Study of Effectiveness of Convalescent Plasma-therapy in Moderate to Severely ill COVID-19 Patients

Background : Convalescent Plasma-therapy, a classic adaptive immunotherapy used in the treatment of SARS, MERS and 2009 H1N1 pandemic with acceptable efficacy and safety in the past. Convalescent Plasma-therapy was taken into consideration in management of COVID-19 disease during the initial days of pandemic but was withdrawn later due to its doubtful beneficial role. This study aims to explore the beneficial role of Convalescent plasma and to determine whether Convalescent Plasma-therapy holds a second chance in treating SARS-CoV-2. Methods : This cross-sectional observational study includes 82 cases of moderate to severely ill COVID-19 patients who received Convalescent Plasma-therapy and 41 controls who didn抰. regular monitoring of Total Leukocyte Count (TLC), PaO2/FiO2 (PaO2 is partial pressure of Oxygen in arterial blood, fractional inspired oxygen (P/F ratio), Neutrophil to Lymphocyte Ratio (N/L ratio) inflammatory markers, respiratory rate, oxygen saturation, ABG and Radiological Imaging was done for comparative analysis. Results : In case group 39 patients (47.56%) were on oxygen mask, 17 patients (20.73%) on Non-invasive Ventilation (NIV), 9 Patients on Non-rebrether Mask (NRM) (10.97%), 16 patients (19.51%) on room air, 1(1.21%) on High Flow Nasal Cannula (HFNC) initially. After 7th day of Convalescent Plasma-therapy 49 patients (59.75%) were on room air which suggests significant improvement in mode of ventilation in case group as compared to Control Group. Mean respiratory rate in case group was 30.46 Cycles Per Minute (CPM) initially and 24.7 CPM on day 7th of Plasma-therapy which is statically significant. Conclusion : Plasma-therapy is effective if given in early stage of disease and Convalescent Plasma donors having adequate antibody titre.

Application of Novel Down-sampling Method in Retinal Vessel Segmentation / 中国医疗器械杂志

Accurate segmentation of retinal blood vessels is of great significance for diagnosing, preventing and detecting eye diseases. In recent years, the U-Net network and its various variants have reached advanced level in the field of medical image segmentation. Most of these networks choose to use simple max pooling to down-sample the intermediate feature layer of the image, which is easy to lose part of the information, so this study proposes a simple and effective new down-sampling method Pixel Fusion-pooling (PF-pooling), which can well fuse the adjacent pixel information of the image. The down-sampling method proposed in this study is a lightweight general module that can be effectively integrated into various network architectures based on convolutional operations. The experimental results on the DRIVE and STARE datasets show that the F1-score index of the U-Net model using PF-pooling on the STARE dataset improved by 1.98%. The accuracy rate is increased by 0.2%, and the sensitivity is increased by 3.88%. And the generalization of the proposed module is verified by replacing different algorithm models. The results show that PF-pooling has achieved performance improvement in both Dense-UNet and Res-UNet models, and has good universality.

Analysis of 74 Open Globe Injuries Requiring Vitreo-Retinal Intervention and Its Correlation with Ocular Trauma Score

Aim: Retrospective study of 74 eyes with open globe injuries requiring V-R Intervention & its correlation with ocular trauma score.Results: Commonest cause of injury: Hammer-chisel/stone in 32.43% (24) & Thorn/wooden stick 27% (20). Average age-30.5yrs. Average interval between trauma & intervention was -10.04days (4hrs – 52days).Discussion: Delay of presentation to ophthalmologist has lot of significance,high incidence of endophthalmitis & retinal detachment compared to other studies. Surgical outcome shows lower incidence of NO Light Perception & Significant reduction in number of cases with </=HM. Patients had better prognosis & visual outcome, higher incidence of 1/200- 20/50; 35.14% cases with >20/200. 60% of our cases had traumatic cataract, visual acuity may be underestimated in traumatic cataract. Faulty Projection of rays probably would be better criteria than RAPD. Extension of wound beyond pars plana, and aniridia (6.7%) are important risk factor.Conclusion: Modification of raw points is recommended in OTS criteria in Indian scenario.

