The primary objective of this study was to show the usefulness and
importance of GeneXpert MTB/RIF, a rapid test that simultaneously detects Mycobacterium tuberculosis complex (MTBC) and
resistance to rifampicin (RIF) in less than 2 hours.
Objective: To generate preliminary information about of enteroviruses and Enterovirus 71 (EV71) in patients with aseptic meningitis in Khartoum State, Sudan.
Method: Cerebrospinal fluid specimens were collected from 89 aseptic meningitis patients from different Khartoum Hospitals
(Mohammed Alamin Hamid Hospital, Soba Teaching Hospital, Omdurman Military Hospital, Alban Gadeed Teaching Hospital and Police Hospital) within February to May 2015. Among these 89 patients, 43 (48%) were males and 46 (52%) were females. The patient’s age ranged between 1 day and 30 years old. The collected specimens were assayed to detect enteroviruses and EV71 RNA using Reverse Transcriptase Polymerase Chain Reaction (RT-PCR) technique
Objective: To generate preliminary information about of enteroviruses and Enterovirus 71 (EV71) in patients with aseptic meningitis in Khartoum State, Sudan.
Method: Cerebrospinal fluid specimens were collected from 89 aseptic meningitis patients from different Khartoum Hospitals
(Mohammed Alamin Hamid Hospital, Soba Teaching Hospital, Omdurman Military Hospital, Alban Gadeed Teaching Hospital and Police Hospital) within February to May 2015. Among these 89 patients, 43 (48%) were males and 46 (52%) were females. The patient’s age ranged between 1 day and 30 years old. The collected specimens were assayed to detect enteroviruses and EV71 RNA using Reverse Transcriptase Polymerase Chain Reaction (RT-PCR) technique
Comparison of Ziehl Neelsen Microscopy with GeneXpert for Detection of Mycoba...iosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
People Living with Human Immunodeficiency Virus in Hadhramout: Clinical Prese...asclepiuspdfs
The objective of the study was to determine the clinical features and outcome of patients living with human immunodeficiency virus (HIV) in Hadhramout and nearby governorates. Materials and Methods: This descriptive study was conducted in the antiretroviral therapy (ART) site at Ibn-Sina General Hospital, Mukalla, Hadhramout governorate. All 145 patients were enrolled in HIV treatment and care program from December 2008 to the end of December 2016 with confirmed HIV test. Data included all personal data, clinical staging, drugs taken, and outcomes. Patients were grouped according to the decades to five groups, ≤15 years, 16–30 years, 31–50 years, 51–70 years, and >70 years. Cases classify according to the antiretroviral drugs to ART group and Pre-ART group. The relevant data parameters were analyzed using SPSS statistical software version 21 and Excel 10. Results: A total of 145 cases, most adults (97.9%), males and females were104 (71.7%) and 41 (28.3%), respectively. Mean age was 36.46 years and 30–50 years the most affected age group (55.2%). Clinical Stages 3 and 4 were the common presentation in 73.8%, and most cases were from Mukalla city. Of the total cases, 74.5% were on ART 53.1 of them improved, pulmonary tuberculosis was found in 4 cases, and death cases were (18.5%), mostly due to late presentation and non-adherence, and mostly occurred in early 6 months of starting the ART. 37 patients were in a pre-treatment group (21.6%), where the mortality rate is 35.1%, mainly due to loss of follow-up. Conclusions: Most cases were adult males, young age and have had late presentation, where mortality is higher in the pre-treatment group due to loss of follow-up and in early 6 months of treatment.
Molecular Detection of Chlamydia Trachomatis and Neisseria Gonorrhea Prevalen...inventionjournals
Background: Chlamydia trachomatis and Neisseria gonorrhea are the most public health concern in developing countries. Screening for sexually transmitted infection such as Neisseria gonorrhea and Chlamydia trachomatis was suggested by CDC at first visit and also last trimester of pregnancy because early infection can asymptomatic and also may complicated by severe sequela. Objective: This paper has aimed at estimating the prevalence of infections by Chlamydia trachomatis and by Neisseria gonorrhea in pregnant women. This study was carried out to determine prevalence of C. trachomatis and N. gonorrhea among pregnant women in Tehran, Iran’ Methods: In this study, 196 urine specimens were collected from pregnant women referred to Rasuol-e- Akram hospital. Detection of organisms was done using duplex PCR method with specific primers for each organisms. Results: Overall, 6.1% and 4.1% of the specimens were positive for C. trachomatis and N. gonorrhea respectively using duplex PCR assay. Co-infection was found in 4.1% of the patients. Conclusion: In comparison to other studies, a moderate and high prevalence of chlamydial and gonococcal infections were seen in pregnant women. According to potentially dangerous complications of chlamydial and gonococcal infections, the results endorse that pregnant women should be screened routinely for detecting the Chlamydia and gonococcus infections.
Dr. Rahul VC Tiwari - Fellowship In Orthognathic Surgery - Jubilee Mission Medical College Hospital and Research Center, Thrissur, Kerala - 29th publication iosr jdms 3rd name
Information about diagnostic methods and techniques for tuberculosis including microscopy, fluorescence microscopy, mycobacterial culture, molecular techniques (line probe assay, Xpert MTB/RIF), interferon gamma release assay (IGRA) and tuberculin skin test (TST)
Study on Sensitivity Pattern of Micro-Organisms in Respiratory Tract Infectio...iosrjce
Wide reports in literatures from different parts of the world revealed that antibiotics are
used both widely and indiscriminately. RTIs comprise the most common indication for consulting a general
practitioner, and obtaining an antibiotic prescription.
