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Παρασκευή 2 Σεπτεμβρίου 2016
IJMS, Vol. 17, Pages 1468: Melanoma Brain Metastasis: Mechanisms, Models, and Medicine
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Empathy and Emotional Intelligence in Dental Practitioners of Bareilly City – A Cross sectional Study
2016-09-02T05-55-34Z
Source: National Journal of Integrated Research in Medicine
Gupta Anushka*, Lakshminarayan Nagesh**.
Background & objectives: Empathy and Emotional Intelligence are the two affective domain parameters which significantly affect a doctors way of treating patients; hence they may influence the doctor-patient relationship. Establishing a proper doctor-patient relationship has a great impact on professional success of the doctor. Thus, the present study was aimed to assess whether there is any association between empathy of dental practitioners towards their patients and the dental practitioners emotional intelligence. Methods: A cross-sectional study was conducted on a sample of 243 dental practitioners including clinicians, academicians and post-graduate students from Bareilly city who were instructed to complete a self-administered questionnaire. The questionnaire consisted of the Health Professional (HP) version of the Jefferson Scale of Physician Empathy (JSPE) and the Schuttes Emotional Intelligence Scale (SEIS). Pearsons correlation coefficient and linear regression were used to test the statistical significance of the observations. Results: A positive correlation was found between empathy and emotional intelligence. The correlation was significant p=0.05, even after adjusting for the confounders and the regression model showed significance with r value of 0.12 Interpretation & Conclusion: Empathetic dentists were found to have higher emotional intelligence. Irrespective of variations in age, gender, qualification, occupation and years of working experience, empathy and emotional intelligence showed positive correlation. [Gupta A NJIRM 2016; 7(4):106-112]
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Admission To Medical Colleges- Predictive Validity Of Selection Criteria.
2016-09-02T05-55-35Z
Source: National Journal of Integrated Research in Medicine
*Dr. Vrushali R Parate,*Dr. Sushma S. Pande,**Dr. Pushpa O. Lokare.
Background & objective: Appropriate selection criteria for admission to medical college is a fundamental prerequisite where number of aspirants seeking admission to medical college has increased. The selection criteria used by medical colleges has been changing from time to time and not uniform all over India. Hence it is important to validate the selection criteria by observing performance of students during medical course. The study aims to find predictive value of entrance test & science score obtained at HSC level on the performance of medical students in I MBBS University Examination. Methods: The study included marks obtained in science subjects at HSC level, Entrance and I MBBS University examination for four consecutive batches(2009 to 2012). Correlation between all three variables was found using spearman rank correlation. Results: Performance in I MBBS examination showed no correlation with Entrance score but correlated significantly with science scores at HSC level (p
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Problem Based Learning In Anatomy – Our Experience
2016-09-02T05-55-35Z
Source: National Journal of Integrated Research in Medicine
Bhosale Yuvaraj J*, Iyer Praveen B**.
: Background: Presently Anatomy is taught in a traditional way through lectures, small group teaching and demonstration. All these are teacher-controlled methods for teaching as per Medical Education Technology. So it was decided to introduce a learner-controlled method for teaching of Anatomy i.e. problem-based learning (PBL) with the following. Objectives:To compare the performance of the students undergoing PBL with the performance of the students taught in a traditional way To compare the perception of the students about PBL in comparison to Traditional way Materials and methods: 32 students who volunteered for the study were divided into two groups. The first group was taught cerebellum by PBL method and the second group was taught cerebrum by PBL method. Cross over method was then applied. Thereafter a theory examination was conducted. A feedback questionnaire was given to the students after the examination. Results: The average score of the students in the PBL group was more than that of the students in the lecture group in 60% questions. The score was same in 20% questions. The score was reverse in 20% of questions. PBL was appreciated and accepted by the students. It can be introduced partly in the existing curriculum. [ Yuvaraj b NJIRM 2016; 7(4): 92-97]
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Perceptions regarding Problem-Based Learning as a Teaching Learning Strategy among medical students
2016-09-02T05-55-35Z
Source: National Journal of Integrated Research in Medicine
Manisha Jindal*, Shalini Srivastav**, Harsh Mahajan***, Geeta Baro****.
Background & Objectives: Problem-based learning (PBL) in medical education can be considered as the most significant innovation in educational tools in the past 35 years. This study was conducted to evaluate the students perceptions regarding PBL which will provide inputs to rectify the curriculum. Methods: The study was conducted in two years on two batches of 100 students each. Six PBL exercises on different topics were successively allotted to each batch of students in groups of 15-18. At the end of each year, the students were asked to fill a 21-item questionnaire on a 5-point Likert scale, regarding their perceptions for PBL. The mean/median scores of ≥3 was considered as positive attitude towards PBL Results: For 20 items related to PBL as T-L strategy and its effect on professional attitude, the mean/median scores was observed to be ≥3. Mean score of 2.04 and median score of 2 was found for the item that considered PBL as a waste of time; reinforcing the liking for PBL. Interpretation and Conclusion: PBL empowers students to engage in collaborative learning, improves inter-personal skills, enhances pre-existing knowledge and develops a professional attitude. It is recommended that it should be integrated in future Indian medical curriculum. [Manisha JNJIRM 2016; 7(4): 87-91]
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Pattern and risk factors of childhood injuries at Emergency Department of Suez Canal University Hospital
2016-09-02T05-43-06Z
Source: Medicine Science | International Medical Journal
Monira Taha Ismail, Lamiaa El-Sayed Fiala, Sobhy Ahmed Sobhy, Hesham Fathey El-Sayed, Hussein Aamer Awaad.