Outcome of Pertrochanteric Femur Fractures with Proximal Femur Locking Compression Plate

Background: Fractures of the proximal femur, including fractures affecting the pertrochanteric region, have become a public health problem. Owing to aging of the population, we have to operate on even more elderly patients who sometimes present with significant co-morbidities. Although conventional implants have given good results in stable peritrochanteric fractures, proximal femur locking compression plate (PFLCP) which has been recently introduced is better suited for comminuted, unstable pertrochanteric fractures and osteoporotic bones. In PF-LCP, bone-implantconstruct so formed is mechanically stable and fixation failure due to screw loosening in osteoporotic bone can be reduced. Materials &Methods: This prospective study was conducted in our institute and was approved by local ethical committee. Twenty-five consecutive patients of either sex with age more than 60 years (range, 60-84) having pertrochanteric fractures were operated upon with PFLCP. A.O classification was followed in the study and Singh抯 index for osteoporosis was calculated. Operating time, blood loss and any technical difficulty with the implant were recorded. Patients were followed clinically and radiologically for union at fracture site and implant-related complications for a period of 24 months. The Harris Hip Score was used to document hip functions at final follow-up. Observations: Amongst the 25 patients, the average operation time in our study was 66.60�.57 minutes. The average radiological union was 3.40�63 months (13.6 weeks). Average time for full weight bearing was 13.12�90 weeks. There were two cases of wound infection, one case of coxa vara and one case of a proximal screw back-out. There was no case of plate lift or screw breakage. There was no case of non-union. Conclusion: The PFLCP can be a feasible alternative to the treatment of peritrochanteric fractures. Treatment with PFLCP can provide good-to-excellent healing in osteoporotic bones having comminuted and unstable peritrochanteric fractures, with a limited occurrence of complications.

Analysis of Pulmonary Fibrosis Animal Models Based on Clinical Characteristics in Traditional Chinese Medicine and Western Medicine / 中国实验方剂学杂志

This paper collated the western medicine and traditional Chinese medicine （TCM） diagnostic criteria of pulmonary fibrosis （PF） based on its clinical characteristics and relevant literature reports and summarized the inductive agents， methods， objects， and mechanisms for replicating the PF animal models as well as their respective advantages and disadvantages. By analyzing the consistency of symptoms among successfully modeled animal models with the clinical characteristics in TCM and western medicine， we found that the intratracheal injection of bleomycin was the most frequently employed method for modeling， and the resulting outcomes were very similar to clinical characteristics in TCM and Western Medicine. Besides， considering the time-saving process， high stability， good repeatability， and low cost， such method was suitable for the rapid screening of drugs. The second preferred method was intraperitoneal injection of paraquat， which exhibited the advantages of high degree of consistency with clinical characteristics of PF caused by paraquat poisoning， low cost， high success rate， and easy operation， which allowed it to be suitable for exploring the mechanism of paraquat poisoning and developing the antidotes. The existing PF animal models shared a fairly high degree of consistency in symptoms with patients diagnosed as having PF in western medicine. However， the criteria for TCM syndrome differentiation remained unclear， and the animal models failed to reflect TCM pathogenesis. It is necessary to establish more accurate TCM diagnostic criteria that focus on syndrome differentiation and reveal TCM etiology and pathogenesis and carry out more experiments concerning TCM syndromes of PF in the future， so as to better treat PF with integrated TCM and Western Medicine.

Prevalence of various dermatoses in pregnancy at a tertiary care centre in Moradabad, Uttar Pradesh, India: an observational study

Background: This was a prospective study which was done to observe various skin lesions in pregnancy and to determine the most likely causes and their incidence in antenatal patients, it was noticed that many women in our institute were having pregnancy related cutaneous complaints thus this observational study was carried out so that better preventive measures and treatment options could be provided to these patients.Methods: Study was conducted in out-patient department of Obstetrics and Gynaecology, TMU, Moradabad. All ANC cases between October 2017 to September 2018 having any type of dermatoses were included in the study irrespective of gestational age. 6348 patients appeared in OPD in the given time period out of which 1256 were included. In case of pruritus, liver function tests were done with USG whole abdomen and patients were reviewed by physician if required. Screening with VDRL, HCV, HbSAg and ELISA for HIV was done in all. Results were tabulated and analyzed.Results: 50.8% primi gravidas ,49.2% multi gravidas. age range 18-38 years. 29.3% presented in third trimester ,25.6% presented in second trimester. Physiological changes seen in all cases, 8.68% specific dermatoses of pregnancy. 40.4 % no complaints, 5.65% melasma, 90.8% hyperpigmentation, 94.6% linea nigra. Secondary areola 89.3%,striae 80.3% out of which 38.9%- primi gravidas and 41.40% -multi gravidas. 92.9% no change in hair density. Montgomery’s tubercles 30-50% of cases. spiders nevi 67%. No cases of palmar erythema. Pruritus gravidarum 38.53%. PUPPP 28.4%. Pemphigoid Gestationis 9.17%. Prurigo of pregnancy 18.34%. Pruritic folliculitis 1.8%. Eczema in pregnancy : pre-existing in 3.7% , out of which exacerbation 1, 3 unaffected. 3 chicken pox.1 filariasis.24 herpetic lesions (herpes simplex).1 scleroderma.17.27% pre-existing taenia infection . Scabies 20.46%.11 0.87% dual infection (scabies-taenia).Conclusions: This study highlights high prevalence of community acquired infections in our region like taenia, scabies giving rise to skin lesions in Antenatal women. Moreover, it highlights a probable association between the prevalence of skin lesions with factors like poor personal hygiene, overcrowding, low socioeconomic status, anaemia and poor nutritional status.

