Epidemiology and clinical course of bronchiolitis in hospitalized children in tertiary care hospital in Kashmir

Background: Bronchiolitis is the commonest lower respiratory tract infection in children < 2 years of age and is responsible for the majority of their pediatrician visits and hospital admission during the winter season. The aim of this study was to describe the epidemiological data, seasonal trends, clinical characteristics, and outcomes of children admitted with bronchiolitis in pediatric hospital GMC Srinagar.Methods: This was a retrospective observational study in children less than 2 years of age admitted in department of pediatrics in GMC Srinagar. Data were collected through review of the medical records of patients with a diagnosis of bronchiolitis on discharge and analyzed through SPSS 20.Results: A total of 228 infants were enrolled in the study. The majority were males (60.08%). The median age on admission was 5.5 months, exclusive breastfeeding was the mode of feeding in majority and 8.77% were ex-preterm. Respiratory syncytial virus (RSV) was identified in majority (103) and admission peak was from October to March. Most of the patients presented on day 3 of the illness. Most patients 45.17% were having feeding difficulties and chest auscultation was normal in about 22% of the children. Oxygen supplementation was administered to 85.52% of the children. The 32 children (14.03%) required admission to PICU. Mechanical ventilation was required in 6 children (18.75%). No death occurred in infants while in the hospital.Conclusions: RSV has been found to be the main responsible virus. Management of bronchiolitis is usually symptomatic as recommended by most of the guidelines.

Bioconversion of glycerol waste to ethanol by Escherichia coli and optimisation of process parameters

Biofuel is one of the best ways to reduce our dependence on fossil fuels. Ever since commercial biodiesel production began, waste glycerol, the biodiesel byproduct, has gained researchers’ interest, especially its recycling. Here, we explored using glycerol residue (carbon source) as a substrate in the fermentation process for ethanol production by Escherichia coli K12 in anaerobic conditions. The factors affecting the ethanol production was optimised by response surface methodology (RSM). Significant variables that impact the ethanol concentration were pH, temperature and the substrate, with a statistically significant effect (P <0.05) on ethanol formation. The significant factor was analyzed by the Box-Behnken design. The optimum conditions for bioethanol formation using glycerol as substrate was obtained at pH 7 and temperature 37°C. The ethanol productivity was 0.77 g/L/h. The ethanol concentration of 9.2 g/L achieved from glycerol residue was close to the theoretical value with the fermentation achieved at optimised terms.

Effect of Salinity Stress on Germination, Seedling Growth, Mineral Uptake and Chlorophyll Contents of Three Cucurbitaceae Species

Abstract This study was performed to screen out the various species of 'Cucurbitaceae' family, musk melon (Kalash and Durga), bottle gourd (Crystal Long and Nuefield) and squash (Green Round, and Squash Malika) against the salt stress. All genotypes were treated with five different levels of NaCl (T0 = control, T1 = 1.5 dS m-1, T2 = 3.0 dS m-1, T3 = 4.5 dS m-1 and T4 = 6.0 dS m-1) and half strength of Hoagland's nutrients solution as the base nutrient solution. Results showed that the bottle gourd varieties "Nuefield" and "Crystal Long" performed best by maintaining the highest germination (93.2% and 85.6%), number of leaves per plant (4.5 and 5.7), shoot length (16.84 cm and 16.14 cm), root length (13.48 cm and 13.00 cm), plant fresh weight (942.2 g and 918.6 g), plant dry weight (118.4 g and 107.5 g), leaf area (171.2 cm2 and 169.1 cm2), chlorophyll content (3.5 μg/cm-2 and 3.4 μg/cm-2) with low chloride (1.57 ppm and 1.59 ppm) and sodium content (0.47 ppm and 0.51 ppm) under salt stress followed by varieties of Squash (Green Round, and Squash Malika) and musk melon (Kalash and Durga). It was also found that a higher level of salinity (4.5 dS m-1 and 6.0 dS m-1) has more adverse effects on the performance of all selected genotypes. Conclusively, it can be recommended that as compared to all tested species, bottle gourd varieties "Nuefield" and "Crystal Long" have the ability to withstand against salinity stress and should be planted under salt stress conditions.