Bacteriological profile of childhood sepsis at a tertiary health centre in so...QUESTJOURNAL
Introduction: Sepsis is a leading cause of morbidity and mortality in children worldwide, even more so in developing countries. Knowledge of common pathogens and their antibiotic susceptibility pattern is useful for guiding initial treatment while awaiting blood culture results. Objective:To determine the major causative organisms and their antibiotic sensitivity pattern of childhood sepsis at the Niger Delta University TeachingHospital (NDUTH), with the aim of revising existing treatment protocols. Methods: Within a 2 year period (1st January 2014 to 31st December 2015) blood culture results of children with clinical suspicion of sepsis were retrospectively studied. Results:During the study period, 116 (12.11%) of the 958 children admitted into the Children Emergency Ward had blood culture tests. Thirty one (26.72%) had positive blood cultures.Eighteen (58.06%) of the organisms were gram positive while thirteen (41.93%) were gram negative. The predominant organism was Staphylococcus aureus in 16 (51.61%) followed by Klebsiella pneumoniae in 5 (16.13%) patients. The bacterial isolates demonstrated the highest sensitivity to the quinolones. Conclusion:There is need for periodic surveillance of the causative organisms and antibiotic susceptibility pattern of childhood sepsis to guide effective management of patients.
A Comparative Study of the Efficacy of 5 Days and 14 Days Ceftriaxone Therapy...iosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
Clinical Features and Patterns of CD4+ T Lymphocyte Counts Among HIV/AIDS Pat...IjcmsdrJournal
Background:The use of CD4+ T Lymphocyte count as a vital component to ascertain the stage of HIV/AIDS disease as well as monitor the progress of the disease continues to take centre stage in the management of HIV/AIDS in Africa and beyond. Most health centres in Sub-saharan Africa rely on cut off reference values from different races and distant parts of the world.
Aim:This study was designed to establish the range of CD4+ T Lymphocyte counts among the HIV-negative individuals and also HIV-positive patients at initial booking in the anti-retroviral clinic of our hospital where clinical diagnosis was established.
Methods:Patients were recruited into the study as they report to the hospital on daily basis; structured questionnaires were administered where socio-demograhic and relevant clinical information were obtained. Blood samples (3-5mls) were collected using aseptic techniqueand processed where HIV screening was conducted, and CD4+ T Lymphocyte cell count was carried out using Cyflow (Partec, Germany). Results were fed into Microsoft excel 2007 version and analysed using SPSS 14.
Results:A total of 386 HIV-positive and 145 HIV-negative individuals were recruited into the study. The average CD4+ T Lymphocytes count among the HIV negative individuals was 850 cells /μL and ranged from 200 to 1950 cells/μL with CD4+ T Lymphocyte counts of less than 300 cells/μL being 5 (3.4%). The CD4+ T Lymphocyte counts of less than 500 cells/μL among the HIV-negative individuals was 19(13.1%). However, the CD4+ T Lymphocyte counts among HIV-infected individuals ranged from 50 to 1450 cells/μL, 0.8% (n=3) while 45.9% (n=177) presented with CD4+ T Lymhocyte counts of 50 or less and less than 250 cells/μL respectively. The fact that 75.9% (n=293) of the patients had a CD4+ T Lymphocyte counts of less than 500 cells/μL shows the general late presentation of patients with HIV infection at our health settings, and as much as 50% of these were aware of their HIV status the very first time.
Molecular Detection of Epstein Barr Virus, Human Papilloma Virus Types 16,18 ...CrimsonpublishersCancer
Breast cancer is the most common among female, constituting about 18% of all female cancers, with 1.7 million new cases reported in the world each year. Recently some studies reported that approximately 18% of cancer cases can be linked to infectious agents including viruses particularly Human Papilloma Virus (HPV) and Epstein Barr virus (EBV).
Managment Of Long Term Care In Era Covid-19komalicarol
COVID-19 gives the chance to address long-term care categories
that are sometimes disregarded and undervalued, such as nursing
and residential homes, as well as homecare. Each method of delivering long-term care must meet the highest possible standards
of ongoing care and quality of life. More study and evaluation are
needed to aid decision-making and policy-making, particularly on
the cost-effectiveness and cost-quality elements for each country,
region, or system.
Renal failure and Quality ofLlife Indicators in Kidney Transplantationkomalicarol
Health-related quality of life (HRQL) contains many aspects of
patients' health such as physical, psychological, social functioning
and a general well-being. Progress in renal transplantation and immunosuppressive therapies have increased significantly in recent
decades, resulting in allograft survival rates at one year is now
over 90%. Numerous clinical trials have established the importance of quality of life in a variety of diseases, and it is extremely
popular to evaluate quality of life in clinical trials as a measure of
patients' subjective state of health. The purpose of the study was
to identify factors associated with quality of life after renal transplantation.
