Septic shock diagnosis and its treatment

In critical care, sepsis continues to be a major cause of mortality. The pathogenic, diagnostic, and therapeutic panorama of sepsis is no longer restricted to the critical care unit: many patients who enter treatment through other doors, both inside and outside the hospital, develop severe illness. Next, administer fluids and broad-spectrum antibiotics after taking the proper cultures. Step up the treatment to include monitoring urine output, blood gases for base excess, lactate, haemoglobin, and glucose if the situation does not get better within the following six hours. These will dictate how bicarbonate, insulin, fluids, transfusions, and vasopressors are managed. The patient should be sent to intensive care if the hypotension doesn't improve (septic shock). Sepsis can now be treated with methods that have produced better results with other illnesses. New medicines have been created as a result of a better understanding of the biology of severe sepsis and septic shock, placing a strong emphasis on early detection and aggressive treatment. The major priorities continue to be prevention through screening, preventing cross infection, and prudent antibiotic usage.

Analgesic and antioxidant activities of the methanolic extract of Operculina turpethum leaves in mice.

Background: Operculina turpethum Linn. (Convolvulaceae) is commonly called “Trivrit” or “India jalap” in English. It is a perennial herbaceous plant with purplish stem and milky-white exudates. This study was aimed at evaluation of the analgesic and antioxidant effects of the methanolic extract of O. turpethum leaves in mice. Methods: The acute oral toxicity of the extract was evaluated using up and down method. The analgesic effects were assessed using acetic acid-induced abdominal writhing reflex and tail flick methods, while the antioxidant activity (AA) was assayed using photometric 2, 2-diphenyl-1-picrylhydrazyl free radical scavenging assay method. Results: The extract produced a concentration-dependent increase in the AA with inhibitory concentration 50% >400 μg/ml. The extract (100, 200 and 400 mg/kg) and aspirin (100 mg/kg) produced a significant (p<0.05) dose-dependent reduction in the number of abdominal constriction induced by intraperitoneal injection of acetic acid in treated mice when compared to the distilled water treated mice. The extract (100, 200, and 400 mg/kg) and pentazocine (3 mg/kg) caused a significant (p<0.05) dose-dependent increase in the pain reaction time in the treated mice groups, when compared to the distilled water treated groups. Conclusion: The study showed that O. turpethum possesses analgesic and antioxidant properties and confirmed the folkloric use of O. turpethum leaves in the traditional pain management.

Phytochemical, Nutrient Composition and Serum Lipid Lowering Effect of Xylopia aethiopica Fruit.

Aims: The present study was carried out to evaluate the effects of Xylopia aethiopica on serum lipids in fed rats. Also the quantitative phytochemical and nutrient composition was investigated. Study Design: Quantitative phytochemical, proximate analysis and in vivo effect on serum lipid profile. Place and Duration of Study: Department of Biochemistry, College of Natural Sciences, Michael Okpara University of Agriculture, Umudike Abia State, between June 2013 and September 2013. Methodology: The fruit were cut into small piece, dried and ground into powder. The quantitative phytochemical and proximate nutrient analyses of the powder sample were determined using standard methods. The serum lipid lowering effects of the powdered fruit in rats was determined by feeding different groups of rats with graded levels (5, 10, 20 and 50%) of the powdered fruit incorporated in their feed for 21 consecutive days and the effects on the total cholesterol, triglyceride, LDL-C, and HDL-C were compared with a negative control. Results: The fruit sample produced significant (p<0.05) concentration-dependent decrease in the total serum cholesterol, triglyceride, LDL-C and VLDL-C levels and increase in serum HDL-C level in fed groups of rats when compared to the control group. The phytochemical analysis showed that the sample contained tannins (4.96%), flavonoids (0.81%), saponins (2.93%) and alkaloids (1.24%). The proximate analysis of the nutrient composition of powdered Xylopia aethiopica sample showed the presence of moisture, lipid, crude fibre, crude protein, ash and nitrogen free extracts in the following proportion 6.32, 12.54, 14.51, 0.91, 2.31 and 63.41% respectively. Conclusion: The fruit sample demonstrated good hypolipidemic effects which may suggest that the consumption of Xylopia aethiopica fruit may help in the reduction of the incidence of hyperlipidemia related diseases in patients.

Early detection of cervical intraepithelial lesions by simple visual inspection after acetic acid among women in Rajshahi medical college hospital.

Aim: To evaluate the performance of visual inspection of acetic acid (VIA) in the detection of precancerous and early cancerous lesions of cervix. Materials and methods: Total 5593 eligible women who randomly came to the Gyenae out patient department (OPD) of RMCH (Rajshahi Medical College Hospital) were examined by VIA. Detection of well defined, opaque, acetowhite lesions close to the squamocolumner junction or in transitional zone or dense acetowhitening of ulceroproliferative growth on the cervix constituted a positive VIA. Those who had abnormal results in screening test & those who had clinically suspicious lesions were sent for colposcopic evaluation (n= 442) & directed biopsy were taken from colposcopically suspected areas (n=214). The final diagnosis was based on histology. Results: Out of 5593 patients, 442 (7.20%) were VIA positive. 442 patients were colposcopically evaluated .Among them, 228 (51.58%) were normal and 202(45.70%) had different stages of cervical intraepithelial lesions (CIN) and 12 ( 2.71 % ) had carcinoma of cervix. Out of 214 patients biopsied, 23.36 % patients had a final diagnosis of CIN lesions, 5 (2.33%) had carcinoma in-situ & 17 cases (7.94%) had invasive carcinoma. Besides to find out the predictable factors of cervical lesions data have been collected from VIA positive patients regarding age of first coitus and first delivery, history of extra marital exposure and STI, use of contraceptive methods and family history of cancer. Age of first coitus between 12 to 15 years and 16 to 20 years were observed among 203 (46 %) and 40 % (177) women respectively. More than half of the patients (62%) were experienced with their first delivery within the age 15-20 years which was below 15 years of 12 % (53) patients. Fifty four percent patients used OCP and barrier methods used were only 10 %. Family history of cancer was observed among 09 % women. 58% patients were belonged to lower middle class and upper group were only 9% (table 1) Conclusion: In our study detection of different grades of intraepithelial lesions (CIN-I, CIN-II, CIN-III, invasive carcinoma) of cervix by VIA was comparable to that of colposcopy. So VIA is suitable for detection of precursor lesions of cervical cancer in low resource settings and also for diagnosis, follow up treatment and epidemiological studies of cervical cancer.