Comparison of the Efficacy and Safety Profiles of a Mixed ‘PF-72’ and ‘0.75% Ropivacaine HCl’ Versus a ‘0.75% Ropivacaine HCl’ and No Treatment Group: A Randomized, Single-Blind, Single-Institution Pilot Study

STUDY DESIGN: Prospective pilot study OBJECTIVES: The efficacy and safety of ‘PF-72’ for management of postoperative acute pain through a mixed ‘PF-72’ and 0.75% ropivacaine hydrochloride solution in patients with posterior spine surgery was evaluated as ‘0.75% ropivacaine’ and ‘untreated’ controls. SUMMARY OF LITERATURE REVIEW: Postoperative acute pain is major surgical side effect that lead to the deterioration of the quality of life. Traditional pain control results in variable side effects, and multimodal pain management has been recommended as an alternative. Local anesthetics is a short-acting time lower than 12 hours. There is controversy about the efficiency and stability of thermoreactive hydrogel products as a drug delivery system. MATERIALS AND METHODS: Patients scheduled for posterior spine surgery were enrolled by the inclusion criteria. In the treated group, PF-72 and ropivacaine mixture was injected to the surgical wound before closure. In control group 1, only 0.75% ropivacaine hydrochloride was injected. In the control group 2, the surgical site was without injection. Ten patients were randomly assigned to each group and standardized drugs for pain control were applied postoperatively and rescue regimens were applied when necessary. Postoperative pain score and the cumulative area under the curve (AUC) of pain score were compared. The percentage of subjects who were painless (pain score ≤ 3) was examined at each observation point. The first time of injection and the total dose of the rescue regimen were examined. Postoperative nausea and vomiting (PONV) were also evaluated. RESULTS: There was no significant difference in demographic data. The sum AUC of pain scores in the treated group was significantly lower than that in the control group 1 and 2 at all observation times. The proportion of painless patients was significantly higher in the treated group than in the control group 2. There was no significant difference between the first administration time and the total usage of the rescue regimen, and the percentage of patients with PONV at all time points. There was no statistically significant difference in the incidence of adverse events. CONCLUSIONS: PF-72 and ropivacaine mixture showed significant effects for pain management up to 72 hours postoperatively for the patients who underwent posterior spinal surgery without fatal complications.

PF-04620110, a Potent Antidiabetic Agent, Suppresses Fatty Acid-Induced NLRP3 Inflammasome Activation in Macrophages

BACKGROUND: Chronic inflammation has been linked to insulin resistance and type 2 diabetes mellitus (T2DM). High-fat diet (HFD)-derived fatty acid is associated with the activation of chronic inflammation in T2DM. PF-04620110, which is currently in phase 1 clinical trials as a selective acyl-CoA:diacylglycerol acyltransferase-1 (DGAT1) inhibitor, is a potent anti-diabetic agent that may be important for the regulation of chronic inflammation in T2DM. However, the mechanisms by which PF-04620110 regulates fatty acid-induced chronic inflammation remain unclear. METHODS: PF-04620110 was used in vitro and in vivo. DGAT1-targeting gRNAs were used for deletion of mouse DGAT1 via CRISPR ribonucleoprotein (RNP) system. The activation of NLRP3 inflammasome was measured by immunoblot or cytokine analysis in vitro and in vivo. RESULTS: Here we show that PF-04620110 suppressed fatty acid-induced nucleotide-binding domain, leucine-rich-repeat-containing receptor (NLR), pyrin-domain-containing 3 (NLRP3) inflammasome activation in macrophages. In contrast, PF-04620110 did not change the activation of the NLR family, CARD-domain-containing 4 (NLRC4), or the absent in melanoma 2 (AIM2) inflammasomes. Moreover, PF-04620110 inhibited K⁺ efflux and the NLRP3 inflammasome complex formation, which are required for NLRP3 inflammasome activation. PF-04620110 reduced the production of interleukin 1β (IL-1β) and IL-18 and blood glucose levels in the plasma of mice fed HFD. Furthermore, genetic inhibition of DGAT1 suppressed fatty acid-induced NLRP3 inflammasome activation. CONCLUSION: Our results suggest that PF-04620110 suppresses fatty acid-induced NLRP3 inflammasome activation.