Role of biomarkers in predicting anastomotic leakage following colorectal surgeries

Background: Recovery after surgery for patients with colorectal disease has improved with the advent of minimal access surgery and standardized recovery protocols. Despite these advances, anastomotic leakage remains one of the most dreaded complications following colorectal surgery, with rates of 3-27 per cent depending on specific risk factors. The aim of the study was to assess sensitivity and specificity of systemic and peritoneal drain-fluid bio-markers in early prediction of anastomotic leak; and to co-relate rise in levels of biomarkers and severity of clinical symptoms in patients who have undergone colo-rectal surgeries.Methods: The present study was a prospective observational study conducted on 60 patients in the Postgraduate Department of Surgery, Government Medical College, Srinagar after obtaining due ethical clearance over a period of two years.Results: The mean age was 54.87±11.901 years with 44 patients (73.3%) were males. Among systemic makers: the mean CRP level was 2.7800±0.500 mg/L, the mean total leukocyte count was 10.783±0.940 thousands and the mean serum procalcitonin level was 0.365±0.1385 ng/ml. Among peritoneal fluid drain bio-makers, the mean IL-6 level was 3551.066±1311.965 pg/ml, the mean IL-10 level was 628.533±460.358 pg/ml and the mean TNF-a level was 16.391±6.736 pg/ml. The anastomotic leak after colo-rectal surgery was noted in 16 patients (26.7%). In our study significant co-relation was noted between the rise in levels of peritoneal drain fluid biomarkers and severity of clinical symptoms but no significant co-relation was noted between the rise in levels of systemic markers and severity of clinical symptoms in patients who have undergone colo-rectal surgeries.Conclusions: Systemic biomarkers are poor predictors of anastomotic leak after colorectal surgery. But sensitivity and specificity of peritoneal fluid drain biomarkers in predicting anastomotic leak was significantly high.

Rubber band ligation of hemorrhoids: a hospital based study

Background: Hemorrhoids are symptomatic anal cushions containing arteriovenous anastomosis. Patient with haemorrhoids can present as bleeding per rectum, something (mass) coming out per rectum, perianal itching, Anaemia due to occult blood loss. Various modalities of treatment have been developed to treat symptomatic haemorrhoids. This study was undertaken to determine the efficacy of rubber band ligation in the management of haemorrhoids.Methods: This study was a prospective study conducted in the Department of Surgery, Government Medical College, Srinagar from June 2015 to June 2018. Patients at any age with first, second- or third-degree internal haemorrhoids were included in the study. Patients with fourth degree, complicated haemorrhoids, previous anorectal surgery or anorectal pathology, and chronic liver disease were excluded. A total of 212 patients were included in the study. Rubber band ligation was done as an OPD procedure. The patients were followed at 2 weeks, 4 weeks, 3-month, 6 month and 1 year after the procedure.Results: In this study, out of 212 patients, 154(72.6%) were males and 58(27.4%) females. The mean age of this study was 38.7 yr. (Range 17-73 yr.). Patients presented with the complaints of bleeding (184, 86.8%), prolapse (114, 53.7%), constipation (116, 54.7%), priuritis ani (36, 17.0%), pain (12, 5.6%). Band ligation was successful in 188(88.8%) patients, 169(79.7%) patients were cured and in 19(8.9%) improvement was obtained. Various complications occurred after band ligation including vasovagal syncope (2, 0.9%), bleeding per anum (6, 2.8%), pain (12, 5.6%), fissure in ano (1, 0.5%). Recurrence after one year was seen in 9(4.2%) patients.Conclusions: Author concluded in this study that RBL is an effective outpatient treatment for grade II and III internal haemorrhoids without much complications.