More Related Content
Similar to GeneXpert MTB/RIF: A Useful Tool for Rapid and Accurate Diagnosis of Tuberculosis and Rifampicin Resistance
Comparison of Ziehl Neelsen Microscopy with GeneXpert for Detection of Mycoba...iosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
People Living with Human Immunodeficiency Virus in Hadhramout: Clinical Prese...asclepiuspdfs
The objective of the study was to determine the clinical features and outcome of patients living with human immunodeficiency virus (HIV) in Hadhramout and nearby governorates. Materials and Methods: This descriptive study was conducted in the antiretroviral therapy (ART) site at Ibn-Sina General Hospital, Mukalla, Hadhramout governorate. All 145 patients were enrolled in HIV treatment and care program from December 2008 to the end of December 2016 with confirmed HIV test. Data included all personal data, clinical staging, drugs taken, and outcomes. Patients were grouped according to the decades to five groups, ≤15 years, 16–30 years, 31–50 years, 51–70 years, and >70 years. Cases classify according to the antiretroviral drugs to ART group and Pre-ART group. The relevant data parameters were analyzed using SPSS statistical software version 21 and Excel 10. Results: A total of 145 cases, most adults (97.9%), males and females were104 (71.7%) and 41 (28.3%), respectively. Mean age was 36.46 years and 30–50 years the most affected age group (55.2%). Clinical Stages 3 and 4 were the common presentation in 73.8%, and most cases were from Mukalla city. Of the total cases, 74.5% were on ART 53.1 of them improved, pulmonary tuberculosis was found in 4 cases, and death cases were (18.5%), mostly due to late presentation and non-adherence, and mostly occurred in early 6 months of starting the ART. 37 patients were in a pre-treatment group (21.6%), where the mortality rate is 35.1%, mainly due to loss of follow-up. Conclusions: Most cases were adult males, young age and have had late presentation, where mortality is higher in the pre-treatment group due to loss of follow-up and in early 6 months of treatment.
Molecular Detection of Chlamydia Trachomatis and Neisseria Gonorrhea Prevalen...inventionjournals
Background: Chlamydia trachomatis and Neisseria gonorrhea are the most public health concern in developing countries. Screening for sexually transmitted infection such as Neisseria gonorrhea and Chlamydia trachomatis was suggested by CDC at first visit and also last trimester of pregnancy because early infection can asymptomatic and also may complicated by severe sequela. Objective: This paper has aimed at estimating the prevalence of infections by Chlamydia trachomatis and by Neisseria gonorrhea in pregnant women. This study was carried out to determine prevalence of C. trachomatis and N. gonorrhea among pregnant women in Tehran, Iran’ Methods: In this study, 196 urine specimens were collected from pregnant women referred to Rasuol-e- Akram hospital. Detection of organisms was done using duplex PCR method with specific primers for each organisms. Results: Overall, 6.1% and 4.1% of the specimens were positive for C. trachomatis and N. gonorrhea respectively using duplex PCR assay. Co-infection was found in 4.1% of the patients. Conclusion: In comparison to other studies, a moderate and high prevalence of chlamydial and gonococcal infections were seen in pregnant women. According to potentially dangerous complications of chlamydial and gonococcal infections, the results endorse that pregnant women should be screened routinely for detecting the Chlamydia and gonococcus infections.
Dr. Rahul VC Tiwari - Fellowship In Orthognathic Surgery - Jubilee Mission Medical College Hospital and Research Center, Thrissur, Kerala - 29th publication iosr jdms 3rd name
Information about diagnostic methods and techniques for tuberculosis including microscopy, fluorescence microscopy, mycobacterial culture, molecular techniques (line probe assay, Xpert MTB/RIF), interferon gamma release assay (IGRA) and tuberculin skin test (TST)
Study on Sensitivity Pattern of Micro-Organisms in Respiratory Tract Infectio...iosrjce
Wide reports in literatures from different parts of the world revealed that antibiotics are
used both widely and indiscriminately. RTIs comprise the most common indication for consulting a general
practitioner, and obtaining an antibiotic prescription.
Bacteriological profile of childhood sepsis at a tertiary health centre in so...QUESTJOURNAL
Introduction: Sepsis is a leading cause of morbidity and mortality in children worldwide, even more so in developing countries. Knowledge of common pathogens and their antibiotic susceptibility pattern is useful for guiding initial treatment while awaiting blood culture results. Objective:To determine the major causative organisms and their antibiotic sensitivity pattern of childhood sepsis at the Niger Delta University TeachingHospital (NDUTH), with the aim of revising existing treatment protocols. Methods: Within a 2 year period (1st January 2014 to 31st December 2015) blood culture results of children with clinical suspicion of sepsis were retrospectively studied. Results:During the study period, 116 (12.11%) of the 958 children admitted into the Children Emergency Ward had blood culture tests. Thirty one (26.72%) had positive blood cultures.Eighteen (58.06%) of the organisms were gram positive while thirteen (41.93%) were gram negative. The predominant organism was Staphylococcus aureus in 16 (51.61%) followed by Klebsiella pneumoniae in 5 (16.13%) patients. The bacterial isolates demonstrated the highest sensitivity to the quinolones. Conclusion:There is need for periodic surveillance of the causative organisms and antibiotic susceptibility pattern of childhood sepsis to guide effective management of patients.