Tobacco Growth Promotion by the Entomopathogenic Fungus, Isaria javanica pf185

Isaria javanica pf185 is an important entomopathogenic fungus with potential for use as an agricultural biocontrol agent. However, the effect of I. javanica pf185 on plant growth is unknown. Enhanced tobacco growth was observed when tobacco roots were exposed to spores, cultures, and fungal cell-free culture supernatants of this fungus. Tobacco seedlings were also exposed to the volatiles of I. javanica pf185 in vitro using I-plates in which the plant and fungus were growing in separate compartments connected only by air space. The length and weight of seedlings, content of leaf chlorophyll, and number of root branches were significantly increased by the fungal volatiles. Heptane, 3-hexanone, 2,4-dimethylhexane, and 2-nonanone were detected, by solid-phase micro-extraction and gas chromatography-mass spectrophotometry, as the key volatile compounds produced by I. javanica pf185. These findings illustrate that I. javanica pf185 can be used to promote plant growth, and also as a biocontrol agent of insect and plant diseases. Further studies are necessary to elucidate the mechanisms by which I. javanica pf185 promotes plant growth.

The differential roles of caspase family members in mediating PF4-induced breast cancer apoptosis

@#Introduction: This study focused on PF4 effects on caspase-3,-6, -7, -8 and -9 which regulate the apopotosis process in breast cancer. Materials and Methods: Breast tumours were induced in forty 21-day-old female Sprague Dawley rats (SDRs) using MNU until tumour size reached 14.5 mm (SD: 0.5 mm). The rats were then divided into two groups: Group 1 (control injected with 0.9% saline; n = 20), and Group 2 (platelet factor 4 (PF4); n = 20). PF4 was administered through focal intralesional injection at 20 µg/lesion dose. Following 5-day treatment, the SDRs were sacrificed. Subsequently, representative sections from the tumour were obtained for haematoxylin and eosin (H&E) staining. The expressions of caspase-3, -6, -7, -8 and -9 were evaluated using immunohistochemistry (IHC) staining. Results: The majority of breast tumour specimens were of aggressive types [ncontrol = 13 (65%); nPF4 = 12 (60%)]. Invasive ductal carcinoma not otherwise specified (IDC-NOS) was the most commonly observed breast tumour histology for control and PF4 groups (n = 8 (40%) in respective groups). PF4-treated group exhibited significant differences in the caspase-3, -6 and -8 expression levels compared to the control group (all p < 0.001). There were no significant differences in caspase-7 (p = 0.347) and caspase-9 (p = 0.373) expression levels between both groups. Conclusion: This study found that PF4 acts via the caspase-mediated extrinsic apoptosis pathway without the involvement of the intrinsic pathway.

Application of P/F Brass ratio method in the context of fast-paced adolescent fertility decline / Aplicación de la técnica P/F de Brass en un contexto de rápida caída de la fecundidad adolescente / Aplicação da técnica P/F de Brass em um contexto de rápida queda da fecundidade adolescente

Abstract Adolescent fertility -fertility rates at ages 15-19- fell substantially (around 30 percent) between 2000 and 2010. It was the first time Brazil experienced such a decline in those ages since 1970, when the census included one question about children born in the past 12 months. This phenomenon has an important implication for the P/F Brass ratio technique: it underestimates the cumulated current fertility up to age group 20-24 (F2), considering this cohort's previous fertility experience. Therefore, the P2/F2 value, used as an adjustment factor for the reported fertility level, is significantly overestimated. This paper discusses this issue and proposes an alternative to correct the reference period error in the 2010 Demographic Census in Brazil. The results of applying the proposed alternative in this specific context were very similar to those obtained using different techniques, thus supporting the strength of our alternative.

