Optimization of registry records [registration of patients] of hemodialysis patients it in the country

Background and Aim: Establishment of registry system is an important criterion for health care management system. In this study we extended registry system which included only a few items of personal information

Data concerning epidemiologic issues and important criteria influencing the status of these patients were collected

Materials and methods: In a cross-sectional study, in cooperation with the specific diseases and organ transplantation management of Ministry of Health and Medical Education, we collected and studied data of the hemodialysis patients in our country

This study included 18,160 patients from 428 dialysis departments

We collected demographic, clinical and laboratory data including demographic characteristics, disease duration, cause of renal disease and recorded serum levels of hemoglobin, calcium, PTH, ferritin and, during a period of 2 months

Using SPSSv.18 software data were analyzed by t-test

Results: The mean age of the patients was 67.86 +/- 16.7 years. The most common causes of ESRD were diabetes [37.35%] and hypertension [23.9%] respectively. 2.2 percent and 3.06 percent of the patients were positive for HBSAg and HCVAb respectively

Most patients [75.7%] had been on dialysis 3 times a week. Hemoglobin levels were less than 10 mg / dl in 42.3 % of the patients . 20.3 % of the patients had calcium levels of less than 8 mg/dL PTH level was more than 300mg/dl in 22.6% of the patients

Conclusion: Poor control of hemoglobin, albumin, ferritin, etc., as predictors of survival in hemodialysis patients can lead to higher mortality and development of cardiovascular disease in these patients

Control of diabetes and high blood pressure can be effective in reducing the incidence of ESRD

Effect of hydro alcoholic extract of Plantago major L. on pentilentetra/ol-induced seizures in male mice

Background and Objective: Epilepsy is a common neurological disorder. Plantago major [P.major] is used in traditional medicine due to flovonoids and vitamic C and antioxidant properties. This study was done to evaluate the hydro alcoholic extract of Plantago major L. on pentilentetrazol-induced seizures in male mice

Methods: In this experimental study, 50 NMRI male mice randomly allocated into control and four experimental groups. Seizures in animals induced by 60 mg/kg/bw of pentilentetrazol [PTZ], interperitoneally. Animals in experimental groups were received 5, 10, 25 and 50 mg/kg/bw of hydro alcoholic extract of Plantago major L. 30 min before each PTZ injection. The animals in control group were received saline, interperitoneally. After treatment, the behavior of animals during 20 minutes and mortality rate were recorded

Results: Seizure threshold of animals significantly increased in experimental groups which were received 50, 25, 10 mg/kg/bw of P.major extract in comparision with controls [P<0.05]. Mortality rate of animals significantly reduced in experimental groups which were received 50, 25, 10 mg/kg/bw of P, major extract in comparision with controls [P<0.05]

Conclusion: The hydro-alcoholic extract of Plantago major L. reduces seizure threshold in pentilentetrazol-induced seizures mice

[Evaluation of maximum levator resection in management of severe Blepharoptosis]

Objective: To study the efficacy of maximal levator resection in patients with severe ptosis with poor levator function [LF]

Patients and methods: 31 patients with severe ptosis underwent maximal levator resection.Palpebral fissure height and LF were assessed preoperatively and postoperatively. Results: All patients showed an excellent reduction in ptosis with a single intervention resulting in a clear visual axis. Palpebral fissure height improved from means [SD] 2.98 preoperatively to 7.70 postoperatively [P value <0.001], No patients underwent additional surgery because of cosmetic issues. All patients showed a marked, consistent, and lasting improvement in LF, going from mean [SD] 2.60 preoperatively to 7.82 postoperatively [P value < 0.001]

Conclusions: Maximal levator resection is an effective surgical technique in management of patients with severe ptosis with good cosmetic appearance in terms of ptosis reduction in the majority of cases and with a significant increase of the levator palpebrae superioris function

Breastfeeding practice in Kuwait: determinants of success and reasons for failure