Injuries are a leading cause of death among children and young adults. Most of these injuries are caused by motor vehicle crashes, falls, and burns. Intentional injuries in all its forms account for over 1.5 million deaths a year. To determine the pattern and characteristics of childhood injuries and to explore the risk factors for such injuries at the emergency department of Suez Canal University Hospital. A cross-sectional study at the emergency department in Suez Canal University Hospital targeted children aged ≤ 18 years presented with an injury from June 2013 to April 2014. The tool in the study was Global Childhood Injury Surveillance Instrument to interview the parents or guardians arriving with injured children. Of the total of 402 injured children, 264 (65.7%) were males and 138 (34.3%) were females. 188 cases (47%) were below 6 years of age. Children travelled an average of 10.5 km to the hospital. Most common type of injuries were falls (29.4%) followed by motor car accidents (17.4%), struck or hit by an object (15.7%), burn (10.4%) and poisoning (8.2%). 44% of childhood intentional injury arrived at the emergency department caused by their friends or acquaintance, 30% by a child, 13% by the unrelated caregiver and 4% by teachers. There were 402 childhood injury-related emergency department visits in Suez Canal University Hospital between June 2013 and April 2014, 152 injury-related inpatient hospitalizations (37.8%) and 21 childhood injury-related deaths (5.2%). 94.3% of them were due to unintentional injuries. Raise public awareness of speeding, seat-belt wearing and home safety.
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Macromol. Rapid Commun. 17/2016
Front Cover: Amino-acid-based surfactants with polymer-izable moieties are used for the preparation of polymer nanoparticles with a chiral surface functionality. As an example of their application, the resulting chiral particles are shown to drive enantioselective crystallization of amino acid conglomerate systems. The cover image represents a chiral particle interacting with a crystal. Further details can be found in the article by L. C. Preiss, M. Wagner, Y. Mastai, K. Landfester, and R. Muñoz-Espí* on page 1421. Cover artwork by Stefan Schuhmacher.
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Macromol. Rapid Commun. 17/2016
Back Cover: A malonate-based alkyl bromide initiator for metal-catalyzed living radical polymerization facilitated sequence analyses by Matrix assisted laser desorption/ionization time of flight mass spectrometry (MALDI-TOF-MS) for alternating copolymers from styrene and maleimide derivatives, due to the selective initiation to the former monomer. Further details can be found in the article by K. Nishimori, M. Ouchi,* and M. Sawamoto* on page 1414.
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Quantifying behavioural determinants relating to health professional reporting of medication errors: a cross-sectional survey using the Theoretical Domains Framework
Abstract
Purpose
The aims of this study were to quantify the behavioural determinants of health professional reporting of medication errors in the United Arab Emirates (UAE) and to explore any differences between respondents.
Methods
A cross-sectional survey of patient-facing doctors, nurses and pharmacists within three major hospitals of Abu Dhabi, the UAE. An online questionnaire was developed based on the Theoretical Domains Framework (TDF, a framework of behaviour change theories). Principal component analysis (PCA) was used to identify components and internal reliability determined. Ethical approval was obtained from a UK university and all hospital ethics committees.
Results
Two hundred and ninety-four responses were received. Questionnaire items clustered into six components of knowledge and skills, feedback and support, action and impact, motivation, effort and emotions. Respondents generally gave positive responses for knowledge and skills, feedback and support and action and impact components. Responses were more neutral for the motivation and effort components. In terms of emotions, the component with the most negative scores, there were significant differences in terms of years registered as health professional (those registered longest most positive, p = 0.002) and age (older most positive, p < 0.001) with no differences for gender and health profession.
Conclusion
Emotional-related issues are the dominant barrier to reporting and are common to all professions. There is a need to develop, test and implement an intervention to impact health professionals' emotions. Such an intervention should focus on evidence-based behaviour change techniques of reducing negative emotions, focusing on emotional consequences and providing social support.
Key messages
• This research used the Theoretical Domains Framework to quantify the behavioural determinants of health professional reporting of medication errors.
• Questionnaire items relating to emotions surrounding reporting generated the most negative responses with significant differences in terms of years registered as health professional (those registered longest most positive) and age (older most positive) with no differences for gender and health profession.
• Interventions based on behaviour change techniques mapped to emotions should be prioritised for development.