Clipless Laparoscopic Cholecystectomy: Our Experience

Background:Laparoscopic cholecystectomy (LC) is acceptedas the gold standart treatment of gallstones. Various methodshave been developed to close the cystic duct (CD) and cysticartery (CA), but titanium clip application is currently themost frequently used technique. High-tech electrosurgicalinstruments, such as Harmonic Scalpel (HS), have been usedboth for dissection of the cystic artery and Cystic duct. Thepresent study was conducted to observe and establish efficacyof clipless cholecystectomy, by use of harmonic scalpel as analternative, for division and sealing of cystic artery and cysticduct.Methods: This study was a hospital based, retrospectivestudy, conducted in Govt. Medical College, Srinagar, usingmedical records. A total of 114 patients included in the study,having been operated by a single surgeon over time period of5 years from February 2014 to january 2019.Results: In our study of 114 patients 82 (71.92%) werefemales and 32 (28.07%) were males with average age of41.4years (16-72 yr). No patient was converted to open withaverage operating time of 24.2 minutes (18-46 minutes). Meanhospital study was 1.42 days (1-8 days) with no mortality.Postoperative complications were found in 6 (5.2%) patientswith bile leak from duct of Lushka in 1 (0.8%) patient, portsite infection in 2 (1.7%) patients and fever in 3 (2.6%)patients.Gallbladder perforation intraoperatively was seen in7 (6.2%) patients.Conclusions:Use of harmonic scalpel is an excellent optionfor the cystic duct closure with less time consumption and lesscomplications

Levetiracetam versus Phenobarbitone for Acute Seizure Control in Neonates

Xenotransplantation is transplantation of living cells, tissuesor organs from one species to another. There is a large numberof patients who need to wait for allotrasplantation due tolimited donors. This drives a need for the transplant of tissuefrom animals to humans. However, immune rejection andinfections are major risks that may prevent a good outcome ofxenotransplantation. Proper documentation and sterilisationof tissues is indispensable. This article highlights the presentday prespectives of Xenotransplantation.

Isolated psoas schwannoma: A rare retroperitoneal tumor

Retroperitoneal neurogenic tumors are very rare. Isolated or primary psoas schwannoma is one of the rarest tumors of retroperitoneum. The images of such a case are presented in this report.

Synthesis of some new 2-[4-[2-furoyl]-1-piperazinyl]-N-aryl/aralkyl acetamides as potent antibacterial agents

In this work, a new series of 2-[4-[2-furoyl]-1-piperazinyl]-N-aryl/aralkyl acetamides has been synthesized and evaluated for their antibacterial potential. The synthesis was initiated by the reaction of different aryl/aralkyl amines [1a-u] with 2-bromoacetylbromide [2] to obtain N-aryl/aralkyl-2-bromoacetamides [3a-u]. Equimolar quantities of different N-aryl/aralkyl-2-bromoacetamides [3a-u] and 2-furoyl-1-piperazine [4] was allowed to react in acetonitrile and in the presence of K2CO3, to form 2-[4-[2-furoyl]-1-piperazinyl]-N-aryl/aralkyl acetamides [5a-u]. The structural elucidation was done by EI-MS, IR and 1 H-NMR techniques of all the synthesized compounds. All of the synthesized molecules were active against various Gram positive and Gram negative bacterial strains. Among them 5o and 5c showed very excellent MIC values. The cytotoxicity of the molecules was also checked to find their utility as possible therapeutic agents, where 5c [0.51%] and 5g [1.32%] are found to be least toxic in the series

Synthesis of 2-Furyl [[4-aralkyl]-1-piperazinyl] methanone derivatives as suitable antibacterial agents with mild cytotoxicity

The aim of the present research work was synthesis of some 2-furyl [[4-aralkyl]-1-piperazinyl] methanone derivatives and to ascertain their antibacterial potential. The cytotoxicity of these molecules was also checked to find out their utility as possible therapeutic agents. The synthesis was initiated by reacting furyl[-1-piperazinyl] methanone [1] in N,N-dimethylformamide [DMF] and lithium hydride with different aralkyl halides [2a-j] to afford 2-furyl[[4-aralkyl]-1piperazinyl] methanone derivatives [3a-j]. The structural confirmation of all the synthesized compounds was done by IR, EI-MS, 1H-NMR and 13C-NMR spectral techniques and through elemental analysis. The results of in vitro antibacterial activity of all the synthesized compounds were screened against Gram-negative [S. typhi, E. coli, P. aeruginosa] and Gram-positive [B. subtilis, S. aureus] bacteria and were found to be decent inhibitors. Amongst the synthesized molecules, 3e showed lowest minimum inhibitory concentration MIC = 7.52 +/- 0.[micro]g/mL against S. Typhi, credibly due to the presence of 2-bromobenzyl group, relative to the reference standard, ciprofloxacin, having MIC = 7.45 +/- 0.58[micro]g/mL