A Comparative Study of the Efficacy of 5 Days and 14 Days Ceftriaxone Therapy...iosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
Clinical Features and Patterns of CD4+ T Lymphocyte Counts Among HIV/AIDS Pat...IjcmsdrJournal
Background:The use of CD4+ T Lymphocyte count as a vital component to ascertain the stage of HIV/AIDS disease as well as monitor the progress of the disease continues to take centre stage in the management of HIV/AIDS in Africa and beyond. Most health centres in Sub-saharan Africa rely on cut off reference values from different races and distant parts of the world.
Aim:This study was designed to establish the range of CD4+ T Lymphocyte counts among the HIV-negative individuals and also HIV-positive patients at initial booking in the anti-retroviral clinic of our hospital where clinical diagnosis was established.
Methods:Patients were recruited into the study as they report to the hospital on daily basis; structured questionnaires were administered where socio-demograhic and relevant clinical information were obtained. Blood samples (3-5mls) were collected using aseptic techniqueand processed where HIV screening was conducted, and CD4+ T Lymphocyte cell count was carried out using Cyflow (Partec, Germany). Results were fed into Microsoft excel 2007 version and analysed using SPSS 14.
Results:A total of 386 HIV-positive and 145 HIV-negative individuals were recruited into the study. The average CD4+ T Lymphocytes count among the HIV negative individuals was 850 cells /μL and ranged from 200 to 1950 cells/μL with CD4+ T Lymphocyte counts of less than 300 cells/μL being 5 (3.4%). The CD4+ T Lymphocyte counts of less than 500 cells/μL among the HIV-negative individuals was 19(13.1%). However, the CD4+ T Lymphocyte counts among HIV-infected individuals ranged from 50 to 1450 cells/μL, 0.8% (n=3) while 45.9% (n=177) presented with CD4+ T Lymhocyte counts of 50 or less and less than 250 cells/μL respectively. The fact that 75.9% (n=293) of the patients had a CD4+ T Lymphocyte counts of less than 500 cells/μL shows the general late presentation of patients with HIV infection at our health settings, and as much as 50% of these were aware of their HIV status the very first time.
Molecular Detection of Epstein Barr Virus, Human Papilloma Virus Types 16,18 ...CrimsonpublishersCancer
Breast cancer is the most common among female, constituting about 18% of all female cancers, with 1.7 million new cases reported in the world each year. Recently some studies reported that approximately 18% of cancer cases can be linked to infectious agents including viruses particularly Human Papilloma Virus (HPV) and Epstein Barr virus (EBV).
Managment Of Long Term Care In Era Covid-19komalicarol
COVID-19 gives the chance to address long-term care categories
that are sometimes disregarded and undervalued, such as nursing
and residential homes, as well as homecare. Each method of delivering long-term care must meet the highest possible standards
of ongoing care and quality of life. More study and evaluation are
needed to aid decision-making and policy-making, particularly on
the cost-effectiveness and cost-quality elements for each country,
region, or system.
Renal failure and Quality ofLlife Indicators in Kidney Transplantationkomalicarol
Health-related quality of life (HRQL) contains many aspects of
patients' health such as physical, psychological, social functioning
and a general well-being. Progress in renal transplantation and immunosuppressive therapies have increased significantly in recent
decades, resulting in allograft survival rates at one year is now
over 90%. Numerous clinical trials have established the importance of quality of life in a variety of diseases, and it is extremely
popular to evaluate quality of life in clinical trials as a measure of
patients' subjective state of health. The purpose of the study was
to identify factors associated with quality of life after renal transplantation.
A case of childhood Burkitt's lymphoma with gingival swelling as the first sy...komalicarol
Burkitt's lymphoma (BL) is a highly infiltrative malignant lymphoma caused by germinal B-cell differentiation. There are several oral symptoms of BL, including tooth mobility, pain, gingival swelling, maxillofacial swelling and pain, and facial sensory
disturbances. In this paper, we report a case of BL in a 4-year-old
child who initially presented with gingival swelling. The diagnosis of BL/leukemia (stage IV) was confirmed by the bone marrow
examination, bone marrow flow cytometry, and B lymphocytoma
mutation gene screening test. After chemotherapy, the general
condition improved, and then there was swelling and pain in the
right cheek. Considering the recurrence of the disease, the patient
died half a year later. This case is characterized by BL with oral
symptoms as the first symptom, emphasizing the important role of
physicians in early detection of systemic disease
Neuropsychiatric Profiles of Brivaracetam: A Literature Reviewkomalicarol
Anti-seizure medications (ASMs) can cause cognitive or behavioral adverse drug reactions, which is a significant consideration
when selecting an appropriate ASM. Brivaracetam (BRV) is a
newer synaptic vesicle protein 2A ligand, which is expected to
have less neuropsychiatric adverse effects due to its mechanism of
action. To understand the impact of BRV on cognition and behavior compared with other ASMs, we conducted literatures searching
from PubMed and MEDLINE databases. After the screening process, a total of two animal studies, one randomized controlled trial, one pooled-analysis of clinical trials, one controlled study and
nine observational studies were included. Animal studies showed
that BRV did not worsen cognition or behavior performance in rodents. Human studies showed that BRV had less cognitive adverse
events compared with other second or third generation ASMs. In
addition, currently available evidence suggests that behavioral disturbance is less common with BRV compared with levetiracetam.
