgery with or without cardiopulmonary bypass. Off-pump coronary artery bypass grafting was implemented to reduce trauma of surgical coronary revascularization by avoiding extracorporeal circulation. TEA in combination with GA further reduces intraoperative stress resulting in more rapid extubation and significantly better pain relief in patients undergoing off-pump coronary artery bypass grafting (OPCAB). In addition, common postoperative complications are also decreased. Methodology: 40 male patients aged between 40-65 years with CAD undergoing OPCAB surgery at NICVD from April 2006 to October 2008 were randomly divided in two groups. Group A received epidural analgesic drugs through an indwelling catheter introduced before induction of anesthesia while group B patients received standard general anesthesia (GA) alone. Group A patients received continuous epidural analgesia delivered through the indwelling catheter with a mixture of Lignocaine (2%) 20 ml + Bupivacaine (0.5%) 20 ml + Fentanyl 50 gm 1 ml + normal saline q.v. 50 ml at the rate of 1-2 ml/hour by a syringe pump for up to 72 hours. Group B patients received conventional intermittent narcotics (Morphine)/NSAIDS (Ketorolac/Diclofen) for up to 72 hours. Results: Haemodynamic parameters of all patients in both the groups were within acceptable range throughout operations. Incidence of cardiac dysrhythmias was less in patients of group A. Group A patients showed faster recovery and better analgesia compared to Group B patients. There was also decreased incidence of nausea, vomiting, arrhythmia, O2 desaturation, confusional states, renal failure and requirement of iontropic support in ICU in Group A patients. TEA for postoperative analgesia was safe and well accepted by the patients. There was no complication related to epidural anesthesia in any patient. Conclusion: TEA in general anesthesia provides faster recovery and effective analgesia. Nonetheless, the actual and potential risks of TEA during cardiac surgery should not be underestimated.