Resumo O Brasil experimentou, entre 2000 e 2010, pela primeira vez desde 1970, quando se introduziu o quesito sobre filhos nascidos vivos nos 12 meses anteriores à data de referência do censo, queda significativa (em torno de 30%) das taxas específicas de fecundidade declarada das mulheres entre 15 e 19 anos (f*1). Esse fenômeno tem uma importante consequência para a aplicação da técnica P/F de Brass: gera um erro, por falta, na fecundidade corrente acumulada até o grupo etário de 20 a 24 anos (F2), se tomada como experiência pregressa dessa coorte, levando a um valor de P2/F2, usado para ajustar o nível da fecundidade declarada, significativamente sobrestimado. O presente trabalho discute detalhadamente este problema e, por fim, propõe uma alternativa para se corrigir o erro de período de referência da fecundidade corrente do Censo Demográfico de 2010 do Brasil. A alternativa proposta, neste contexto específico, gerou estimativas de taxa de fecundidade total muito próximas às produzidas por outras técnicas.

Resumen Por la primera vez desde 1970 —cuando se introdujo la pregunta sobre nacidos vivos en los 12 meses anteriores a la fecha de referencia del censo— Brasil experimentó, entre 2000 y 2010, una disminución significativa de aproximadamente 30% de las tasas específicas de fecundidad declarada de mujeres entre 15 y 19 años (f*1). Este fenómeno trae una consecuencia importante para la aplicación de la técnica P/F de Brass: genera un error por falta en la fecundidad actual acumulada para el grupo de edad de 20 a 24 años (F2), lo que concomitantemente provoca una significativa sobrestimación en el valor de P2/F2 —utilizado para corregir el nivel de la fecundidad declarada—. Este trabajo discute este problema y propone finalmente una adaptación de la técnica original de Brass para aplicarla a los datos del censo de 2010. La alternativa propuesta generó, en este contexto específico, estimaciones de la tasa global de fecundidad similares a las producidas por otras técnicas.

Role of SphK1 in renal tubulointerstitial fibrosis and its mechanism / 中国药理学通报

Aim To investigate the effect of sphingo-sine kinase 1 (SphK1 )on unilateral ureteral obstruc-tion(UUO)-induced tubulointerstitial fibrosis and ex-plore the possible mechanism.Methods The CD-1 mice were randomly divided into four groups:sham-op-eration group(Sham),PF-543 treatment control group (Sham +PF-543),model group(UUO)and PF-543 treatment group(UUO +PF-543).On 1 ,3,7 and 1 4 d after operation,eight mice were selected randomly from each group and sacrificed.The protein expressions of SphK1 ,mature TGF-β1 ,FN,ColⅠ,LC3,Beclin1 ,Atg5 and Atg1 2 were observed by Western blot.The histo-logical changes were examined by Masson′s trichrome stain.Immunhistochemistry was performed to measure the levels of expression of SphK1 ,FN and Col Ⅰ. Transmission electron microscope was used to observe the autophagic body.Results SphK1 expression and autophagy were both upregulated in a mouse model of kidney fibrosis induced by UUO. Meanwhile, in-creased mature TGF-β1 and deposition of extracellular matrix(ECM)were observed in tubulointerstitial areas compared with sham-operated mice.After intraperito-neal injection with the SphK1 specific inhibitor PF-543 in UUO mice,enhanced expression of SphK1 and acti-vated autophagy were significantly abrogated.Howev-er,aggravation of renal fibrosis was detected when SphK1 inhibitor PF-543 was applied to suppress SphK1 expression in UUO mice.Conclusion SphK1 activa-tion is renoprotective through the induction of autoph-agy in the pathogenesis of kidney fibrosis.

The collection and analysis research of quality control data for using ventilator in hospital / 中国医学装备

Objective:To collect and analyze the quality control data of ventilator, so as to apply these statistical data to guide the maintenance and management of ventilator.Methods: The displayed value and monitoring value of the tidal volume, respiratory frequency, inspiratory oxygen concentration, inspiratory pressure level and positive end expira tory pressure (PEEP) under different setting of 50 using ventilators in hospital were collected by using PF-300 gas analyzer, and then each parameter was analyzed as classification.Results: The total quality rate of ventilators was 80%, the ranking of quality rate as different brand was: brand B>brand A>brand C, and it was as different department: department 5>department 4=department 3>department1>department2, and the quality rates of less than 3 years and more than 3 years were 87% and 77%, respectively, as service life of ventilator. And the ranking of quality rates as parameters of ventilator was: PEEP=respiratory frequency >peak pressure>tidal volume >oxygen concentration. It was as accuracy of monitoring: brand A>brand C>brand B. It was as stability of monitoring: brand A>brand B=brand C. On the other hand, it was as the accuracy of displayed value: brand A>brand B>brand C, while it was as the stability of displayed value: brand A>brand C>brand B.Conclusion: The analysis of quality control data only suits to the ventilator which is used in our hospital. The engineer can targeted to strengthen the ventilator maintenance work and improve the quality and safety of equipment, so as to give the better service for patients according to quality control data of using ventilators in hospital.