This review revealed that BRV has a limited impact on cognition
and behavior. For patients who are intolerant to levetiracetam
and have levetiracetam-related behavioral side effects, switching
to BRV could be beneficial. However, the heterogeneity between
studies makes the quality of the evidence weak and further trials
are needed to confirm the findings.
Clinical and evolutionary features of SARS CoV-2 infection (COVID-19) in chil...komalicarol
Starting with December 2019 the medical world has faced a
new challenge as a consequence of a new type of coronavirus-2019-nCoV, similar to several familiar strains that determine
a comparable symptomatology (SARS- severe acute respiratory syndrome, MERS- Middle East severe acute respiratory syndrome), subsequently named SARS CoV-2, while the disease it
causes- COVID-19. The virus is of animal origin and through an
intermediate host (probably also a mammal) it suffered genetic
changes thus acquiring human cells receptors. In consequence,
SARS CoV-2 virus affects both children and even more frequently where it determines more severe clinical forms of disease. In
children, COVID-19 has various clinical forms, from asymptomatic ones to severe ones, complicated by multisystem inflammatory
syndrome (MIS-C Multisystem Inflammatory Syndrome – Child
or PIMS - TS (Paediatric Multisystem Inflammatory Syndrome
temporally associated with COVID-19) that sometimes can lead
to death
Viral load and antibody responses in an asymptomatic/minimally symptomatic SA...komalicarol
Asymptomatic patients with severe acute respiratory syndrome
coronavirus 2 (SARS-CoV-2), are silent carriers of the disease. We
aimed to characterize their dynamics of disease occurrence, viral
shedding and antibody responses using a cohort of asymptomatic/
minimally symptomatic patients from Sri Lanka during the first
wave of COVID-19.
Vonlay; A paradigm shift in post endodontic restoration: A case report.komalicarol
Porcelain veneers have long been a popular restorative option that
have evolved into a well- accepted treatment that can be fabricated
in various ways. Onlays are another common treatment modality
used in contemporary dentistry to restore large areas of decay and
to replace old restorations. With the availability of newer highstrength materials such as lithium disilicate and processing technologies like CAD/CAM and heat pressing, dental professionals
are now able to produce highly esthetic, high-strength restorations
that blend seamlessly with the natural dentition while also withstanding posterior occlusal forces. A tooth more complex restoration is required after endodontic treatment when compared to normal tooth restoration, because of factors such as extensive caries,
post-treatment root canal dentin and even the economics condition
of the patient.One such design proposed by Dr.Ronald E Goldstein
is “Veenerlay”or “Vonlay”. Vonlay is a blend of an onlay with an
extended buccal veneer surface for use in premolar region, where
there is sufficient enamel present to bond. This restorative option
requires a much less invasive preparation than a full coverage
crown but provides the same structural benefits. Thus, the aim of
this case report is to present a case of Vonlay following endodontic
treatement of lower mandibular premol
A COVID Journey in Diabetes: T1D Diabetes Patient 44 years - Winning in Insul...komalicarol
Complications of Hypoglycaemia, Hypoglycaemia
and Neuroglycopenia are often encountered by patients treated
with insulin. It is feared by patients and families often leading to
emotional and mental scars and can affect lifestyle and confidence.
Hypoglycaemia can occur in premature babies, persons with hypopituitarism and Addison’s Disease. Low blood glucose can affect
athletes and the elderly leading to falls. Cases are individual and
often difficult for families, clinicians, lawyers and courts to understand.
Loops Around the Heart – A Giant Snakelike Right Coronary Artery Ectasia with...komalicarol
Coronary artery dilatation is an uncommon finding and is incidentally found during diagnostic coronary angiography or at necropsy.
The pathogenesis of dilatation of coronary arteries is still not very
well understood and therapeutic strategies are not clear. It is useful to know the difference between aneurysm and ectasia. In this
report we demonstrate the diagnostic workup of an asymptomatic
patient with a remarkable snakelike dilatation of the right coronary
artery with unique convolute. For the first time we used intracoronary injection and simultaneous echocardiographic visualization
of contrast agent (Sonovue) to proof a fistula to the coronary sinus.
Like our patient, most of the patients are asymptomatic in absence
of coronary artery disease and we decided on a conservative approach because of his very complex anatomy
Skull Metastasis From Papillary Thyroid Carcinoma : Case Report and Literatur...komalicarol
Although papillary thyroid carcinoma is a relatively common form of malignancy, metastatic spread to the skull
is exceptional. Here, we report a case of papillary thyroid carcinoma revealed by frontal skull metastasis.
Diabetes and Covid-19 Pandemic - A T1 Patient Perspective - Derek C Beattykomalicarol
A patient treated and cared for by NHS Scotland and NHS England
the author has in his 44 years T1D Diabetes journey experienced
surgery provided by the NHS by way of Vitrectomy, Ophthalmic
laser and correction, and Orthopedic knee correction following
a balance issue associated with IV antibiotic treatment for Otitis
Externa and Osteomyelitis associated with long term T1 Diabetes
with neuropathy. Interestingly IV antibiotic treatment led to glycemic issues offering explanation as to why on occasion glycaemia
abnormalities can occur with antibiotic treatment for infection.
Growth Charts-Curves of Children's Height - How to Construct Themkomalicarol
A person born in 1990, for example, grew to one year old on his/
her birth day in 1991 and 17 years old in 2007. No one grows
to their 17 or 20 years old instantaneously. It takes a long-capricious time of mental and physical activities to grow. As regards
children’s milk consumption, for example, school lunch programs
were put into in practice on national scale only in the late 1990s.
