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Hepatitis C virus (HCV) infection affects kidneys with different histopathological patterns on kidney biopsy, which commonly include membranoproliferative glomerulonephritis (MPGN) pattern with mixed cryoglobulinemia (CG), thrombotic microangiopathy, membranous nephropathy and small to medium vessel vasculitis. Type 1 MPGN associated with type II mixed CG is the most common glomerulopathy associated with hepatitis C infection. Treatment of these glomerulopathies and cryoglobulinemic renal disease associatedwith HCV infection includes antiviral therapy for HCV, B-cell depletion therapy for prevention of immune complexes and cryoglobulins or nonspecific immunosuppressive therapy. We describe a patient who presented to us with HCV associated MPGN type 1 with cryogloblinemia and detectable HCV RNA, who recovered completely with directly acting antiviral agents (DAA) alone without immunosuppression.
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Background: Regulatory guidelines recommend shelf life of herbal products to be established throughsystematic stability studies.Objective: The study was designed to establish shelf life of Syzygium cumini extract through acceleratedand long-term stability testing as per WHO guidelines.Material and methods: The extract was stored under accelerated (40_x005F_x005F_x0001_C/75 %RH) and long-term (25_x005F_x005F_x0001_C/60%RH) stability conditions for 6 and 30 months, respectively. Samples were withdrawn at periodic intervals and analysed through two validated HPLC-UV methods (I and II) for fingerprint and quantitativeanalysis of markers. Antidiabetic activity of control and stability samples was evaluated by a-glucosidaseinhibitory model.Results: Method I generated a well resolved fingerprint of the control sample that was found to containgallic acid (GA, 1.45 % w/w) and ellagic acid (EA, 3.97 % w/w). The content of GA did not change underboth the stability conditions, but that of EA varied insignificantly (3.97e4.77 % w/w) under long-termconditions up to 24 months and subsequently decrease to 3.15 % w/w after 30 months. There was novisible change in LC-UV fingerprint of any stability sample with respect to control. a-Glucosidaseinhibitory activity of all stability samples also remained unaltered as compared to control sample (IC501.48 mg/mL). GA and EA did not elicit any activity at the concentrations present in the extract.Conclusion: Phytochemical composition and antidiabetic efficacy of S. cumini extract remain unchangedduring its storage under both accelerated and long-term stability conditions, which suggest its shelf lifeto be 30 months. Also, GA and EA are not appropriate anti-diabetic markers
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Background: The greatest advance in pediatric pain medicine is the recognition that untreated pain is a significant cause of morbidity and even mortality after surgical trauma. Author compared the analgesic efficacy and duration of analgesia of rectal acetaminophen and I.V. acetaminophen.Methods: A total of 80 children in the age group of 2-5 years were randomly selected and divided into 2 groups. Group I received 15 mg/kg I.V. paracetamol and group II received 40 mg/kg rectal acetaminophen. Post-operative pain scores were measured using Face, Legs, Activity, Cry and Consolability scale and duration of analgesia were recorded and compared.Results: The pain scores in group I was lower immediately after extubation and at 30 minutes post extubations but at one, two and four hours the pains score were comparable in both the groups. At 6 hours, the pain score was significantly more in I.V. group and also the duration of analgesia was 9-10 hours in rectal acetaminophen group where as in I.V. group, it was 5-6 hours.Conclusions: Rectal acetaminophen 40 mg/kg produces prolonged analgesia as compared to I.V. paracetamol 15 mg/kg and also is more convenient and cost effective and is devoid of side effects of I.V. cannulation.
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Background: This study deal with the morphology of spleen regarding to shape, notches, and fissure on superior, inferior and diaphragmatic, visceral surface and compared with different study done previously. Methods: This study was done in the department of Anatomy, Chattishgarh Institute of Medical Science, Bilaspur, C.G. India. The study was done on 50 formalin fixed human middle age cadaveric spleen. The spleen was observed grossly and photograph was taken. The data was displayed in tabulated form. Results: The present study was done on 50 formalin fixed human cadaveric spleen, out of which 23(46%) spleen showed wedge shape, 19 (38%) spleen showed tetrahedral shape, 8(16%) spleen showed triangular shape. Among 50 spleen 35 (70%) exhibit notches on the superior border ,4(8%) exhibit notches on the inferior border, 6 (12%) exhibit no notches on either border of spleen, 5(10%) exhibit notches on the both border of spleen, 3 (6%) having fissures on the diaphragmatic surface of spleen . Notches on the superior border are commonly observed but it varies between 1 to 6 and in majority of spleen, it exhibits 1-3 notches respectively. Conclusion: This study provide knowledge about shape, notches, fissures of spleen hence this study useful for clinicians, surgeon, anatomist, radiologist for proper diagnosis and treatment of disease.