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The Perception Of MBBS Interns Towards Biochemistry Curriculum In A South Indian Medical College.
2016-09-02T05-26-14Z
Source: National Journal of Integrated Research in Medicine
Vanishree.B.J,* Rekha Nayaka***,Manjunath S.Somannavar*,Smita.S.Sonoli**.
: Introduction: The concepts taught in pre-clinical sciences serve as a backbone to understand the clinical sciences. The system of teaching basic science subjects through didactic lectures followed in most of the medical colleges is more of a teacher centered. The medical educators are concerned about the learning outcomes of the traditional programs of teaching. Usually feedback on curriculum is obtained by subject experts from other universities. There is an unmet need to obtain the perceptions of graduates as they represent one of the important stakeholders of curriculum. Objective: To collect the interns perception about the content, need and application of biochemistry knowledge during their internship using a pre-designed and pre validated questionnaire. Materials and Methods: It was a cross sectional study done on interns who were asked to give feedback on biochemistry curriculum using the questionnaire. All the opinions were rated using 5- point Likert scale, ranging from strongly disagree to strongly agree. Results: 72.9% of interns were in favor of integrating basic science subjects with clinical sciences . Around 74.5 % (2/3rd) expressed that adopting interactive teaching strategies and problem based learning helped them in better understanding of the subject. Conclusion: The final goal of teaching in a medical sector includes attainment of knowledge, skills, attitudes and morals required to perform professional tasks safely and competently. In order to achieve this interactive, practical/case oriented and integrated teaching should be promoted. [Vanishree.B.JNJIRM 2016; 7(4): 82-86]
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The Perception Of MBBS Interns Towards Biochemistry Curriculum In A South Indian Medical College.
2016-09-02T05-26-14Z
Source: National Journal of Integrated Research in Medicine
Vanishree.B.J,* Rekha Nayaka***,Manjunath S.Somannavar*,Smita.S.Sonoli**.
: Introduction: The concepts taught in pre-clinical sciences serve as a backbone to understand the clinical sciences. The system of teaching basic science subjects through didactic lectures followed in most of the medical colleges is more of a teacher centered. The medical educators are concerned about the learning outcomes of the traditional programs of teaching. Usually feedback on curriculum is obtained by subject experts from other universities. There is an unmet need to obtain the perceptions of graduates as they represent one of the important stakeholders of curriculum. Objective: To collect the interns perception about the content, need and application of biochemistry knowledge during their internship using a pre-designed and pre validated questionnaire. Materials and Methods: It was a cross sectional study done on interns who were asked to give feedback on biochemistry curriculum using the questionnaire. All the opinions were rated using 5- point Likert scale, ranging from strongly disagree to strongly agree. Results: 72.9% of interns were in favor of integrating basic science subjects with clinical sciences . Around 74.5 % (2/3rd) expressed that adopting interactive teaching strategies and problem based learning helped them in better understanding of the subject. Conclusion: The final goal of teaching in a medical sector includes attainment of knowledge, skills, attitudes and morals required to perform professional tasks safely and competently. In order to achieve this interactive, practical/case oriented and integrated teaching should be promoted. [Vanishree.B.JNJIRM 2016; 7(4): 82-86]
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Pros And Cons Of Problem-Based Learning In Medical Education: Students’ Viewpoint
2016-09-02T05-26-14Z
Source: National Journal of Integrated Research in Medicine
Manisha Jindal*, Harsh Mahajan**, Shalini Srivastav**, Geeta Baro***.
: Background and Objectives: Problem-based learning (PBL) is an innovative educational approach in which the students determine what they need to learn. The present study was done to review the pros and cons of PBL, with the aim to introduce reforms in the traditional teaching methodology.Methods: A total of 200 MBBS students participated in the study. Six PBL exercises were allotted to the students and after their completion, they were asked to fill the questionnaire regarding their perceptions about PBL on a 5-point Likert scale, as well as open ended questions to elicit two reasons each for liking and disliking PBL.Results: Regarding the students perceptions, the mean/median scores of all the items was found to be ≥ 3, indicating the positive inclination of students towards PBL. The major favourable factors of PBL were the opportunity of group discussion (16%) and better understanding (15.8%). The major drawbacks in PBL were that preparation required more time (20.5%), inadequate discussion (12.8%) and large group size(11.0%) Interpretation and Conclusion: Students generally favour PBL, as it enhances their ability to handle and solve real-life problems; however, few of the challenges are also accompanied with it which should be looked into to improvise it. [Manisha J NJIRM 2016; 7(4):78-81]
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Can A Single 10 Minutes’ Session Of Meditation Be Useful For Reducing Blood Pressure?
2016-09-02T05-26-14Z
Source: National Journal of Integrated Research in Medicine
Hasmukh Shah*, Nilesh Patel**, S. K. Singh***.