Synthesis, pharmacological screening and computational analysis of some 2-[l-Indol-3-yl]-A [[un]substituted phenylmethylidene] acetohydrazides and 2-[l-Indol-3-yl]-7V[[un]substituted benzoyl/2-thienylcarbonyl] acetohydrazides

The undertaken research was initiated by transforming 2-[l-Indol-3-yl]acetic acid [1] in catalytic amount of sulfuric acid and ethanol to ethyl 2-[l-Indol-3-yl]acetate [2], which was then reacted with hydrazine monohydrate in methanol to form 2-[l-Indol-3-yl]acetohydrazide [3]. Further, The reaction scheme was designed into two pathways where, first pathway involved The reaction of 3 with substituted aromatic aldehydes [4a-o] in methanol with few drops of glacial acetic acid to generate 2-[l-Indol-3-yl]-AD-[[un]substitutedphenylmethylidene]acetohydrazides [5a-o] and in second pathway 3 was reacted with acyl halides [6a-e] in basic aqueous medium [pH 9-10] to afford 2-[l-Indol-3-yl]-AD-[[un]substitutedbenzoyl/2-thienylcarbonyl]acetohydrazides [7a-e]. All The synthesized derivatives were characterized by IR, EI-MS and !H-NMR spectral techniques and evaluated for their anti-bacterial potentials against Gram positive and Gram negative bacterial strains and it was found that compounds 7a-d exhibited antibacterial activities very close to standard Ciprofloxacin. The synthesized derivatives demonstrated moderate to weak anti-enzymatic potential against oc-Glucosidase and Butyrylcholinesterase [BChE] where, compounds 7c and 5c exhibited comparatively better inhibition against these enzymes respectively. Compounds 7a, 7d and 7e showed excellent anti-enzymatic potentials against Lipoxygenase [LOX] and their IC[5]o values were much lower than the reference standard Baicalein. Enzyme inhibitory activities were also supported by computational docking results. Compounds 5c, 7a, 7b and 7c also showed low values of % hemolytic activity as well, showing that these molecules were not toxic, indicating that these molecules can be utilized as potential therapeutic agents against inflammatory ailments

Synthesis, biological screening and molecular docking studies of some ethylated sulfonamides having 1,4-Benzodioxane moiety

The presented study comprises the synthesis of a new series of ethylated sulfonamides in which 1,4- benzodioxane moietyhas been incorporated. The reaction of 1,4-benzodioxane-6-amine [1] with ethane sulfonyl chloride [2] yielded N-[2,3-dihydrobenzo[1,4]dioxin-6-yl] ethanesulfonamide [3], which further on treatment with various alkyl/aralkyl halides, 4a-r, in N,N-dimethylformamide [DMF] and in the presence of lithium hydride [LiH] acting as a weak base and catalyst;yielded derivativesofN-alkyl/aralkyl substituted N-[2,3-dihydrobenzo [1,4] dioxin-6- yl] ethanesulfonamides [5a-r]. The characterization of these derivatives was carried out by different spectroscopic techniques like infra red, proton-NMR and mass spectrometry; then screened against various enzymes i.e. acetylcholinesterase, butyrylcholinesterase, lipoxygenase and alpha-glucosidase enzymes and five different bacterial strains. The synthesized compounds were found to be good inhibitors of lipoxygenase but moderate inhibitors of AChE, BChE and alpha-glucosidase; whereas compounds 3, 5a, 5f, 5n and 5r were found good antibacterial compounds. The interaction between inhibitors and target enzymes [cholinestrases and lipoxygenase] was computationally observed which correlated with the experimental results

Synthesis and antibacterial screening of S-substituted derivatives of 5-[3,4-methylenedioxyphenyl]-1,3,4-oxadiazol-2-thiol

