Rectus sheath hematoma – An uncommon complication following caesarean delivery.

Rectus sheath hematoma is a well documented clinical entity, though uncommon and often clinically misdiagnosed cause of acute abdomen. The non-specific nature of presentation combined with a lower incidence of the disorder leads to difficulty in diagnosing. Our patient presented with rectus sheath hematoma, following caesarean section on 9th post-operative day. She presented with wound discharge and lower abdominal pain. The case report is presented to increase the awareness in considering this entity in the differential diagnosis and management of acute lower abdominal pain. Rectus sheath hematoma’s early diagnosis and appropriate treatment may help to prevent complications.

Development and evaluation of an in vivo assay in Caenorhabditis elegans for screening of compounds for their effect on cytochrome P450 expression.

Most drugs and xenobiotics induce the expression of cytochrome P450 (CYP) enzymes, which reduce the bioavailability of the inducer and/or co-administered drugs. Therefore, evaluation of new drug candidates for their effect on CYP expression is an essential step in drug development. The available methods for this purpose are expensive and not amenable to high-throughput screening. We developed a fluorescence-based in vivo assay using transgenic Caenorhabditis elegans worms that express the green fluorescent protein (GFP) under the control of various CYP promoters. Using this assay, we found striking similarities between the worm CYPs and their human orthologs in their response to treatment with various drugs. For example,the antibiotic rifampicin, one of the strongest inducers of the human gene CYP3A4, was the strongest inducer of the worm ortholog CYP13A7. Since worms can be easily grown in liquid medium in microtitre plates, the assay described in this paper is suitable for the screening of a large number of potential lead compounds in the drug discovery process.

Factors predicting occult bacteremia in young children.

A febrile child without a definite localizing sign of infection may be in initial phase of bacteremia which unless treated would result in systemic complication. These instances are referred to as "Occult bacteremia". The common pathogens isolated in these children are Streptococcus pneumoniae, Hemophilus influenzae and Neisseria meningitidis. A hundred consecutive children in the age group of 3-36 months attending pediatric outpatient department and casualty were clinically evaluated using AIOS (acute illness observation scale) score and were subjected to complete blood counts, smear for malarial parasites, ESR and blood culture. In the 19-month study period, 4 instances of occult bacteremia were identified. Streptococcus pneumoniae was cultured in 3 cases and H. influenzae in one. A febrile and toxic child in the age group of 3-36 months has a high risk of occult bacteremia. High fever of temperature > or = 102 degrees F, ESR > or = 15 mm/hour, and total leukocyte count > or = 15,000/mm3, in a child with AIOS score of > or = 10 may be considered for more detailed investigations and early intervention with antimicrobial therapy.