Concurrent raltitrexed plus oxaliplatin and radiotherapy versus PF synchronous radio-therapy on advanced esophageal cancer / 中国肿瘤临床

Objective:To compare the therapeutic and adverse effects of concurrent raltitrexed plus oxaliplatin and radiotherapy with those of PF synchronous radiotherapy in the treatment of advanced esophageal cancer. Methods:A total of 84 pathologically con-firmed patients with advanced esophageal carcinoma were randomly distributed to the concurrent raltitrexed plus oxaliplatin and ra-diotherapy group (experimental group, n=40) and to the PF synchronous radiotherapy group (control group, n=44). All patients were treated with 3DCRT at a total dose of 60 Gy/30f. The chemotherapy in the experimental group consists of raltitrexed at 2.5 mg/m2, d1, plus oxaliplatin at 130 mg/m2, d2. The chemotherapy of the control group consists of DDP at 25 mg/m2, Dd1-3, plus 5-FU 500 mg/m2, d1-5. Two cycles of concurrent chemotherapy were administered during radiotherapy on d1 and d29. The comparison results were used to estimate the therapeutic and adverse effects of the two groups. Results:The rerponse rate, complete response, and one-year overall survival rate of the experimental group were higher than those of the control group [(87.50%vs. 79.54%, P=0.3293), (32.50%vs. 18.18%, P=0.13), and (82.50%vs. 79.50%, P=0.701)], but the difference was not statistically significant. The incidence rates of nau-sea and vomiting, appetite degression, leucopenia, radiation-induced esophagitis, and cardiotoxicity were significantly lower (P0.05). Conclusion:Simi-lar to PF chemotherapy and radiotherapy, the concurrent raltitrexed plus oxaliplatin and radiotherapy achieved a similar short-term therapeutic effect but lower adverse effects on patients with esophageal cancer.

Distribution and homology of foodborne-associated extended-spectrumβ-lactamases-producing Escherichia coli / 中国感染控制杂志

Objective To study the distribution and homology of foodborne-associated extended-spectrumβ-lacta-mases (ESBLs)-producing Escherichiacoli (E. coli).Methods ESBLs-producing E. coli were isolated from differ-ent food specimens in Shaoguan from 2014 to 2015,strains were typed with pulsed-field gel electrophoresis (PFGE) and BioNumerics software.Results 1 1 strains of diarrhea-causing E. coli and 29 strains of ESBLs-producing E. co-li were isolated from 347 different sources of food specimens. PFGE analysis showed that 29 strains could be divided into 21 cluster groups,group A was predominant pattern,which included 7 strains(J2,J3,J4,J7,J9,B4,S3), group B included 2 strains (J6,J8),the other strains were sporadic clones. Similarity coefficient (SC)of 3 strains (J2,J7,J9)from health practitioners was 100% ,SC of strains from drinking water and patients with diarrhea (B4) was 97. 1% ,SC of S3 strain and 4 strains (J2,J3,J7,J9 )from health practitioners were all>90. 0% . Conclusion Foodborne-associated ESBLs-producing E. coli are widely distributed in food,water,animal,and pop-ulations,and can be transmitted through food chain,surveillance should enhanced to avoid further spread.

Tratamiento exitoso con fondaparinux en trombocitopenia inducida por heparina y trombosis / Successful treatment with fondaparinux in heparin-induced thrombocytopenia and thrombosis

La trombocitopenia inducida por heparina (TIH) es una reacción adversa inmunológica caracterizada por trombocitopenia y la asociación paradojal de trombosis arterial o venosa. Es causada por la formación de anticuerpos IgG contra el complejo multimolecular de heparina-factor plaquetario 4 (FP4). Fondaparinux es un inhibidor selectivo del factor Xa que tiene escasa afinidad por el FP4 y posee un menor potencial para inducir una respuesta inmunológica, haciendo del mismo un agente potencialmente útil en el tratamiento de la TIH. Se presenta el caso de una mujer de 73 años con TIH asociada a fenómenos trombóticos arteriales y venosos, que recibió exitosamente fondaparinux, con normalización del recuento plaquetario y sin progresión trombótica.