The most emerging class among the heterocyclic compounds is 1,3,4-oxadiazoles for their diverse biological activities. In the present research work, piperonylic acid [1] was converted consecutively into corresponding ester [2], hydrazide [3] and 1,3,4-oxadiazole [4] through intermolecular cyclization. The synthesized compound 4 was subjected further to S-alkylation/aralkylation, using alkyl/aralkyl halides [5a-m] and S-substituted-1,3,4-oxadiazole derivatives were synthesized [6a-m]. The structure elucidation of the synthesized molecules was processed through [1]H-NMR, IR and mass spectral data. The antibacterial activity showed these molecules moderately good inhibitors of gram-negative and gram-positive bacteria

Synthesis of 2-[[5-phenyl-1,3,4-Oxadiazol-2-yl]sulfanyl]-N-substituted acetamides as potential antimicrobial and hemolytic agents

A new series of N-substituted derivatives of 2-[[5-phenyl-1,3,4-Oxadiazol-2-yl]sulfanyl] acetamides was synthesized. The synthesis was carried out by converting benzoic acid [1] into ethyl benzoate [2], benzohydrazide [3] and then 5-pheny-1,3,4-Oxadiazol-2-thiol [4] step by st0ep. The target compounds 6a-p were synthesized by reaction of compound 4 with equimolar ratios of different N-alkyl/aryl substituted 2-bromoacetamide [5a-p] in the presence of DMF and sodium hydride [NaH]. The spectral [EI-MS, IR, 1H-NMR] characterization of all the synthesized compounds reveal their successful synthesis. The compounds were also screened for antimicrobial and hemolytic activity and most of them were found to be active against the selected microbial species at variable extent relative to reference standards. But 6h was the most active against the selected panel of microbes. This series showed less toxicity and may be considered for further biological screening and application trial except 6m, possessing higher cytotoxicity

Ways to manage hepatitis C without cirrhosis: treatment by comparison of coded eastern medicine hepcinal with interferon alpha 2b and ribavirin

Hepatitis C virus [HCV] infection is a serious and significant global health problem in the Pakistan and elsewhere. In majority of cases HCV infection remains asymptomatic but in advance cases it may progress to fibrosis of liver, shrinkage of liver cells or failure of liver. The hepatitis C may progress to cause liver cirrhosis that mostly develop in 20% of the affected patients in 20 years with an increased risk in male, alcoholic drink, immune-compromised and who acquire HCV infection after the age of 40 years. This was an open-label prospective study conducted on 66 clinically and immunologically diagnosed cases of HCV infection. In Hepcinal treated group, there were significant improvement in HCV associated symptoms compared to control group [p<0.05]. While Interferon therapy resulted in significant improvement in serological response [55.88%] compared to Hepcinal treated patients [46.88%]. It was concluded that Hepcinal has shown better clinical response but no significant serological response [p=0.3244] and it might be an alternative therapy to treat hepatitis C infection and to prevent its progression into chronic ailment

Prevalence of hepatitis B and C seropositivity in patients presenting for dental treatment

The objective of this study was to determine the prevalence of hepatitis B and C among the patients who came for dental treatment to Bacha Khan Medical and Dental College, Mardan. Four hundred patients formed the study group. The blood samples of all these patients were taken in the hospital laboratory and were screened for HBsAg and Anti HCV using immunochromatography [ICT] method. The blood was collected by authorized technician and the sera were separated from the coagulated blood by centrifugation at 5000 rpm[revolution per minute] for 10 minutes at 4[degree]C and stored at -20[degree]C for further use. The HBV screening was based on the detection of antibodies against the related virus in the sera using enzyme immunoassays. HCV test is based on detecting viral specific antibodies in serum samples. Of 400 patients examined, 180 [45%] were females and 220[55%] were males. Their ages ranged from 15 to 60 years with a mean age of 33.61 +/- 15.41 years. The highest prevalence was found in lab. technicians and drivers [HCV=18% HBS=12%]. The prevalence of HCV and HBV was nearly equal [HCV=7.75% and HBV = 7.0%]. There was no statistical significant difference in prevalence of HCV and HBV in male and females

Comparative clinical study on the efficacy of biocor plus compared with simvastatin for the management of hypercholesterolemia