To explore the possible determinants of duration of breastfeeding in Kuwait, 234 mothers completed a questionnaire concerning the feeding of their youngest infant. The questionnaire addressed the factors that contributed to their willingness to continue breastfeeding and enquired about the factors leading to their decision to end it. Only 26.5% of the mothers had continued breastfeeding for 6 months or more. Separate family housing, higher maternal age, late initiation of breastfeeding, being employed without the feasibility to breastfeed at work, breastfeeding information given after rather than before birth, and maternal and infant sickness were all significant contributors influencing early cessation. Father's support was a significant factor that encouraged the practice. In conclusion, preventive strategies are recommended for boosting breastfeeding, with special emphasis on the factors linked to early cessation, aiming at full implementation of the WHO global public health recommendations for successful breastfeeding in Kuwait

[ patient's satisfaction and understanding from received trainings in hospitals of Gonabad university of medical sciences]

Introduction: Training to patient is one of the essential principles in taking care of patient. Nurses have to do their training role, for providing patient satisfaction, increasing gaining in health and reducing recon fining to bed. So this research has done with the aim of examination of Patient's satisfaction and understanding from received training in hospitals Gonabad university of medical sciences

Method: This is a cross sectional study done on Quota samples [384] the patient on discharge from Gonabad hospitals. Data collected by a questionnaire that they compiled just for this purpose and they were reliable and confidant scientifically. They analyzed by means of SPSS software version 16 and ways of descriptive and analytic statistics at the significant level P<0.05

Results: The most training function of therapy staff was in pharmaceutical therapy and following therapy after discharging from hospital. The least trainings were about type and quality of diet, prevention of disease and quality of doing religious duties. Also the average and standard deviation of satisfaction from training function of physicians and nurses were 33.42 +/- 6.04 and 32.6 +/- 5.37 orderly and this difference was significant statistically [P=0.001]. There were a significant relation between sex and score of satisfaction that women have more satisfaction than men [P=0.001]

Conclusion: Trainings and Patient's satisfaction regarding these trainings, in all of domains, isn't suitable. Therefore, greater emphasis on education to patients and their satisfaction particularly in relation to type and quality of diet is necessary. Education about the prognosis and process of the disease and doing religious duties is more recommended

Assessment of adiponectin as a marker for severity of pulmonary tuberculosis

To evaluate the serum levels of adiponectin in patients with both active and old pulmonary Tuberculosis [TB] and their possible relation with the severity of the disease, forty patients of both sexes suffering from pulmonary TB [20 cases active and 20 cases old] were matched with 20 healthy control volunteers in this study from February 2014 to June 2014. Body mass index [BMI] and serum levels of adiponectin were measured in all subjects. Both BMI and serum levels of adiponectin were significantly different between active TB patients and control. Comparing old TB patients with controls also have the same results. No correlation between BMI and serum adiponectin level in old TB patients was found, while adiponectin levels in active TB patients show a significant negative correlation. Increased adiponectin in serum of TB patients may be a promising marker for severity of the disease independent of BMI

Use of enzyme linked immunospot assay [ELISpot] for monitoring treatment response of pulmonary tuberculosis patients