Heparin induced thrombocytopenia (HIT) is an immune-mediated adverse reaction characterized by thrombocytopenia and paradoxical arterial or venous thrombosis, due to the formation IgG antibodies directed to a multimolecular complex of heparin-platelet factor 4 (PF4). Fondaparinux is a selective factor Xa inhibitor with little affinity for PF4 and thus less likely to induce an immune response, making fondaparinux a potentially useful drug for the treatment of HIT. Herein we report the case of a 73 years old woman with HIT associated with arterial and venous thrombosis that was successfully treated with fondaparinux, with normalization of the platelet countand without progression of thrombosis.

Liberación de pravastatina sódica formulada en matrices poliméricas a base de Quitosan/Pluronic F ̶ 127 / Release of pravastine sodium formulated in polymer chitosan/pluronic f-127 matrices

Introducción: el desarrollo de medicamentos transdérmicos manifiesta gran interés en los últimos años debido a las ventajas que ofrece; sin embargo, muchos de los sistemas desarrollados utilizan componentes solubles lo cual podría llevar a una ineficacia terapéutica si la matriz polimérica del sistema se solubiliza muy rápido, por ello se ensayan polímeros insolubles que permitan modular la liberación de un ingrediente farmacéuticamente activo. Objetivo: evaluar la liberación de pravastatina sódica en matrices poliméricas insolubles de quitosan/PF-127 con el método de paleta sobre disco para obtener su perfil cinético de liberación, con la finalidad de proponerse como matrices viables para la elaboración de parches transdérmicos. Métodos: se realizaron estudios de contenido químico, diámetro y espesor de las películas, calorimetrías de barrido diferencial y estudios de liberación. La cuantificación del principio activo se realizó mediante espectrofotometría UV-Vis a 238 nm. Resultados: se obtuvieron parches transdérmicos con buena uniformidad de contenido, espesor, diámetro, con una buena estabilidad en base a los estudios de calorimetría. El uso de PF-127 incrementó o retardó la liberación de pravastatina de la matriz polimérica dependiendo de su concentración y al realizarse los perfiles cinéticos de liberación las formulaciones se ajustaron a una cinética de orden 0 que describe el comportamiento de algunos sistemas transdérmicos. Conclusiones: los resultados manifiestan la posibilidad de usar esta matriz polimérica insoluble de quitosana con PF-127 para modular la liberación de pravastatina sódica y de fármacos con estructura similar a la misma por vía transdérmica, lo que generará de esta manera nuevas alternativas a las formas farmacéuticas orales para el tratamiento de padecimientos y enfermedades(AU)

Introduction: the development of transdermal drugs has aroused great interest in recent years due to their advantages, however many of the drug delivery systems use soluble matrix components which could trigger therapeutic problems due to a rapid release of the active ingredient. Therefore, insoluble polymers are being tested that can modulate the release of a pharmaceutically active ingredient. Objective: to evaluate the release of pravastatin sodium in insoluble polymer chitosan/PF-127 matrices by VER to obtain kinetic profile of release in order to submit them as viable systems for the manufacture of transdermal patches. Methods: studies on the chemical content, diameter and thickness of films, differential scanning calorimetry and release studies were performed. The UV-Vis spectrophotometry at 238 nm allowed quantitating the active principle. Results: transdermal patches with adequate uniform drug content, suitable thickness and diameter with good stability, based on calorimetric studies, were obtained. The use of PF-127 increased or delayed the release of pravastatin sodium from the polymeric matrix depending on concentration. When performing the kinetic profiles of release, the formulations were regulated to zero kinetic that describes the behavior of some transdernal systems. Conclusions: the results demonstrated the possibility of using these insoluble polymer chitosan/PF-127 matrices to modulate the release of pravastin sodium and of other structurally similar drugs, thus creating new alternatives to existing pharmaceutical oral forms for treatment of diseases(AU)

Assessing the Performance Characteristics of the “CareStartTM Malaria HRP2 pf (CAT NO: G0141, ACCESSBIO)” Rapid Diagnostic Test for Asymptomatic Malaria in Mutengene, Cameroon.