Introduction: There is substantial evidence on the usefulness of meditation for the reduction of blood pressure and stress. Regular practice of meditation improves cardiovascular and mental health. There are lots of documented evidences that meditation is effective in coronary artery diseases. Aims: The study was done to ascertain immediate effect of meditation on blood pressure profile in young healthy students. Methodology: Our study was done in 84 healthy students of 17-20 years of age group of Pramukhswami Medical College, Karamsad. In study group (n=42), students were asked to sit in quiet room and meditation was done for 10 minutes. In this group, blood pressure and heart rate were taken before the meditation and after the meditation. In control group (n=42), blood pressure and heart rate were taken initially then they were allowed to sit comfortably in quiet room for 10 minutes, after that again blood pressure and heart rate were taken. Results: In comparison to control group, in study group SBP, PP and MAP were significantly reduced after meditation from 116.38±14.10 to 109.88±10.55 (P
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In Search Of Research- Cross Sectional Study To Assess Knowledge, Attitude And Practice Of Research In Undergraduate Medical Students.
2016-09-02T05-26-14Z
Source: National Journal of Integrated Research in Medicine
Dr AshwiniRatnakar*, Dr SunitaPatil**, Dr ManasiGosavi*, Dr BhagyashriHungund**, Dr HemaBannur***..
Background & Objective of the study: Research in medical field is growing in leaps and bounds creating a new career option for the students. But there is poor understanding of research and its vastness among undergraduate students. There is dire need to expose undergraduate students to some basics of research activity. Prior to their orientation towards research there is a need to assess the knowledge, attitude and practice of research so as to pave way for developing new methodologies, strategies to foster student interest in research as an academic career and help create young researchers among this field.Objective of the study was to assess the knowledge,attitude and practice of research among medical undergraduate students.Materials & methods: A pre-validated questionnaire was prepared, provided to II Phase-II term MBBS students and their response was collected. Quantitative evaluation of the data acquired was done. Results: Response rate to the questionnaire was 84.8%. Though 81.2% students showed positive attitude towards research, mean score of research knowledge was 51.7% and mean score of research practice was only 11.9%. Conclusion: Undergraduate students have positive attitude towards research but their knowledge & practice of research is low. Further steps have to be undertaken to raise this bar of knowledge and practice of research among the undergraduate students. [Dr Ashwini R NJIRM 2016; 7(4) :68-72]
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Comparative Study Of Dynamic Hip Screw And Trochanteric Nail For Management Of Stable Intertrochanteric Fracture
2016-09-02T05-26-14Z
Source: National Journal of Integrated Research in Medicine
Mohammad Jesan*,Khanmaddipati Veera Venkat Rao**, Abdul Qayyum Khan***, Mohammad Khalid Anwar Sherwani****,Malik Mohammad Azharuddin*****,Mehtab Ahmad******.
: Background& objectives : Intertrochanteric fractures of hip are relatively one of the common fractures and it is imposing a huge burden on patients in terms of medical expenses and morbidity .A sliding hip screw (DHS) and trochanteric nail (TN) both are described for fixation of these fractures. The discussion about the selection of ideal implant is controversial in terms of outcomes in various studies. Methods: Ninety patients with intertrochanteric fracture were treated in our hospital from Jan 2009 to Dec 2011. All AO 31-A1 patients who were between 40-80 years old were included to compare Dynamic hip screw and Trochanteric nail in the management of intertrochanteric fractures by analyzing operative time, duration of hospital stay, complications, time taken to union and post operative mobility. 63 patients were enrolled in DHS group and 27 were enrolled in intertrochanteric nail group.Results: Patients treated with DHS had shorter operative time ,less radiological exposure ,easy reduction and fewer intraoperative and postoperative complications .Implant failure and non union was noted in one out of twenty seven patients treated with trochanteric nail group.Interpretation & Conclusions : The analysis of our study supports the use of DHS rather than trochanteric nail for the treatment of stable intertrochanteric fractures in elderly patients [Jesan M NJIRM 2016; 7(4):61-67]
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Nerve Conduction Studies In Lower Limb Weakness
2016-09-02T05-26-14Z
Source: National Journal of Integrated Research in Medicine
Vijay Vaidya*,Mukesh Dinkar**,Balaji Wasudeo Ghugare***,Manjiri Uttam Joshi****.
Introduction: Nerve conduction studies (NCS) are an essential part of the work-up of peripheral neuropathies. NCS with EMG allows diagnostic classification, understanding and separation of different neuropathies. Symmetrical lower limb weakness of neurological origin often demands EDX study. Neuropathies may be mixed or motor or sensory. Further it may be either axonal or demyelinating. Aims and objectives: To assess nerve conduction studies in symmetrical lower limb weakness patients with peripheral neuropathies. To estimate prevalence of neuropathies in this cohort. Material methods: Forty cases and equal no of controls underwent NCV study. Tibial peroneal motor and sural sensory nerve conductions were done. Data was stored in excel sheet for analysis. Different NCV variables were compared between the groups. Unpaired ttest was used for comparison of variables. Level of significance was kept at p value
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Estimation Of Serum Β2-Microglobulin In Oral Precancerous Lesions And Oral Squamous Cell Carcinoma
2016-09-02T05-26-14Z
Source: National Journal of Integrated Research in Medicine
Pratik Rupakar*, Akilahmed Kureshi**, Aanal Balar***, Mahammadhusen Khatri****, Mayur Parmar*****, Piyush Pujara******, Maitri Shah*******.