Tuberculosis [TB] remains one of the major causes of death from a single infectious agent worldwide. The rapid emergence of drug resistant mycobacteria has strengthened the demand for rapid methods for detection of mycobacteria in clinical samples. As prevention of tuberculosis relies on the early detection and cure of the infectious cases, current efforts are focused upon improving the rapidity of identification of Mycobacterium tuberculosis, allowing prompt initiation of appropriate therapy. The rapid enzyme linked immunospot assay [ELISpot] method was developed in the late 1990s based on the numbers of spots made by interferon gamma producing T cells stimulated by culture filtrate protein-10 [CFP-10] or early secretory antigenic target-6 [ESAT-6]. Therefore, a T-cell response to these antigens could in theory serve as a specific marker of M. tuberculosis infection. Is to assess the potential utility of ELISpot assay for monitoring treatment response of pulmonary tuberculosis patients. The study was done on 30 patients diagnosed as pulmonary tuberculosis on clinical, radiological and bacteriological bases. They were collected from Zagazig Chest Hospital and Zagazig University Hospitals from January 2010 to January 2011. A total of 15 healthy volunteers were enrolled in this study as control subjects. The following were performed for all patients before treatment initiation: full history taking, complete clinical examination, chest X-ray, postero-anterior and lateral views, tuberculin skin test [TST] by Mantoux technique, and routine laboratory investigations. Three successive sputum samples for sputum smear Ziehl-Neelsen [Z-N] staining and sputum collection for Mycobacterium culture on Lowenstein-Jensen media [LJ. Media] were done. Collection of 2 ml heparinized blood for enzyme linked immunospot assay [ELISpot] was done. All patients received four antituberculous drugs, isoniazid, rifampicin, pyrazinamide and ethambutol, for the initial 2 months. After 2 months of therapy; another three successive sputum samples for sputum smear Ziehl-Neelsen [Z-N] staining and sputum collection for Mycobacterium culture on Lowenstein-Jensen media were done. Collection of 2 ml heparinized blood for enzyme linked immunospot assay [ELISpot] was done. The results of this study showed that all patients were complaining of cough and expectoration. Tuberculin skin test was positive in 18 patients [60%]. Most patients [46.6%] had moderately advanced disease as regards the radiological extent. It was found that the median INF-y ELISpot response to ESAT-6 was significantly decreased after 2 months of antituberculosis therapy. The number of pre-treatment ESAT-6 ELISpot count in patients with positive tuberculin skin test was significantly higher than those with negative tuberculin skin test [P < 0.01]. As regards bacillary load, a statistical significant difference between patients with AFB+ + + and patients with [AFB +, AFB + +] as regards pre-treatment ELISpot count was recorded. Higher statistical significant difference in patients with AFB +, AFB + + and AFB + + 4- pre and post treatment ESAT-6 ELISpot count was found. It was found that the number of pre-treatment ESAT-6 ELISpot count in patients with cavitary lesion was higher than those without cavitary lesion and the difference was highly significant [P = 0.01]. As regards radiological extent, it was found that the number of pre-treatment ESAT-6 ELISpot count in patients with far advanced disease was higher than patients with minimal or moderately advanced disease. Also, after 2 months of therapy the number of ESAT-6 ELISpot count in patients with far advanced disease showed more decline than patients with minimal or moderately advanced disease. It was found that ELISpot assay sensitivity, specificity, positive predictive value and negative predictive value in relation to L.J. media were 93.3%, 100%, 100% and 88.2%, respectively. ELISpot assay may be used as a useful tool in the diagnosis of pulmonary tuberculosis. The decrease in the M. tuberculosis-specific T cell responses following 2 months of successful antituberculosis therapy may have a clinical value as a supplemental tool for the monitoring treatment response of pulmonary tuberculosis patients

Physiological effect of peri winkle [C. roseus] on diabetic albino rat

Diabetes mellitus [DM] is a major health problem worldwide in recent time. Asia and Africa are the most viable areas where the disease is feared to raise 2-3 folds. Many herbal products have been recommended for the treatment of DM in ancient literature of Ayurveda in India and other worldwide. Thirty male adult albino rats were used to investigate the effect of Catharanthus rosea [C.roseus] on diabetic rats. Rats were divided into three equal groups, control, diabetic non treated and diabetic C.roseus treated groups. After thirty days of treatment all rats of each group were sacrificed. The body weight of each rat was determined at the beginning and the end of each period. Blood glucose, serum insulin, lipid and protein profiles, liver and kidney functions, blood picture and liver glycogen were determined for each rat at the end of each period. Pancreatic samples were obtained and processed for microscopic and quantitative evaluation after staining the prepared sections with heamatoxylin and eosin as well as special stain for demonstration of the different pancreatic cells in the islets of Langerhans. The obtained results showed that the diabetic rats were diagnosed by laboratory assessment to body weight loss, hyperglycemia, and hypoinsulinemia, significant increase in liver and kidney functions, lipid and protein profiles and decreased liver glycogen content. While, C.roseus treatment led to a significant improvement in these parameters except liver function. Microscopically there was definite vaculation, degeneration, karyolysis and pyknosis of beta pancreatic cells in the diabetic group, while other pancreatic cells were not affected [alpha and delta cells]. The use of C.roseus treatment of this study greatly improves such cellular changes. It was recommended that the use of the water extract of C. roseus levies as a hypoglycemic agent may offer a new hope to the diabetics in future. It's well recommended to use variable doses and different periods of treatment to evaluate the best dose and period