Those in their late adolescence in 2007 were not the beneficiaries
of free milk, when they were in primary school.
Dermatological health in the COVID-19 erakomalicarol
COVID-19 and its impact on dermatological health was reviewed
from theoretical and statistical frameworks in the present study. A
cross-sectional and retrospective work was documented with a selection of sources indexed to Scopus, considering the period from
2019 to 2022, as well as the search by keywords. Approaches were
discussed in order to outline a comprehensive model that considered the differences between the parties involved, as well as their
relationships in a risk context. The proposal contributes to the state
of the question in terms of the prediction of contingencies derived
from the probability and affectation of dermatological health
The Importance of Framing at the Beginning of an Review Dialoguekomalicarol
Long-term care of patients with chronic conditions in general practice rarely focuses on the treatment process. A specific interaction
tool, the Review Dialogue (RD), has been developed to integrate
patients’ health-related problems/risks as well as coping strategies
and to agree upon shared treatment objectives assuming that periodical RDs will help to achieve them. Initiated by the GP, the RD
changes the role expectations of the patient and doctor. Therefore,
the framing of the encounters is of particular importance.
Early detection of interstitial lung disease in asymptomatic patients with 2-...komalicarol
Pulmonary involvement is a common manifestation of Dermatomyositis (DM), the most frequent histologic pattern being Interstitial Lung Disease (ILD) which is a major contributor to
morbidity and mortality in these patients. Therefore, this disease
should be investigated and it is essential to perform pulmonary
function tests (PFTs) and High-Resolution Computed Tomography
(HRCT) early in the course of the disease to make a definitive
diagnosis. Nowadays, 2-deoxy-2-[18F] fluoro-D-glucose positron
emission tomography/computed tomography
Association between Galectin-3 and oxidative stress parameters with coronary ...komalicarol
Galectin-3 (Gal-3), as a mediator of inflammation and fibrosis, has been reported to be a biomarker of severity in
coronary artery disease (CAD). The study aimed to assess the relationships between coronary artery disease (CAD) and risk factors,
including parameters of oxidative stress in Tunisian patients CAD.
The risks of using 2,4?dinitrophenol (2,4?DNP) as a weight loss agent: a lite...komalicarol
The prevalence of obesity has steadily increased in response to
changes in diet and physical activity patterns over the past 10
years, becoming one of the leading causes of morbidity and mortality worldwide. In addition, the popularity of social networks
has increased social and cultural pressure for the search for the
“perfect body”. These factors result in the search for fast and unconventional methods of weight loss, such as the use of weight
loss accelerating drugs. 2,4-Dinitrophenol (2-4-DNP or DNP) is
an industrial chemical used to lose weight quickly. Due to its great
potential for toxicity, its use has been banned in several countries
since 1938
Height is a measure of consumption that incorporates nutritional needs: When ...komalicarol
Japan suffered heavily from WWII. Per capita food supply was
1,450 and 1,700 kcal/day in 1946 and 1947, respectively. Japan’s
economy quickly recovered to the pre-war level in 10 years after
the war, 2,200 kcal/day in average food supply in 1955, making
steady progress toward the end of the century. People in Japan,
the younger generations, in particular, learned to eat more animal
products and children started growing taller in height
Successful management of a broken stylet retained in tracheobronchial tree-a ...komalicarol
In Covid-19 pandemic, the use of video laryngoscope for tracheal
intubation is highly recommended due to the increasing distance
between patient’s airway and operator. An endotracheal tube with
an intubating stylet has been proposed to facilitate tracheal tube
insertion, especially when video laryngoscope was used. Thus in
routine anesthesia practice intubating stylet is used as an aid in tracheal intubation for confirmed or suspected Covid-19 infected patients. At the present time, the disposable plastic covered or plastic
bougie is more recommended but in some institutes, the malleable
aluminum stylets are still in use. Though shearing of part of the
stylet has been reported in past but we report a case with as unrecognized broken piece of stylet into his right main bronchus, which
was later extracted immediately and successfully before causing
adverse symptoms or hurts.
Risk Analysis of Secular Trends for a Later Age at MPV of Weight in an Earthq...komalicarol
The Great East Japan Earthquake occurred in 2011, bringing unprecedented damage to the Tohoku region of Japan. Today, after 11
years, the scars from that tremendous damage remain. The health
damage to young school children has been particularly great. One
may imagine a slowing trend in physical growth from the effects
of that disaster, but no clear findings have been reported.
These lecture slides, by Dr Sidra Arshad, offer a quick overview of the physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar lead (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
6. Describe the flow of current around the heart during the cardiac cycle
7. Discuss the placement and polarity of the leads of electrocardiograph
8. Describe the normal electrocardiograms recorded from the limb leads and explain the physiological basis of the different records that are obtained
9. Define mean electrical vector (axis) of the heart and give the normal range
10. Define the mean QRS vector
11. Describe the axes of leads (hexagonal reference system)
12. Comprehend the vectorial analysis of the normal ECG
13. Determine the mean electrical axis of the ventricular QRS and appreciate the mean axis deviation
14. Explain the concepts of current of injury, J point, and their significance
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. Chapter 3, Cardiology Explained, https://www.ncbi.nlm.nih.gov/books/NBK2214/
7. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Muktapishti is a traditional Ayurvedic preparation made from Shoditha Mukta (Purified Pearl), is believed to help regulate thyroid function and reduce symptoms of hyperthyroidism due to its cooling and balancing properties. Clinical evidence on its efficacy remains limited, necessitating further research to validate its therapeutic benefits.