: Background & objectives:The purpose of this study was to assess the serum levels of β2 microglobulin in oral squamous cell carcinoma and oral leukoplakia and to evaluate the possible role of β2 microglobulin as a biochemical parameter in the diagnosis of oral cancer.Methods: Serum β2 microglobulin levels were evaluated using ELISA in thirty patients with oral squamous cell carcinoma, thirty patients with oral leukoplakia, and thirty age-&sexmatched disease-free controls.Results: It was observed that there was a significant increase in serum β2 microglobulin levels in oral squamous cell carcinoma patients as compared to oral leukoplakia and controls. Progressively higher values were obtained as the cancer advanced clinically with respect to clinical staging, tumor size and nodal status. Although, serum β2 microglobulin levels were increased in oral leukoplakia compared to controls, it was found to be statistically insignificant.Interpretation & conclusion: From these results, it seems that evaluation of serum β2 microglobulin levels may be useful as one of the battery of tests in assessment of oral carcinoma and leukoplakia. [Pratik Rupakar NJIRM 2016; 7(4):51-55]
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Evaluating The Quality Of Life Of Postmenopausal Members And Non-Members Of The Elderly Support Association
2016-09-02T05-26-14Z
Source: National Journal of Integrated Research in Medicine
Mina Shirvani.
: Background: It should be noted that menopause is the discontinuation of the menstrual cycle during the threshold of aging and a complicated process. Early diagnosis and initiation of hormone therapy, if necessary, use of mental relaxation techniques, harmonizing the family, social protection, and strengthening of elderly support centers can make it easier for a postmenopausal woman to go through this critical stage. Objective: The purpose of this study was to evaluate the quality of life of postmenopausal members and non-members of the elderly support association in Borujen city, Iran. Method: This study was a cross-sectional descriptive study conducted in Borujen city in 2012. The participants were postmenopausal women of over 55 years. Thus, 40 postmenopausal members of the elderly support association of Borujen city and 40 non-members were randomly selected. The 36 Item Short-Form Health Survey (SF-36), with the 4 psychological, social, physical-movement, and environmental domains, was completed. Data were analyzed using SPSS software. Results: The mean total score of quality of life of member of the association was significantly higher than non-members. Student's t-test showed a significant relationship between quality of life and membership of the association (P
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Impact Of Training On Knowledge And Practices Of Nurses Regarding Hospital Infection Control In A Tertiary Care Centre
2016-09-02T05-26-14Z
Source: National Journal of Integrated Research in Medicine
R.Jyoti Chandak*, Poonam S.Loomba**,B.Mishra,V.Dogra***.
: Background and objective:Nurses provide the first-hand bedside care to the patients in a hospital thus have a direct role in hospital infection control. Thus to improve hygiene behaviour of staff, training sessions on hospital infection control is necessary. The objective of this study was to assess the impact of training on knowledge and practices regarding hospital infection control amongst nursing staff working in tertiary care centre. Method: The study included 89 nurses from different wards and I.C.U. A pre-test and a post-test was conducted with a set of 20 self designed multiple choice questions in three days session of training covering important aspects of hospital infection control. Improvement in pre-test and post test for individual candidate was assessed and statistical data analysis was done. Results: Response rate of the questionnare was 100%.The mean pre-test score was 9(S.D 3.06) while mean post-test score was 14(S.D 6.34). The difference in pre-test and post-test was statistically significant(P
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Effect of treatment of rectal cancer metastasis with intravitreal bevacizumab (Avastin) in patient with subretinal fluid and macular oedema: short-term follow-up
We describe the management of subretinal fluid and macular oedema due to colorectal cancer metastasis to the choroid using intravitreal bevacizumab. A patient with grade VI KRAS mutation rectal cancer with metastasis to the lung and cerebellum presented with left eye choroidal metastasis 1 week after being started on the experimental medication KTN3379. After intravitreal bevacizumab administration, the patient had improvement in macular subretinal fluid, but eventually progressed to severe cystoid macular oedema despite monthly intravitreal bevacizumab treatment.
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Ethiopian-Israeli community
The Ethiopian-Jewish community in Israel is an immigrant population numbering 131 400 as of 2012. Many arrived from 1980 to 1992 by airborne operations coordinated by the Israeli government. Immigration was prompted by Israeli recognition of the community's Jewish citizenship eligibility status. This period in Israel's history saw the First Lebanon War, the First Intifada, the Gulf War and the beginning of Soviet Jewish immigration. The Ethiopian community faced difficult integration, cross-cultural misunderstandings and the development of chronic disease, due to lifestyle changes and differences in cultural beliefs. These factors significantly affect the community's health. Governmental and non-governmental organisations have sought to improve the quality of life for Ethiopian Israelis through empowerment and education. Enhancing societal integration, augmenting cross-cultural communication and understanding and instituting community-based health projects are essential in improving the health of this community. Successful healthcare intervention requires a biopsychosocial model of analysis and usage of a culturally appropriate context.