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Introduction: Drug Rash with Eosinophilia and Systemic Symptoms (DRESS) is designated as a lethal adverse drug effect with characteristic sign and symptoms such as skin rashes, fever, leukocytosis with eosinophilia or atypical lymphocytes, lymph node enlargement, and liver or renal dysfunction. Incidences of the DRESS range from 1/1000-1/10,000 drug exposures and are associated with a mortality rate of 10%. Pathogenesis of DRESS relates to an abnormal immune response in a genetically vulnerable individual, i.e. presence of human leukocyte antigen (HLA)*5801 and HLA-B* 5701 genotype and slow acetylation metabolic pathways. Methods: 48 cases were associated with the “Sulfasalazine-induced DRESS syndrome” reported between January 1990- March 2015 in PubMed-MEDLINE and HighWire Press. The “RegiSCAR” scoring system was used to analyze the case reports. Using this system, cases were classified into 4 categories as “no”, “possible, “probable” and “definite”. Results: The vast majority of cases were classified as “probable/definite” DRESS cases (83%). Hypereosinophilia, atypical lymphocytes and fever were significantly associated with “probable/ definite” DRESS cases. Liver involvement and skin rash was described in almost all of the cases, including “possible cases”. DRESS was found fatal in two cases. Conclusion: Awareness of DRESS is essential for diagnosis with the presence of skin rash, liver involvement, fever, hyper eosinophilia and lymphadenopathy. Early identification, followed by a prompt withdrawal of the culprit drug is the most essential measure to avoid disease evolution and to restore wellness.
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In order to obtain more knowledge about the causation of periodontal diseases the various forms of the disease have to be classified. In the past 130 years, various classification systems for periodontal diseases based on the understanding of the nature of these diseases at the time the classifications were proposed. Revisions to existing systems have been largely influenced by three dominant paradigms that reflect thinking at the time the classifications were proposed: the clinical characteristics paradigm (1870-1920), the classical pathology paradigm (1920-1970), and the infection/host response paradigm (1970-present). The changes in the paradigm have always been followed by the conceptual changes in the classification of periodontal disease. Although classification systems for periodontal diseases currently in use are firmly based on, and dominated by, the infection/host response paradigm, some features of the older paradigms are still valid and have been retained.
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Host-Parasite Interactions , Host Specificity , Humans , Periodontal Diseases/classification , Periodontal Diseases/microbiology , Periodontal Diseases/pathology , Periodontitis/classification , Periodontitis/microbiology , Periodontitis/pathologyABSTRACT
Aim: The study was aimed to determine the association of adipose derived hormones, adiponectin, leptin, and adiponectin/leptin (A/L) ratio with presence and degree of atherosclerosis in metabolic syndrome patients. Study Design: Open label, pilot, case-control study. Place and Duration of Study: Sadbhavna Medical and Heart Institute, Patiala and, Department of Pharmaceutical Sciences and Drug Research, Punjabi University, Patiala, Punjab, (INDIA), between January 2013 and December 2013. Methodology: Metabolic syndrome patients (n=55) with age ≥ 18 years, undergoing angiography for diagnosis and/or interventional treatment of atherosclerosis, and 25 matched control subjects were recruited. Evaluation of traditional and novel cardiovascular risk factors (adipose-derived hormones) and their association with angiographic-derived presence and degree of atherosclerosis indices (number of blocked vessels, severity index, and extent index) was carried out. Continuous variables were expressed as mean ± standard error mean and discrete variables were presented as frequencies and percentages. One way ANOVA was used to assess the difference b/w the groups characterized according to the number of vessels blocked. For each of the indices, the significant univariate predictors were entered into a forward stepwise multivariate regression model (model 1 and model 2) to determine the independent predictors. Statistical significance was accepted at P≤. 05. Results: The independent predictors of atherosclerosis for number of blocked vessels were low serum adiponectin and high total cholesterol level. For extent and severity index, low adiponectin level was the only significant and independent predictor. Leptin and A/L ratio could not prove as significant predictors (P≥. 05). Conclusion: Total cholesterol, adiponectin, leptin and A/L ratio might play a vital pathogenic role not only in the occurrence, but also in the severity, extent, number of vessels blocked complexity in metabolic syndrome patients.