Gastric perforation without generalized peritonitis; a very rare complication after necrosectomy for necrotizing pancreatitis

Gastric perforation is a very rare complication of necrotizing pancreatitis. We present an interesting case of gastric perforation after necrosectomy for necrotizing pancreatitis without generalized peritonitis. Abdominal drain was seen inside the stomach on endoscopy and there were no clinical features of generalized peritonitis even after 10 days of surgery. Patient was re-explored. The drain was removed and stomach was primarily repaired. The patient recovered uneventfully and was discharged home on 6th post operative day. On follow-up visit after one month patient was doing very well and had no complications

Prevalence of shoulder disorders in tertiary care centre.

Background: Shoulder pain is the third most common musculoskeletal condition has a lifetime prevalence of up to 70% and this seems to be increasing in incidence. The diagnosis of these disorders is based primarily upon results of clinical tests. The prevalence of shoulder pain in India has not been reported. The aim of present study is to study and report the prevalence of various disorders causing shoulder pain in patients reporting to a tertiary care hospital in North India. Methods: This is a prospective hospital based cross-sectional study carried in a tertiary care hospital and 130 patients satisfying inclusion criteria over a period of two year were included. Results: Age of patients ranged between 23-69 years (51.36 ± 11.86 years). A predominance of females was observed (Male-Female ratio: 0.81:1). The commonest cause of pain was periarthritis shoulder (43.1%), subacromial (SA) impingement (13.8%), acute rotator cuff injury (13.1%), GH arthritis (10.0%) and AC Arthritis (8.5%). The major risk factors were diabetes mellitus, excessive overhead lifting and trauma. Conclusion: Periarthritis and subacromial pain syndrome are two most common diagnoses reporting to a tertiary care centre. Periarthritis is the commonest diagnosis in both genders. AC arthritis is more common in females (P <0.001) and rotator cuff injury is more in males (P <0.001). Periarthritis, GH arthritis and AC arthritis is much more common in fifth and sixth decades and rotator cuff injury is seen in young adults.

Validation of Ponseti method for clubfoot deformity correction.

Background: Idiopathic Congenital Talipes Equino-Varus (CTEV) is a complex deformity of foot that is difficult to treat. The goal of treatment is to gain a functional, pain free, plantigrade foot, with good mobility and without callosities. Currently, the most accepted and popular method is the Ponseti method which allows correction of all components of CTEV by manipulation and serial casting without any major surgical intervention. This prospective study was done in a tertiary care centre to statistically assess the efficacy of Ponseti method. Methods: We treated 150 children (210 feet) with idiopathic clubfoot deformity, using Ponseti technique. The severity of foot deformities were assessed by Pirani scoring system and were also recorded clinically, radiologically and podographically. The changes in the mean Catterall-Pirani scores at different follow ups were evaluated statistically. Results: The mean number of casts that were applied to obtain correction was 7.86 (range 5 to 11 casts). Percutaneous tendoachilles tenotomy was done in 70% of feet. All children were given foot abduction orthosis after the correction. The results were graded according to Ponseti and Smoley criteria. Good results were obtained in 83% of feet, acceptable results in 7% of feet and poor results in 10% of cases. Statistically significant correction was achieved in manipulation and casting stage which was maintained during bracing phase. The recurrences of the deformity were primarily due to poor compliance in the use of orthosis in post correction phase. Conclusion: The Ponseti method of correction is a safe and effective treatment for congenital idiopathic clubfoot and radically decreases the need for extensive corrective surgery. Non-compliance with orthotics is the main factor causing relapse of the deformity.

Cloning and expression of functional reteplase in escherichia coli TOP10

Production of tissue Plasminogen Activator protein [t-PA] in prokaryotes systems has many problems such as the lack of active protein production, multiple purification steps, and renaturation process which has been shown to be costly and time-consuming. In this study, reteplase which is the nonglycosylated active domain of t-PA was used to transform TOP10 Escherichia coli [E. coli] bacteria to resolve some of the above mentioned problems. Reteplase cDNA was ligated into pBAD/gIII plasmid which allowed secretion of this protein into the periplasmic space and would allow the correct formation of disulfide bonds in protein structure. The presence of reteplase cDNA in pBAD/gIII plasmid was confirmed by restriction digestion and sequencing. After induction of the expression of this protein by adding 0.0002% L-Arabinose to the medium, the proteins in periplasmic space as well as the inclusion bodies formed inside the cell were extracted. Subsequently, these proteins were purified and detected by Western blot method. Our results showed that the amount of reteplase extracted from periplasmic space was much lower than the extracted inclusion bodies and large quantities of the recombinant protein were present as inclusion bodies. Therefore, it was more efficient to use inclusion body extraction method for protein isolation and purification. We produced active reteplase after its expression in E. coli TOP10 and isolation of inclusion bodies produced the best results for purification and extraction of this protein

[ role of advanced technologies in disasters recovery and rehabilitation]

The number of disasters is increasing in the world which can lead to death, injury and disability in affected people. Although on-time, rapid and effective recovery and rehabilitation services/measures in post disaster phase prevent more injuries and disabilities. However, providing these services will have some difficulties in the scene of disasters. This study aims to review the potential of advanced technologies in disasters recovery and rehabilitation. Following an expanded English literature review, a database containing the related articles was developed. The core research group classified the appropriate articles and drafted the first version of the results. Using an expert panel methodology, the results were finalized based on the participants view points. Advanced technology can help responders to manage disaster recovery and rehabilitation phase. Using telerehabilitation, telecommunication, Geo Information Technology and mobile technologies are some examples which could reduce post disaster impacts. Despite wide use of advanced technology in pre-disaster phase, this potential has been considered less in disasters recovery and rehabilitation measures. This study suggests more research in disaster rehabilitation engineering

Studies on antibacterial activity of some traditional medicinal plants used in folk medicine

Ethanolic extracts of eight medicinal plants commonly used in folk medicine were tested for their antibacterial activity against four Gram positive strains [Bacillus subtilis, Staphylococcus aureus, Staphylococcus epidermidis and, Streptococcus pneumoniae] and six Gram negative strains [Escherichia coli, Proteus vulgaris, Proteus mirabilis. Salmonella typhi para A, Salmonella typhi para B and Shigella dysenteriae] that were obtained from different pathological laboratories located in Karachi, Pakistan. Disc diffusion method was used to analyze antibacterial activity. Out of eight, five medicinal plants showed antibacterial activity against two or more than two microbial species. The most effective antimicrobial plant found to be Punica granatum followed by Curcuma zedoaria Rosc, Grewia asiatica L and Carissa carandas L, Curcuma caesia Roxb respectively. From these results, it is evident that medicinal plants could be used as a potential source of new antibacterial agents

Swine flu: are we the next victims?

Current pandemic influenza due to A [S-OIV A] [H1N1] virus is becoming more threatening day by day throughout the world. It is the time to provide relevant information to the masses regarding this destructing threat to the health of public. The objective of the present paper is to update the current status of swine flu and to provide information to general public, clinicians and other health professionals about H1N1