Extended spectrum B-lactamase-producing Escherichia coli in clinical isolates in Benghazi, Libya: phenotypic detection and antimicrobial susceptibility pattern

beta-lactams are the most widely used group of antimicrobials; however, growing resistance to these invaluable drugs mediated by extended spectrum beta-lactamase [ESBL] enzymes is a major concern. The present study was undertaken to determine the prevalence of these enzymes and their effect on antimicrobial susceptibility pattern by different phenotypic detection tests in clinical isolates of Escherichia coli in Benghazi, Libya. Antimicrobial susceptibility testing was carried out by Kirby-Bauer method. Ceftazidime and cefotaxime were used for screening potential ESBL producers. Confirmation was done by a combination of double disk synergy test [DDST] and phenotypic confirmatory disk diffusion tests [PCDDTs]. A total of 120 E. coli strains [40 urine, 20 sputum, 20 blood, and 40 wound swabs] from inpatients at different hospitals of Benghazi, Libya, were included in the study, of which, 24 [20%] isolates were ESBL producers. The resistance pattern to the tested antibiotics was as follows: ampicillin [80%], co-trimoxazole [60%], ciprofloxacine [40%], cefotaxime [30%], ceftazidime [30%], Ceftriaxone [30%], gentamicin [30%], cefpirome [35%], ofloxacin [30%], imipenem [25%], and nitrofurantoin [40%]. All the isolates tested showed resistance to two or more drugs and were considered to be multidrug resistant. A higher rate of ESBL production and multidrug resistance was seen among isolates from pus swabs as compared to other sources. ESBL producers mediated high resistance to both beta-lactams and non-beta-lactams. Prolonged hospital stay and prior use of third-generation cephalosporins were identified as important risk factors for ESBL acquisition. There is insufficient data regarding ESBL prevalence among E. coli strains from Benghazi, Libya. ESBLs not only pose a great threat to future of beta-lactams, but they also endanger the utility of many non-beta-lactams. To ensure rationale in antibiotic treatment, ESBL detection and reporting assumes a priority in near future in Benghazi, Libya

Chemical and biological studies of Kalanchoe pinnata (Lam.) growing in Bangladesh

Objective: To isolate compounds from K. pinnata and elucidate their structures and to explore preliminary antioxidant, antimicrobial, cytotoxic and thombolytic activities of extractives of the plant. Methods: The methanol extract of whole plant of K. pinnata has been subjected to different chromatographic separation and purification processes to isolate the secondary metabolites. The structures of the isolated compounds have been elucidated by extensive NMR studies. The free radical scavenging activity of the crude extract and its different Kupchan fractions were determined on stable radical DPPH. In vitro antimicrobial activity was determined by the disk diffusion method. Cytotoxicity screening has been performed against Artemia salina. Total phenolics content, membrane stabilizing activity and thombolytic activities were assessed by following established protocol. Results: The isolated compounds were identified as glut-5(6)-en-3-one, taraxerone, 3β-friedelanol, β-amyrin-3-acetate, 3,5,7,3',5'-pentahydroxyflavone and β-sitosterol. The chloroform soluble fraction showed potent antioxidant activity of (IC50=80.0 μg/mL) and significant cytotoxicity, while the crude extract demonstrated noticeable total polyphenol content (149.24 mg of GAE/gm of extractive), moderate membrane stabilizing activity and inhibition of clot lysis of blood. Conclusions: The obtained results rationalize the folkloric use of the plant and can be further investigated to isolate the active compounds responsible for the biological activities.