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ANCA-negative eosinophilic granulomatosis with polyangitis (EGPA) manifesting as a large intracardiac thrombus and glomerulonephritis with angionecrosis
A 59-year-old woman with a history of bronchial asthma presented with a prolonged fever and eosinophilia. There was transient proteinuria and troponin level was elevated. Antineutrophil cytoplasmic antibody was negative and she did not fulfil criteria for eosinophilic granulomatosis with polyangitis (EGPA). Echocardiography showed a large apical mass in the left ventricle, but there was no systolic dysfunction, local asynergy or ventricular remodelling. On MRI, apical mass was compatible with a thrombus and endocardial region was diffusely damaged. Loeffler endocarditis-like cardiac manifestation led to meticulous examination, which found no aetiology for eosinophilia. Finally, renal biopsy revealed eosinophil infiltration and glomerular angionecrosis, confirming as EGPA. This case highlights the isolated large cardiac thrombus as a rare presenting sign for EGPA and underscores current complicated strategy to diagnose EGPA. Of note, this clinical challenge was mostly caused by inchoate comprehension of hypereosinophilia-related disorders.
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Orolingual angioedema to alteplase. Identify, counsel and monitor at risk patients
Orolingual angioedema (OLA) is a known complication of intravenous alteplase used to treat ischaemic stroke. The incidence may be as high as 5.1%. ACE inhibitors are thought to increase the risk of developing this potentially life-threatening complication. This case report demonstrates how we may improve in the identification of risk factors in the history; the counselling of patients appropriately; in seeking alternative therapies such as mechanical thrombectomy; and in the monitoring of patients for signs of OLA once alteplase has been given.
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Penetrating cardiac injury: sustaining health by building team resilience in growing civilian violence
Penetrating cardiac injury (PCI) is gradually increasing in developing countries owing to large-scale manufacturing of illegal country-made weapons. These injuries are associated with significant morbidity and mortality. Logistically it is difficult to have all organ-based specialists arrive together and attend every critically injured patient round-the-clock in developing countries. It is therefore important for doctors (physicians, surgeons and anaesthetists) to be trained for adequate management of critically injured patients following trauma. We report the approach towards 2 cases of haemodynamically unstable PCI managed by a team of trauma doctors. Time lag (duration between injury and arrival at hospital) and quick horizontal resuscitation are important considerations in the treatment. By not referring these patients to different hospitals the team actually reduced the time lag, and a quick life-saving surgery by trauma surgeons (trained in torso surgery) offered these almost dying patients a chance of survival.
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Traumatic anterior dislocation of the hip
Description
A 31-year-old male motorcyclist presented to the emergency department(ED) following a road traffic accident with significant right hip pain and inability to weight bear. On examination the patient had a shortened and externally rotated leg with absent peripheral pulses and cold peripheries concerning for vascular compromise. A plain radiograph demonstrated an anterior hip dislocation (AHD) with a greater trochanter (GT) fracture (figure 1). An urgent CT of the pelvis was performed to exclude the possibility of a femoral neck fracture (figure 2A, B). The hip was reduced under conscious sedation in the ED using the Allis method. The peripheral pulses returned. A further CT angiogram of the pelvis was performed which showed concentric reduction, an undisplaced GT fracture and a short segment dissection of the right external iliac artery which was managed conservatively as directed by the vascular team (figure 3A,...
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Protective altruistic phlebotomy: hereditary haemochromatosis presenting as hepatocellular carcinoma in a non-cirrhotic 83-year-old man
Hereditary haemochromatosis is a multisystem disorder of iron metabolism. Hepatic manifestations include hepatomegaly, cirrhosis and hepatocellular carcinoma. Hepatocellular carcinoma is almost always preceded by cirrhosis. We present a case of an 83-year-old man without history of liver disease or iron overload who presented with abdominal pain. Workup revealed mildly elevated transaminases, ferritin of 3996 and a solitary liver tumour. Biopsy was consistent with hepatocellular carcinoma in a background of haemosiderosis without cirrhosis. He was diagnosed with hereditary haemochromatosis and hepatocellular carcinoma. He underwent a partial hepatectomy and was started on routine phlebotomy and surveillance imaging. He has improved and has not had signs of recurrence or new complications of haemochromatosis. We suggest a possible reason for his unique and late presentation.
