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Neurofibromatosis-1(NF-1) is one of the most common single-gene disorders in humans. Patients with NF-1 may present with a wide variety of clinical manifestations. Spinal deformity is the most common musculoskeletal manifestation of NF-1. Rib head dislocation into the spinal canal is not a common entity but if left untreated can lead to serious neurological complications. The present report describes thoracolumbar dystrophic scoliosis with rib head dislocation into the spinal canal in a 28-year-old male who presented with complaint of spinal deformity with gait disturbance. Cobb angles measured 92 degrees of scoliosis (T9-L2), and 110 degrees of kyphosis and also highlights the importance of preoperative planning and radiological imaging for the successful surgical outcomes and our experience of single-stage posterior deformity correction with pedicle screw construct along with rib head excision
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Background: Antibiotics are the most commonly used drugs often associated with inappropriate use leading to resistance. While knowledge enlightens and provides an insight into the problems faced, behavioral change solely depends on the beliefs and attitude. Aim of this study to evaluate the knowledge and beliefs about antimicrobial prescribing among prescribers in a teaching tertiary care hospitalMethods: The present study was conducted in the Department of Pharmacology, ESIC Medical College and Hospital, Faridabad. after Ethical clearance from the Institutional Ethics Committee. Design of this study was a prospective, cross-sectional study carried out in the form of a survey in which a pretested, semi-structured, validated questionnaire of 30 questions was provided to Junior residents, Senior residents and Faculty of different specialties and response was recorded. Questionnaire comprises of 10 questions each in knowledge, attitude and practice section.Results: Out of 132 prescribers 86.5% believed that irrational practice will cause global resistant development. majority (92.3%) were expressing the need that sample culture should be sent before starting antibiotics but only 69.2 % were of the opinion that culture and sensitivity should be done in all infections and 92.3% were expressing the view that hospital antibiotics policy is useful in reducing AMR.Conclusions: The present survey on antibiotic usage gives useful information about the knowledge, attitudes and practices of prescribers and help plan suitable educational interventions that aim at improving the antimicrobial prescribing and minimizing the development of resistance.
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Background: Chemotherapy induced nausea and vomiting (CINV) remains one of the most common and debilitating complications of highly emetogenic chemotherapy (HEC). This study was undertaken to evaluate palanosetron against other 5-HT3 receptor antagonists in preventing delayed CINV with the aim of achieving complete response (CR) and improving quality of life (QoL).Methods: This was a prospective, observational study conducted on 75 histopathologically proven patients of squamous cell carcinoma of Head and Neck (H&N), who came to the Department of Radiation Oncology, Gandhi Medical College and Hamidia Hospital, Bhopal from January to December 2015. Standard protocol based chemotherapy containing highly emetogenic cisplatin based chemotherapy was administered to all the patients. For prevention of delayed chemotherapy induced nausea and vomiting all patients were prescribed oral 5-HT3 antagonists. Oral Ondansetron 4mg TDS was given to cohort 1, oral Granisetron 1 mg BD to cohort2 and oral Palanosetron 0.5mg OD was given to cohort 3. They were graded as complete response when they did not have complains of nausea and vomiting.Results: In Ondansetron, Granisetron and in Palanosetron cohort 29%, 53% and 98% patients had complete response.Conclusions: Palanosetron appears superior. Our study was conducted on handfull of patients and compared palanosetron against only two 5-HT3 receptor antagonists, so a larger study is suggested to establish the efficacy and better response of palanosetron.
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Diversity refers variety in nature i.e. the variety of life on Earth and its biological diversity is commonly referred to as biodiversity. Sandi Bird sanctuary was developed and conserved in the year 1990 as natural biodiversity hub for aquatic vegetation as well as local residents and migratory birds. This Sanctuary has an area of 309 hectares. A study of faunal diversity in Sandi Bird Sanctuary was done during January 2013 to March 2014. Sandi Bird Sanctuary is well known as popular tourist destination because of the diverse assemblage of avifauna especially migratory water birds that congregate at the Sandi Bird Sanctuary in winter. The result includes 3 species of annelids belonging to 3 orders, 10 orders of insects with 61 species, 4 species of mollusks belonging to 3 orders, 11 species of fishes belonging to 5 families, 3 species of amphibians and 15 species of reptiles belonging to 13 families, 157 species of birds, and 12 species of mammals belonging to 09 families from Sandi Bird Sanctuary. The sanctuary is an envoy area of the Indo-gangetic eco-system. Wetland vegetation is also found in the sanctuary.
ABSTRACT
Cystinosis, an inherited disease caused by a defect in the lysosomal cystine transporter (CTNS), is characterized by renal proximal tubular dysfunction. Adenosine triphosphate (ATP) depletion appears to be a key event in the pathophysiology of the disease, even though the manner in which ATP depletion occurs is still a puzzle. We present a model that explains how a futile cycle that is generated between two ATP-utilizing enzymes of the γ-glutamyl cycle leads to ATP depletion. The enzyme γ-glutamyl cysteine synthetase (γ-GCS), in the absence of cysteine, forms 5- oxoproline (instead of the normal substrate, γ-glutamyl cysteine) and the 5-oxoproline is converted into glutamate by the ATP-dependant enzyme, 5-oxoprolinase. Thus, in cysteine-limiting conditions, glutamate is cycled back into glutamate via 5-oxoproline at the cost of two ATP molecules without production of glutathione and is the cause of the decreased levels of glutathione synthesis, as well as the ATP depletion observed in these cells. The model is also compatible with the differences seen in the human patients and the mouse model of cystinosis, where renal failure is not observed.