Hypercholestriolemia is major risk factor that enhances the incidence of cardiovascular disease and coronary artery disease. The present study was conducted to normalize the lipid profile in the blood by using Biocor Plus for hypercholesterolemia compared with Simvastatin. It was prospective randomized case control study conducted on 70 diagnosed patients of hypercholesterolemia at Sohail Memorial Hospital, Karachi and Amir Habib Medical Center and Maternity Home, Karachi. Patients of both genders [30-70 years] with clinical diagnosis of Hypercholesterolemia. Sample sizes for this study included total of 70 subjects. There was statistically significant difference when comparing the effectiveness of test drug, Biocor Plus to control drug, Simvastatin for the treatment of primary hypercholesterolemia. This is clearly evident that the herbal coded test drug, Biocor Plus possesses a therapeutic value for the treatment of primary hypercholesterolemia. There were no untoward or significant side effects associated with the use of Biocor Plus that proved its good acceptability by the patients. Moreover there was subjective feeling of wellbeing regarding breathlessness and chest tightness or pressure in the patients taking Biocor Plus. This makes an interesting point to focus on this effective alternative drug for primary hypercholesterolemia

Comparative clinical efficacy and safety of coded herbal medicine dermovix in the management of patients with atopic dermatitis versus allopathic medicine

Atopic dermatitis [AD] is defined as a chronic, highly pruritic inflammatory condition of skin. It is estimated that this disease may lead significant morbidity and also adversely affects the quality of life. Atopic dermatitis responds well to home treatment. Proper skin care reduces the need for medicines. Topical creams and oral antihistamines can be used to suppress the symptoms. The clinical trial was conducted on 60 patients in which 30 are control and 30 are test by taking written consent from them. Dermovix significantly improved skin symptoms associated with AD. This Dermovix ointment was safe and well tolerated in specified age group patients. Overall results of individual group were analyzed by using Paired sample t-test and level of significance of all the symptoms was calculated. Both the drugs showed similar efficacy and the calculated p value was p<0.05. Except in case of dry skin the test drug had shown not significant p value i.e. 0.407. When we compare all these and their effects and patients' complaints then Test group have shown better results because of no side effects

Concise review on the insight of hepatitis C

Hepatitis C is the disease of liver caused by hepatitis C virus [HCV]. Due to its widespread impact on human population, there is continued surge for new therapeutic agents to treat and reduce HCV. Hence, nowadays HCV is considered as global burden throughout the world. Advancements in therapeutic invention and clinical outcomes are dependent on HCV genome and diversity in nature, pathogenesis, dietary factors, social, economic and environmental factors. In this review we have focused mainly on HCV genome, its history and clinical outcomes from its discovery to present day research. In this article the authors have reviewed the published data from year 1997 to 2014. The topics of main concerns were hepatitis C with diverse nature and recent advances in the treatment of chronic hepatitis C. The authors used MeSH terms "Hepatitis C Virus [HCV]", recent advances in the treatment of "HCV", "HCV and Immunity", "vaccination", or "Interferon therapy" to search the PubMed database. All relevant studies identified were included and are described according to the subheadings. Recent advancement in molecular biology and experimental techniques has opened new insights into the pathophysiology of HCV which is helping in combating this life threatening disease. Although the response to current treatment regimen for HCV is improved however complete recovery from the disease is still a challenge which requires more extensive studies from basic science research to large multicenter clinical trials

Effectiveness of Ilizarov frame fixation on functional outcome in aseptic tibial non-union cases at Abha, Kingdom of Saudi Arabia: an experimental study

The Objective of the study is to evaluate the effect of Ilizarov frame fixation on functional outcome in aseptic tibial non-union cases. In this clinical study, 12 cases of posttraumatic aseptic tibial non-union were selected. After blood analysis and clinical assessment, the aseptic nonunion cases underwent ilizarov fixation for their problem. The pre and post-surgery functional outcome was measured by modified functional evaluation system by Karlstrom-Olerud. Out of the 12 patients, 3 females and 9 males, 5 had non-union of type A and were treated by compression technique. The other 7 had non-union of type B and were treated using bone-transport. Tibial union was achieved in all the cases. The functional outcome has shown 4 good, 2 satisfactory, 4 moderate and 2 poor. The Ilizarov technique is an effective method in treating the aseptic tibial non-union