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Idiopathic subvalvular aortic aneurysm masquerading as acute coronary syndrome
Subvalvular aneurysms are the least common type of left ventricular (LV) aneurysms and can be fatal. Subaortic LV aneurysms are much rarer than submitral LV aneurysms and mostly reported in infancy. They can be congenital or acquired secondary to infections, cardiac surgery or trauma. Here, we report a unique presentation of a large, idiopathic subaortic aneurysm in an adult masquerading as an acute coronary syndrome. Diagnosis was made with the help of a CT aortography. Aneurysm was surgically resected with good results. This case highlights the clinical presentation and management of subaortic aneurysms, an important differential for congenital aortic malformations.
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Toxins, Vol. 8, Pages 259: A Novel Zak Knockout Mouse with a Defective Ribotoxic Stress Response
Ricin activates the proinflammatory ribotoxic stress response through the mitogen activated protein 3 kinase (MAP3K) ZAK, resulting in activation of mitogen activated protein kinases (MAPKs) p38 and JNK1/2. We had a novel zak−/− mouse generated to study the role of ZAK signaling in vivo during ricin intoxication. To characterize this murine strain, we intoxicated zak−/− and zak+/+ bone marrow–derived murine macrophages with ricin, measured p38 and JNK1/2 activation by Western blot, and measured zak, c-jun, and cxcl-1 expression by qRT-PCR. To determine whether zak−/− mice differed from wild-type mice in their in vivo response to ricin, we performed oral ricin intoxication experiments with zak+/+ and zak−/− mice, using blinded histopathology scoring of duodenal tissue sections to determine differences in tissue damage. Unlike macrophages derived from zak+/+ mice, those derived from the novel zak−/− strain fail to activate p38 and JNK1/2 and have decreased c-jun and cxcl-1 expression following ricin intoxication. Furthermore, compared with zak+/+ mice, zak−/− mice have decreased duodenal damage following in vivo ricin challenge. zak−/− mice demonstrate a distinct ribotoxic stress–associated phenotype in response to ricin and therefore provide a new animal model for in vivo studies of ZAK signaling.
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YEARS algorithm in suspected pulmonary embolism: Towards a reduced rate of pulmonary imaging
European Society of Cardiology News
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Retrospective one-million-subject fixed-cohort survey of utilization of emergency departments due to traumatic causes in Taiwan, 2001–2010
World Journal of Emergency Surgery
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Clinical spectrum of electrical burns – A prospective study from the developing world
Burns
http://ift.tt/2bJG3uq
Investigation of single nucleotide polymorphism loci susceptible to degradation by ultraviolet light
Journal of Forensic and Legal Medicine
http://ift.tt/2bPeRrv
PRAGUE-18 trial prasugrel and ticagrelor: Equally safe and effective in STEMI
European Society of Cardiology News
http://ift.tt/2bPfEbR
Blood transfusions in severe burn patients: Epidemiology and predictive factors
Burns
http://ift.tt/2bJERao
Clinical research on postoperative trauma care: has the position of observational studies changed?
European Journal of Trauma and Emergency Surgery
http://ift.tt/2bJFwsl
Presentations to an urban emergency department in Switzerland due to acute γ-hydroxybutyrate toxicity
Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
http://ift.tt/2bPf91w
Social challenges of visible scarring after severe burn: A qualitative analysis
Burns
http://ift.tt/2bJFNvH
Simulator-based air medical training program Christoph Life: From concept to course
Air Medical Journal
http://ift.tt/2bPeTQa
Intravascular imaging identifies some heart attack patients who can forego stenting
European Society of Cardiology News
http://ift.tt/2bPfNfB
Perioperative inflammatory response in major fracture: do geriatric patients behave differently?
European Journal of Trauma and Emergency Surgery
http://ift.tt/2bJEJYD
A rapid and effective antidote for anticoagulant bleeds
European Society of Cardiology News
http://ift.tt/2bPf7GW
Psc-AFP from Psoralea corylifolia L. overexpressed in Pichia pastoris increases antimicrobial activity and enhances disease resistance of transgenic tobacco
Abstract
Psc-AFP, isolated from the seeds of Psoralea corylifolia L., is an antimicrobial protein with trypsin inhibitor activity. Its encoding gene was cloned by 3′- rapid amplification of cDNA ends (RACE) combined with Y-shaped adaptor-dependent extension (YADE) method. The gene Psc-AFP encodes a protein of 203 amino acids with a deduced signal peptide of 24 residues. The growth inhibition effect exerted by the heterologously expressed Psc-AFP in Pichia pastoris revealed that the recombinant Psc-AFP inhibited mycelium growth of Aspergillus niger, Rhizoctonia solani, and Alternaria brassicae and conidial germination of Alternaria alternata. The recombinant Psc-AFP also showed protease inhibitor activity manifested by the inhibition of trypsin. The transgenic tobacco bioassays confirmed that overexpressing Psc-AFP significantly enhanced the disease resistance of tobacco and that some of the transgenic lines were almost fully tolerant to Ralstonia solanacearum and A. alternata, whereas no apparent alteration in plant growth and development was observed. Collectively, these results indicate that the recombinant Psc-AFP is an active antimicrobial protein, with protease inhibitor activity that can be successfully produced in the yeast and tobacco and, therefore, maybe a potential antimicrobial candidate for practical use.
http://ift.tt/2bGKovl
Expressions of ion co-transporter genes in salicylate-induced tinnitus and treatment effects of spirulina
Abstract
Background
Although the activity of tinnitus-related ion co-transporter are known, their mRNA expressions has seldom been reported. We aimed to investigate the mRNA expressions of tinnitus-related ion co-transporter genes, and treatment effects of Spirulina.