Toxoplasma gondii infection in pregnant women with previous adverse pregnancy outcome

Adverse pregnancy outcome include two or more consecutive spontaneous abortions, intrauterine foetal death, intrauterine growth retardation, low birth weight, stillbirths, early neonatal death and/or congenital anomalies. Maternal infections and infestations play a critical role in adverse pregnancy outcome. In Libya, scare data exist on the roles of Toxoplasma gondii [T.Gondii] in the etiology of adverse pregnancy outcome. The aim of this study was to evaluate the seroprevalence of T. gondii in relation to previous adverse pregnancy outcome in pregnant women. We also aimed to find out the possible risk factors of acquiring this infection in Libyan women at Benghazi region. We included 143 pregnant women with adverse pregnancy outcome who attended Gynecology and Obstetric Department in Jamhoriya Teaching Hospital over a period of six months to estimate seroprevalences of IgM and IgG antibodies to Toxoplasma gondii. Serum samples were collected and assayed using quantitative ELISA technique. Out of 143 serum sample, 64 [44.8%] were positive for Toxoplasma. IgM seropositivities to Toxoplasma were 8.4%. All of those with high IgG and IgM positive cases gave a positive history of habitual abortion. Further remarks were obtained and will be presented and stressed

Sonographic, hysteroscopic, and pathologic findings in patients with abnormal uterine bleeding

Abnormal uterine bleeding AUB is the cause of gynecological referral in about 50% of perimenopausal women. The main aim in investigating this condition is to exclude focal, premalignant, or malignant endometrial disease. This is achieved via sonographic, hysteroscopic, and pathologic examinations. To evaluate the sonographic, hysteroscopic, and pathologic findings in women with AUB in a new one stop clinic. Prospective, observational study of 240 premenopausal and 55 postmenopausal consecutive patients with abnormal uterine bleeding. All patients 35 years or more with AUB not related to pregnancy were included. Exclusion criteria included active pelvic infection, severe cardiopulmonary co morbidity, cervical cancer, and initiation of contraception within the last 3 months. All the patients had vaginal sonographic examination, office hysteroscopy, and endometrial biopsy on one stop bases. Diagnostic indices of the different methods. Endometrial biopsy was the gold standard for diagnosing hyperplasia or cancer and combined hysteroscopy and biopsy 'was the gold standard for focal lesion and global endometrial disease. For focal lesion vaginal ultrasound had 42% sensitivity, 87% specificity, 3.2 positive predictive value, and 0.67% negative predictive value. Office hysteroscopy had corresponding figures of 91%, 100%, 91, and 0.09 respectively. Endometrial biopsy had corresponding figures of 17%, 100%, 17, and 0.83 respectively. Office hysteroscopy is the gold standard for diagnosing endometrial focal lesions and combined VUS and EB failed to detect more than 50% of them. This makes that 14% of patients wrongly diagnosed of being free of endometrial focal lesion. So, OH should be included in the initial evaluation of patients with AUB

Tracing the effect of antidepressants therapy on handwriting documentaries

Handwriting is an acquired skill that is considered one of the most important parameters of personal identification. The production of handwriting involves a complex physical act between the brain and the moving hand and fingers in an extensive muscle and nerve system coordination to produce the finished writing. Some of the centrally acting drugs such as antidepressants can exhibit some interventions, which interfere with the process of writing. The aim of this work is to study the changes in the individual handwriting after different periods of therapeutic intake of the two main classes of antidepressant drugs from different technical points of view that are important in forensic document examination. In this study, 70 right-handed educated adult males and females were included by their handwritings. They were selected from the outpatients of the neuropsychiatric clinics in Kasr El-Aini hospitals. They were receiving regular antidepressants therapeutic regimen of one of the two targeted classes. Every subject was asked to present a personal handwriting document prior to the start of the treatment. A part of this document [about 4-5 lines] with its exact verbal contents was asked to be written by the same person. In all cases, the writing position was standardized regarding the posture of the writer and his position in front of the desk. The pen used was the same in all cases to facilitate the detection of the fine changes in the handwriting features. Groups were matched according to age, sex, treatment duration and the type of the used drug. It was shown that after drug intake there was a significant increase in tremors, pen pressure and word size in TCA users more than SSRI users. In addition, there were significant retouching and disturbance in word shape in TCA users more than SSRI users. Recorded changes were more obvious in males than females especially in patients aged more than 50 years. The results revealed direct relationship between duration of exposure to antidepressant drugs and their effects on handwriting parameters. Non significant increase in retouching, pen pressure, tremors and word size was recorded in TCA users when compared to SSRI users. [In conclusion, the effect of antidepressant drugs on the handwriting has to be considered while examining a document by the forensic expert, so as not to be misled by the drug intake and judge the document as a forged one

