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Now days due to lactation failure cow milk is the first choice for an infant and accordingly is one of the first and most common causes of food allergy in early childhood. Cow milk allergy is the allergy to the protein (casein and whey protein) in cow milk. It is the leading cause of food allergy in infants and early childhood (less than 3 years). This review summarizes current evidence and recommendations regarding cow milk protein allergy (CMPA), the most common food allergy in young children, for the parents with incidence estimated as 2% to 7.5% in the first year of life. In classics, it has been mentioned that cow milk should always processed with Laghupanchmoola before it is consumed. There is no treatment for this disease in modern science as well as in Ayurveda, so there is a need to find a safe and effective remedy in the management of CMPA. A 1-year old male patient was brought to Out Patient Department of Kaumarabhritya, Rishikul campus UAU Haridwar Uttrakhand, with complaints of loose motion and vomiting after cow’s milk intake. These complaints were persisting for the past 20 days. After that he gradually developed abdominal pain for 10 days. This condition can be understood as CMPA treatments including Laghupanchmoola granules with cow milk, course of 2 months. There were significant improvements in the condition of the patient.
ABSTRACT
Background: The discrimination between benign and malignant adnexal masses is important for clinical management and surgical planning in such patients. Various combined methods of evaluation adnexal mass have also been proposed. Risk of malignancy index (RMI) is a combined parameter which is simple, preclinical and highly sensitive, and more specific. Risk of malignancy index 4 (RMI 4) is calculated as a product of ultrasound score (U)×menopausal score (M)×CA 125×tumor size. Objective of this study was to determine if the RMI (RMI 4) can distinguish between benign and malignant adnexal masses.Methods: A prospective study was conducted on 30 women with an adnexal mass presenting in the OPD and emergency and RMI-4 calculated. Cut off level of 450 was set to differentiate between benign and malignant mass.Results: In this study, the value of RMI-4 is less than 450 in 17 patients with benign disease and 3 patients with malignant disease. The value is more than 450 in 2 patients with benign disease and 8 patients with malignant disease. RMI-4 >450 had a sensitivity of 72.73% and specificity is 89.47%. The positive predictive value is 80% and negative predictive value is 85%. The p-value for RMI-4 in this study is 0.001 which is highly significant.Conclusions: RMI is a reliable, simple, easy to use and cost-effective method in differentiating benign from malignant adnexal masses.
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Objectives: The aim of the study was to evaluate the fetal well being by non-stress-test (NST) and vibroacoustic stimulationtest (VAST) in high-risk pregnancies, to assess the perinatal outcome, to study the ability of the VAST to convert a false-positive(non-reactive) NST to a reactive one.Materials and Methods: Atotal of 100 pregnant women with >32 weeks gestation having certain high-risk factors were subjectedto NST and if NST came out to be non-reactive, vibroacoustic stimulation was given with artificial larynx. Perinatal outcome wasassessed by various parameters (meconium stained liquor, Apgar score at 5 min, neonatal intensive care units admission). Theresults were analyzed by Chi-square test to find the association between NST, VAST results, and perinatal outcome.Results: It was found that VAST reduced the number of false-positive results by 31%. As compared to NST, VAST had lesssensitivity (78.05% vs. 80.48%), and better specificity (95.08% vs. 83.61%), better positive predictive valve (91.43% vs. 82.35%)in predicting perinatal outcome.Conclusion: The addition of vibroacoustic stimulation to the NST reduced significantly the number of non-reactive tests. NSTwhen reactive does represents a satisfactory indicator for fetal well-being but non-reactive test needs further evaluation beforeany active intervention.
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Background: Dengue fever has become a major public health concern. The disease is now endemic in more than 100 countries with very high case fatality rate and children are the most affected age group worldwide. During explosive outbreaks, there is sudden surge in demands of blood components. Hence the aim of present research was to study the rational use of blood components in children with dengue by using WHO 2012 and NVBDCP 2015 (GOI) guidelines.Methods: Total 219 children of age ?12 years, who has been diagnosed to have dengue and received blood component therapy during 12 months of study period, were included in the study. The transfusions of blood components [packed red cells (PRC), platelets and fresh frozen plasma (FFP)] were being given to the cases accordance to the WHO and NVBDCP guidelines. The patients' demographic data, diagnosis, details of blood component therapy used the reason for transfusion was recorded.Results: Out of 219 children, 12(5.4%) children received platelet transfusion, 4(1.8%) children received PRC transfusion and 5(2.2%) children received FFP transfusion. One transfusion (4.7%) out of 12 platelet transfusion was inappropriate and all PRC and FFP transfusions were appropriate according to WHO and National Vector Born Disease Control Programme (GOI) guidelines.Conclusions: The need for platelet transfusion is often overemphasized and the fact is that the platelet count alone is not a predictor of bleeding. Unnecessary and empirical use of platelets should be completely avoided.