Aim: The aim of this study was to determine the prevalence and density of malaria parasites in asymptomatic school children in Mutengene and evaluate the performance characteristics of the ‘CareStartTM Malaria HRP2 pf (CAT NO: G0141, ACCESSBIO)’ rapid diagnostic test (RDT) using light microscopy as a gold standard. Study Design: The study was a cross-sectional survey. Place and Duration of Study: The study was carried out in Mutengene, from February to March, 2013. Methodology: A total of 406 pupils were studied. Demographic data was taken for each child and capillary blood was collected. Blood films were prepared for the assessment of parasite density and speciation. A drop of blood was used on the RDT to determine the malaria status. Results: The mean age at 95% confidence interval (CI) was 8 ± 2 years (range = 4 -15 years) and the overall prevalence of malaria was 39.9% (162) by microscopy. The geometric mean parasite density (GMPD) was 2332.7 parasites/µL (range: 218 - 16000). Only 386 pupils were examined by both methods. More pupils were positive by microscopy (40.9%, CI = 36.1 - 45.9) than by RDT (27.9%, CI = 23.7 - 32.7) and the difference was statistically significant (χ2 = 16.1, P <0.0001). The majority of those detected had high infection (≥ 5000 parasite/µL). Less than 50% of those with low (25.0%, CI = 12.0 - 44.9), moderate (40.7%, CI = 32.24-49.70) and high parasitaemia (75%, CI = 5.00-89.82) were positive by RDT and the difference was significant (χ2 = 10.09, P = 0.006). The RDT showed a low sensitivity of 48.5% (CI = 40.3 – 56.9%) and specificity of 84.0% (CI = 80.0- 88.2%). Conclusion: More research needs to be done on the RDT to improve on its performance characteristics before it could be used in mass surveillance programmes.

Characterization of oleic acid-induced acute respiratory distress syndrome model in rat.

Animal studies using oleic acid (OA) model to produce acute respiratory distress syndrome (ARDS) have been inconsistent. Therefore, the present study was undertaken to establish an acute model of ARDS in rats using OA and to characterize its effect on cardio-respiratory parameters and lethality. The trachea, jugular vein and femoral artery of anesthetized adult rats were cannulated. A dose of OA (30-90 µL; iv) was injected in each animal and changes in respiratory frequency (RF), heart rate (HR) and mean arterial pressure (MAP) were recorded. Minute ventilation and PaO2/FiO2 (P/F) ratio were also determined. At the end, lungs were excised for determination of pulmonary water content and histological examination. At all doses of OA, there was immediate decrease followed by increase in RF, however at 75 and 90 µL of OA, RF decreased abruptly and the animals died by 63 ± 8.2 min and 19 ± 6.3 min; respectively. In all the groups, HR and MAP changes followed the respiratory changes. The minute ventilation increased in a dose-dependent manner while the values of P/F ratio decreased correspondingly. Pulmonary edema was induced at all doses. Histological examination of the lung showed alveolar damage, microvascular congestion, microvascular injury, infiltration of inflammatory cells, pulmonary edema and necrosis in a dose-dependent manner. With these results, OA can be used to induce different grades of ARDS in rats and OA doses of 50, 60 and 75 µL resemble mild, moderate and severe forms of ARDS respectively. Hence, OA model serves as a useful tool to study the pathophysiology of ARDS.

Correlation of thrombocytopenia in urban childern with malaria.

Background: Malaria, is endemic in Surat, (an industrious city of Gujarat), which is categorised under High risk zone. Malaria affects all blood components and is a true haematological disease. Thrombocytopenia and anaemia are the most frequently malaria associated haematological complications of malaria. Aims & Objective: To study the occurrence, severity and correlation of Thrombocytopenia in urban children with malaria. Materials and Methods: A retrospective study was conducted at Surat Municipal Institute Of Medical Education and Research (SMIMER) , Surat Gujarat . The Data of all smear positive and Rapid Diagnostic Test positive malaria cases of age between 1 and 17 year admitted in the Deptt. Of Pediatrics were collected. These patients were further assessed for thrombocytopenia, its severity, its relation with type of malaria and age. Results: Thrombocytopenia was observed in 233 (74%) cases of Malaria of which P. vivax was in 103 (44%) cases, P. falciparum in 130(56%) cases. Severe thrombocytopenia was observed in 22% and 29% cases of Pv and Pf malaria respectively. Sensitivity of thrombocytopenia in Pv and Pf was 71.53% and 76.92% whereas specificity was 66.67 for both respectively. Sensitivity of thrombocytopenia in Pv increased as the platelet count decreased. Conclusion: Thrombocytopenia is a frequent overall manifestation of both falciparum and Vivax malaria Severe Thrombocytopenia should alert one to consider a possibility of malaria in children.