[Enhancing the dissolution rate of felodipine by mechanical activation]

This research aimed to study the effect of mechanical activation [Slugging and Milling "SM"] on the physiochemical properties of the Felodipine with hydrophilic polymer was studied. Two types of PhysicalMixtures [PM] was prepared: The first one was physical mixture of Felodipine with poly ethylene glycol [PEG6000] and / or surfactant which is poloxamer [POL], and the second one was physical mixture of Felodipine with poly vinyl pyrolidine [PVP] and / or surfactant which is poloxamer. Then slugging and milling [SM] was made for each mixture. To know the effect of SM on the physiochemical properties of the previous prepared mixture, a comparison between each mixture before and after SM was made, by using differential scanning calorimetry [DSC], Fourier Transmission Infrared [FTIR] and X-ray diffractometry. The effect of [SM] on the mechanochemistry of each material was studied by comparison the DSC scan for each material alone before and after SM. Finally the physical interaction between polymer [PEG or PVP] and surfactant [POL] was studied. The result of DSC showed that is a physical interaction between polymer and Felodipine in case of SM, but this interaction were absent in case of the physical mixture. The result of DSC also showed the effect of SM on the mechanochemistry of the used material. The result of FTIR showed a hydrophilic interaction between Felodipine and polymer in case of SM and also showed a significant interaction between polymer [PVP] and surfactant [POL]. Finally the result of X-ray showed that Felodipine remains in his crystal form after SM

Clinical characteristics and outcome of children stung by scorpion referred to Assiut University Children Hospital

Scorpion envenomation continues to be a health problem in tropical and subtropical regions particularly among children. The aim of this study was to evaluate demographic and clinical characteristics as well as outcomes in referred children to Assiut University Children Hospital during the year 2010 with history of scorpion sting, and to describe features that may be associated with poor outcome. The medical files of these cases were reviewed retrospectively for demographic data, time and site of singing, and clinical presentation with recording of local reaction and systemic manifestations especially neurological, cardiopulmonary and gastrointestinal manifestations. According to Abrougs clinical severity classification, cases were divided into three classes of severity. Laboratory investigations of the cases were reviewed for CBC, blood urea nitrogen, liver function tests, creatinine phosphokinase [CPK], lactate dehydrogenase [LDH], arterial blood gases and serum electrolytes including sodium, potassium, and calcium. Referral to the ICU, connection to mechanical ventilation and death were also recorded. Results showed that 111 children presented to the Emergency Unit with history of scorpion sting; 69 males and 42 females with the mean age was 6.1 +/- 3.5 years [range 1-16 years]. Out of the studied cases, 53.2% were classified as class III of clinical severity with recorded pulmonary edema in 33.3%, cardiogenic shock in 46.8% and severe neurological manifestations in 22.8%. Connection to mechanical ventilation was recorded in 25.2%. Twelve cases [10.8%] were classified as class II with mild systemic manifestations, and 36% of cases were classified as class I with only local reaction. Outcome of these cases were discharge without sequelae in 55.8%, discharge with sequelae in 26.1% and death in 18.1%. Stung children with scorpion who died were significantly presented with lower GCS, pulmonary edema and cardiogenic shock than cases who survived. Regarding laboratory studies, died cases showed significantly higher levels of total leukocytic count, blood glucose level, serum sodium level, CPK and LDH than cases who survived. In conclusion more than half of stung children with scorpion suffered severe clinical presentation and about one fifth died. Aggressive treatment regimens are recommended for such cases to improve the outcome