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Background: Both pharmacological and non-pharmacological strategies for pain relief in labor have been tried and tested sincelong. Combined spinal-epidural analgesia (CSEA) satisfies the basic requisites of labor analgesia. Various concentrations oflocal anesthetics along with the addition of opioids can be used. The objective of this study is to compare the quality of laboranalgesia with two different concentrations of ropivacaine (0.2% vs. 0.125%) and assess fetomaternal outcome.Materials and Methods: A total of 60 primipara women with a singleton pregnancy in active labor were given CSEA afterrandomly allocating them in two groups of 30 each. Both Group A and Group B received intrathecal injection of 4 mg (2 ml)0.2% ropivacaine + 25 µg (0.5 ml) fentanyl: Group A - epidural dose of 15 ml of 0.2% ropivacaine solution + 2 µg/ml fentanyland Group B - epidural dose of 15 ml of 0.125% ropivacaine + 2 µg/ml fentanyl. Then, continuous epidural infusion was startedat the rate of 10 ml/h which was continued until the end of delivery.Results: GroupA showed better maintenance of analgesia and better maternal satisfaction while parturients in Group B neededrescue top-up analgesia due to breakthrough pain.Conclusions: It was concluded that ropivacaine in both concentrations (0.2% and 0.125%) with fentanyl is effective forinitiation of labor analgesia. However, quality of analgesia with 0.2% ropivacaine concentration is superior to 0.125%concentration.
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Background & Objective: Human parvovirus B19 infections may cause a widespread benign and self-limiting disease in children known as erythema infectiosum or fifth disease. Infections caused by human parvovirus B19 can result in a wide spectrum of manifestations, which are usually influenced by the patient's immunologic and hematologic status. Patients with underlying hematologic and immunologic disorders who become infected with this virus are at risk for aplastic anemia. We studied different hematological manifestations of Parvovirus infection like anemia, thrombocytopenia , eosinophilia and pancytopenia. Methodology: It was a retrospective study in which we studied 17 patients with parvo B 19 virus positivity their clinical presentation, predisposing diseases , CBC parameters and response to treatment. Parvo virus infection was diagnosed by parvo IgM titer(>11NTU considered as positive) .Also BM histopathology was done whenever possible. Results: Out of 17 patients studied with parvo virus B 19 positivity 12(70.58%) were male and 5(29.42%) were female .The age of presentation was between 2.5 to 14year,with mean of 8.7year.Parvo virus infection was seen amongst patients with HIV n=8(47.05% ), Hemolytic anemia n=4(23.52%),ITP n=2(11.76%) and eosinophilia n=1(5.88%), plasmodium falciparum infection n=1(5.88%) & patient with acute lymphocytic leukemia n=1(5.88%).Commonest hematological manifestations were unexplained anemia n=16(94.11%) , thrombocytopenia n=5(29.41%), eosinophilia n=1(7.7%) , bicytopenia n=6(35.29%) , pancytopenia n=2(11.76%). Out of 17 patients 7(41.17%) were treated with IvIg and rest 10 required only supportive care as infection was transient. Conclusion: Parvo virus infection induced anemia is more severe and persistent in immunocompromised patients. Patients with hemolytic anemias may present with transient aplastic crisis due to parvo virus infection. Parvo virus infection may be considered as a possible etiologic agent for ITP. Coexistent Parvo virus infection in patients with P.falci malaria may be a cause for severe anemia. The hematological manifestations of parvovirus infection results from direct consequences of the ability of parvovirus B19 to target the erythroid cell lineage. However, accumulating evidence suggests that this virus can also affect other cell lineages pathogenesis of which remains to be fully elucidated.[
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Phospholipases A2 (PLA2) are enzymes that specifically hydrolyze the sn-2 fatty acid acyl bond of phospholipids, producing a free fatty acid and a lyso-phospholipid. We report the cloning and expression of a secretory phospholipase A2 (sPLA2) from Mesobuthus tamulus, Indian red scorpion. The nucleotide sequence codes for a 167 residue enzyme. The open reading frame codes for a 31 amino acid signal peptide followed by a mature portion of the protein. The primary structure shows the calcium binding motif, catalytic residues, 8 highly-conserved cysteines and C-terminal extension which classify it as a group III PLA2. The entire transcript was expressed in Escherichia coli and was purified by metal affinity chromatography under denaturing conditions. The protein was refolded by serial dilutions in the refolding buffer to its active form. Hemolytic assays indicate that the protein adopts a functional conformation. The functional requisites such as optimum pH of 8 and calcium dependency are shown. This report provides a simple but robust methodology for recombinant expression of toxic proteins.