Methods
The mRNA expressions of K+–Cl− co-transporter (KCC2) and Na-K-2Cl co-transporter 1 (NKCC1) genes in the cochlea and brain of mice were evaluated after tinnitus was induced by intraperitoneal injection of salicylate. The effects of spirulina water extract on these gene expressions were investigated.
Results
Compared to the control group, the tinnitus scores increased significantly, however, the salicylate-induced tinnitus could be reduced significantly by spirulina water extract. The tinnitus group had higher of borderline significance mRNA expression of KCC2 gene in the cochlear, significantly higher in the temporal lobes and in the frontal lobes. Meanwhile, compared to the tinnitus group, the spirulina group had significantly lower mRNA expression of KCC2 gene in the cochlear, temporal lobes, frontal lobes and parahippocampus/hippocampus. However, the NKCC1 mRNA expression was not significantly different between three groups in the cochlea and these brain areas.
Conclusion
Salicylate-induced tinnitus might be associated with increased mRNA expression of KCC2 gene, but not with mRNA expressions of NKCC1 gene in the cochlear and some tinnitus-related brain areas. Spirulina reduced the expression of KCC2 genes in salicylate-induced tinnitus.
http://ift.tt/2bZX5nQ
Isolation And Antimicrobial Susceptibility Pattern Of Staphylococcus Aureus.
2016-09-02T04-55-34Z
Source: National Journal of Integrated Research in Medicine
Kulkarni VL*, Kulkarni DM**, Nilekar SL***, More SR****.
Introduction- Staphylococcus aureus is one of the principal human pathogens that colonizes healthy individuals as well as causes severe infections in hospitalized patients. They have differential ability to spread and cause outbreaks in hospitals. The study was done to isolate S.aureus from various clinical samples and to know their antibiogram. Methodology- The study included a total of 312 Staphylococcus aureus strains isolated from various clinical specimens. The specimens received were processed further for identification by standard microbiological procedures like direct microscopic examination, culture and various standard identification methods. Antimicrobial susceptibility testing was done by Kirby-Bauer disc diffusion method on Mueller-Hinton agar as per CLSI guidelines. Result- A total of 312 isolates of S. aureus were obtained from various clinical samples. Male to female ratio was 1.6:1. Infection rate was more in age group 46-60 years. Staphylococcus aureus isolates were more commonly obtained from surgery department (38.78%) followed by orthopedics. All the strains were 100% sensitive to Vancomycin, Netilmicin, Linezolid and Teicoplanin. Higher resistance was noted against Penicillin(94.87%), Trimethoprim/Sulfamethoxazole(72.44%).Lower resistance was noted against Nitrofurantoin(13.33%). Conclusion- The determination of the anti-microbial susceptibility is also crucial for an optimal therapy, for epidemiological purposes and for infection control measures. [Kulkarni VL NJIRM 2016; 7(4):33-38]
http://ift.tt/2bZ6NZW
Study Of Sociodemographic and Clinical Features Of Tuberculosis Cases In Hiv Patients
2016-09-02T04-55-34Z
Source: National Journal of Integrated Research in Medicine
Siddaraya Hanjagi*, Sanganna L Lakkannavar**.
Background: Infection with HIV is the most potent risk factor for progression to active tuberculosis. Mycobacterium tuberculosis only have an approximately 10% lifetime risk of developing TB compared with 60% or more in persons infected with HIV and TB. Methodology: 100 HIV infected patients having symptoms of Tuberculosis were taken up for the study for a period of 18 months, meeting the criteria for the present study. Diagnosis of tuberculosis was based on clinical evaluation, sputum smear. Results: 100 HIV patients studied for period of 18 months . Majority of patients were in the age group of 30-41 years. 64% were males and 36% females. Labourers are commonly affected. Common presenting symptoms were fever(74%) cough (72%) and weight loss(62%). Associated clinical findings were pallor(63%), (12%) and oral thrush(14%). Pulmonary TB (69%) is the most common form. Conclusion: Majority of patients were in the age group of 30-41 years, 64% were males 36% females. Most common occupation affected was labourers. Fever (74%), cough (72%) and weight loss (62%), pallor (63%), lymphadenopathy (12%) and oral thrush (14%). Most common form of tuberculosis was pulmonary TB (69%). Among extra pulmonary tuberculosis pleural effusion (8%) was the most common presentation. [Siddaraya H NJIRM 2016; 7(4): 28-32]
http://ift.tt/2bPVJLC
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