[Tabriz general dental practitioners' knowledge and attitude evaluation on space maintainer]

Space maintainers are appliances used to preserve the space and prevent ectopic movement of adjacent and opposing teeth when premature loss of deciduous teeth occurs. This study aimed at evaluation of general dental practitioners' knowledge and attitudes regarding the space maintainers in Tabriz. This descriptive cross-sectional study involved 151 subjects, selected randomly from 450 general dentist practicing in Tabriz city/province, located in the North-West of Iran. A self-administered questionnaire was provided to subjects and included questions to evaluate the knowledge and attitudes as well as their case selection policy. Data were analyzed using Chi-square and ANOVA tests. 103[70%] of dentists were male. The mean age of subjects was 33.32 years. The mean score on knowledge was 5.32 out of 10 and the mean score on attitude was 25.3 out of 40. About 76.5% [n=115] of participating dentists admitted child patients, younger than 12 years old. These dentists had higher scores in both sections than others. This difference wasn't significant. Increasing scores in the years after graduation was followed by decreasing scores which was statistically significant [P<0.05]. The general dental practitioners under investigation in this study had a good attitude towards the use of space maintainers. Their knowledge in this regard, however, could be improved by means of attending continuing dental education programs, workshops, brochures and pamphlets

Macro- and micromorphology of the leaves, stems and flowers of Chrysanthemum carinatum L.

The genus Chrysanthemum L. is sometimes called Ismelia, it comprises about 150 species native to tropical and temperate North and South America. Chrysanthemum carinatum L. is known as Painted daisy, German flag and Tricolor Chrysanthemum. Some species of genus Chrysanthemum are used medicinally to cure influenza symptoms, liver and menstrual disorders and have anti-inflammatory and antispasmodic effects

[Comparative study of pregnancy outcome in premature rupture of membranes with amniotic fluid indices of less and more than 5]

Preterm premature rupture of the membranes [PPROM] is one of the most important causes of perinatal morbidity and mortality. The aim of this study was to evaluate pregnancy outcome in preterm premature rupture of the membranes with amniotic fluid index less than 5 and more than 5. This prospective study was performed on 137 pregnant women with gestational age of 28-34 weeks with PPROM from Oct 2006 to Oct 2008. The patients were divided in two groups according to amniotic fluid index: AFI<5 [77cases], AFI >/= 5 [60 cases]. Chi-square test was used for qualitative variables, while T-student test was used for quantitative test. Both groups were similar with respect to number of pregnancies, gestational age at rupture of the membranes and birth weight. In the group with AFI<5, applied latency was significantly shorter [PV=0.049], rate of cesarean section was higher due to fetal distress [PV=0.008], neonatal Apgar score in first minute was lower during the first week [PV=0.0127] and the rate of neonatal death was higher [PV=0.045] during the first week. An AFI<5 cm after PPROM is associated with earlier delivery, higher rate of cesarean due to fetal distress, higher rate of neonatal death, and lower neonatal Apgar score in first minute during the first week

Cardiac arrest in intensive care unit: case report and future recommendations

Initiation of hemofiltration in a patient in septic shock can cause hemodynamic compromise potentially leading to cardiac arrest. We propose that the standard '4Hs and 4Ts' approach to the differential diagnosis of a cardiac arrest should be supplemented in critically ill patients with anaphylaxis and human and technical errors involving drug administration [the 5th H and T]. To illustrate the point, we report a case where norepinephrine infused through a central venous catheter [CVC] was being removed by the central venovenous hemofiltration [CVH] catheter causing the hemodynamic instability. CVVH has this potential of interfering with the systemic availability of drugs infused via a closely located CVC