Local Advanced Lung Cancer: Artificial Intelligence, Synergetics, Complex Sys...Oleg Kshivets
Overall life span (LS) was 1671.7±1721.6 days and cumulative 5YS reached 62.4%, 10 years – 50.4%, 20 years – 44.6%. 94 LCP lived more than 5 years without cancer (LS=2958.6±1723.6 days), 22 – more than 10 years (LS=5571±1841.8 days). 67 LCP died because of LC (LS=471.9±344 days). AT significantly improved 5YS (68% vs. 53.7%) (P=0.028 by log-rank test). Cox modeling displayed that 5YS of LCP significantly depended on: N0-N12, T3-4, blood cell circuit, cell ratio factors (ratio between cancer cells-CC and blood cells subpopulations), LC cell dynamics, recalcification time, heparin tolerance, prothrombin index, protein, AT, procedure type (P=0.000-0.031). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and N0-12 (rank=1), thrombocytes/CC (rank=2), segmented neutrophils/CC (3), eosinophils/CC (4), erythrocytes/CC (5), healthy cells/CC (6), lymphocytes/CC (7), stick neutrophils/CC (8), leucocytes/CC (9), monocytes/CC (10). Correct prediction of 5YS was 100% by neural networks computing (error=0.000; area under ROC curve=1.0).
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
Integrating Ayurveda into Parkinson’s Management: A Holistic ApproachAyurveda ForAll
Explore the benefits of combining Ayurveda with conventional Parkinson's treatments. Learn how a holistic approach can manage symptoms, enhance well-being, and balance body energies. Discover the steps to safely integrate Ayurvedic practices into your Parkinson’s care plan, including expert guidance on diet, herbal remedies, and lifestyle modifications.
Adv. biopharm. APPLICATION OF PHARMACOKINETICS : TARGETED DRUG DELIVERY SYSTEMSAkankshaAshtankar
MIP 201T & MPH 202T
ADVANCED BIOPHARMACEUTICS & PHARMACOKINETICS : UNIT 5
APPLICATION OF PHARMACOKINETICS : TARGETED DRUG DELIVERY SYSTEMS By - AKANKSHA ASHTANKAR
- Video recording of this lecture in English language: https://youtu.be/kqbnxVAZs-0
- Video recording of this lecture in Arabic language: https://youtu.be/SINlygW1Mpc
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Basavarajeeyam is a Sreshta Sangraha grantha (Compiled book ), written by Neelkanta kotturu Basavaraja Virachita. It contains 25 Prakaranas, First 24 Chapters related to Rogas& 25th to Rasadravyas.
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
2. http://www.acmcasereport.com/ 2
Volume 9 Issue 16 -2022 Review Article
2. Introduction
MTB still remains one of the main causes of death determined by
an infectious agent (above HIV/AIDS) [1]. Every year worldwide,
several million people fall ill with tuberculosis [3]. Rapid detection
of Mycobacterium tuberculosis and rifampicin resistance in infect-
ed patients is crucial for early diagnosis and disease management,
because of the high rates of transmission from an individual to an-
other and development of multidrug – resistant tuberculosis (MDR
- TB) and extensively drug – resistant tuberculosis (XDR - TB).
Culture remains the “gold standard” for final diagnosis, but the
determination is slow and the results may come up in 2 to 8 weeks.
Smear microscopy for AFB (acid – fast bacili) is inexpensive and
fast, but the sensitivity is very low. Therefore, rapid diagnosis leads
to early treatment initiation, improves the outcome of patients and
increases the public health awareness [4]. The GeneXpert MTB/
RIF assay is an automated nucleic amplification test,that detects
Mycobacterium tuberculosis complex and rifampicin resistance
associated mutation [5]. The result is obtained in approximately 2
hours giving the clinician a rapid and accurate diagnosis and offer-
ing the patient the chance to early initiation of the treatment. The
technique is endorsed by the World Health Organization (WHO)
as the point – of – care test for diagnosis of pulmonary and ex-
trapulmonary tuberculosis. The sensitivity of the test ranges from
72.5 to 98.2%, both in smear neagative and smear positive sam-
ples, and has a specificity of 98.2% [6,7]. It has many advantages,
including easy to use, bio – safe, absence of sample contamination.
The disadvantages include: shelf life of the cartridge of only 18
months, costs, temperature control, a stable electricity supply and
annual recalibration of the analyzer [8].
3. Materials and Methods
We performed a retrospective study, which included 141 patients
tested positive for MTB. All patients were admitted at the Clin-
ical Hospital of Pneumology and Infectious Disease “Dr. Victor
Babes” Timisoara, between January 2021 and December 2021.
Tuberculosis diagnosis was suspected based on epidemiological
and clinical findings and confirmed by radiological and laborato-
ry findings. 141 samples were collected and analyzed: 129 pul-
monary and 12 extrapulmonary samples. On all specimens col-
lected, the following examinations were performed: microscopic
examination, LPA, culture, MGIT culture and GeneXpert MTB/
RIF. All the results were interpreted in the Hospital Laboratory
and transmitted to clinicians for early diagnosis and treatment of
the patients. The origin of the 129 pulmonary samples was as it
follows: 114 sputum samples, 5 pleural fluid samples, 8 bronchial
aspirate samples and 2 samples obtained by bronchoalveolar lav-
age. Extrapulmonary specimens were as it follows: 1 lymph node
aspirate probe, 1 sample from facial fistula secretion, 7 gastric lav-
age samples, 2 bone marrow aspirate samples and 1 cerebrospinal
fluid sample. The demographics of patients included age, sex and
provenance medium (rural or urban). Smear microscopy was per-
formed for all 141 patients. After growth of the culture, in cases in
which Mycobacterium tuberculosis complex strains were identi-
fied, drug susceptibility testing was performed (Streptomycin, Iso-
niazid, Rifampicin, Ethambutol and Pyrazinamide resistance were
also determined in order to identify MDR – TB or XDR - TB). All
the procedures for GeneXpert assay were conducted according to
the manufacturer’s instructions [9]
. In samples detected positive by
the device, rifampicin resistance was also noted.
4. Results
141 positive samples were analyzed, all patients being admitted
between January and December 2021. The male gender was pre-
dominant with 99 cases (70.2 %), for a sex ratio M/F of 2.35. The
mean age was 44.82 (range from 3 to 85 years) and the age group
of 31 to 60 years was the most represented with 60.2% or 85 cases.
Males were predominant in the age group 31-60 and >60 years old,
while women were predominant in the interval group <30 years.
Divided by the provenience environment, most patients (77 –
54.6%) came from the city. The samples we analyzed comprised of
pulmonary samples as sputum (n=114), pleural fluid (n=5), brochi-
al aspirate (n=8), bronchoalveolar lavage (n=2) and extrapulmo-
nary samples as lymph node aspirate (n=1), facial fistula secretion
(n=1), gastric lavage (n=7), bone marrow aspirate (n=2) and cere-
brospinal fluid (n=1). GeneXpert was positive in all 141 patients,
no matter of their provenance (pulmonary or extrapulmonary).
MGIT culture was performed in 137 of the 141 cases, 5 cases test-
ing negative, but GeneXpert confirmed a positive result, because
it’s the only method that can detect MTB in cases with only traces
of the infectious agent. Microscopic exam was performed for all
141 cases, testing negative in 54 cases. Culture on Löwenstein –
Jensen tested negative for 3 patients. GeneXpert is by far the most
accurate and rapid testing tool, providing a reliable result, even in
cases in which culture or microscopy appear to be negative, due to
small concentration of MTB. From 141 patients, 11 of them also
tested positive for rifampicin resistance gene. All 11 patients were
male, 7 of them (63.6 %) coming from the city environment. 8 of
the patients tested positive for Isoniazide resistance as well, con-
firming MDR – TB. 3 from the 11 cases with rifampicin resistance,
were also resistant to Streptomycin, Isoniazide, Ethambutol and
Pyrazinamide.
5. Discussions
In the study, we investigated the performance of the MTB/RIF as-
say with pulmonary and extrapulmonary specimens obtained dur-
ing the clinical routine. Tuberculosis is a public health threat, thus
early detection is extremely important for reducing transmission
and deaths. That’s why it is important to have a rapid and accurate
diagnosis test. Although smear microscopy is a rapid and inex-
pensive method to detect AFB, a low number of bacilli presented
in the sample can lead to a negative report in smear microscopy.
So, smear microscopy can easily miss such cases. Also, smear mi-
croscopy fails to differentiate MTB from MTB complex [10,11].
3. http://www.acmcasereport.com/ 3
Volume 9 Issue 16 -2022 Review Article
Culture still remains the gold standard for tuberculosis detection,
but it demands a longer time for diagnosis extended up to 4 weeks
[12,13]. That’s why GeneXpert is a very reliable alternative, by
improving diagnosis in smear – negative and culture – negative
tuberculosis [14]
. Being a molecular technique, GeneXpert detects
the DNA of MTB (viable or non-viable). In cultures, only viable
cells can grow [15,16]. GeneXpert also detects rifampicin resist-
ance. Resistance to anti-tuberculosis drugs is currently one of the
major challenges in the management of this disease [17,18]. In our
case, we detected 11 cases of resistance to Rifampicin. 8 of them
(72.7%) proved to be MDR – TB and 3 of them (27.2%) proved
to be XDR – TB. Several studies report similar results [19,20,21].
6. Conclusions
In conclusion, GeneXpert MTB/RIF test depends less on the us-
er’s skills, has a short turnaround time and detects simultaneously
MTB and RIF resistance and all that in less than 2 hours [22]. Gen-
eXpert can help clinicians to make better and informed decisions
in the management of tuberculosis cases. The findings in our study
reflect that GeneXpert is a valuable inclusion in the fight against
tuberculosis, providing precious advances in tuberculosis control
campaigns. The Xpert assay has brought a major change in the
speed, simplicity and accuracy, diagnosing not only tuberculosis,
but also drug resistance to rifampicin. The utility of GeneXpert in
diagnosis of pauci bacillary tuberculosis appears to be the most
valuable contribution of this test.
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