The relationship between pertussis symptomatology, incidence and serology in adolescents

Adolescents have an unknown true incidence of pertussis and are important reservoirs of transmission. We evaluated the incidence of coughing illnesses, serologic evidence of recent infection and the relationship between symptomatology and serology in adolescents. A retrospective respiratory questionnaire and anti-pertussis toxin immunoglobulin G measurement was undertaken in a convenience sample of adolescents and was repeated one year later. The US Centers for Disease Control clinical case definition of pertussis was used. At least a third of coughing illnesses met the CDC clinical case definition. Symptoms correlated with serology. Pertussis was endemic with a high annual incidence of new infections.     

Late endocarditis of Amplatzer atrial septal occluder device in a child

Bacterial endocarditis following atrial septal defect closure using Amplatzer device in a child is extremely rare. We report a 10-year-old girl who developed late bacterial endocarditis, 6 years after placement of an Amplatzer atrial septal occluder device. Successful explantation of the device and repair of the resultant septal defect was carried out using a homograft patch. The rare occurrence of this entity prompted us to highlight the importance of long-term follow up, review the management and explore preventive strategies for similar patients who have multiple co-morbidities and a cardiac device. A high index of suspicion is warranted particularly in pediatric patients.     

Antidiabetic and in vitro antioxidant potential of Hybanthus enneaspermus (Linn) F. Muell in streptozotocin-induced diabetic rats

Objective

To evaluate antidiabetic and antioxidant potential of Hybanthus enneaspermus in different models.

Methods

The oral glucose tolerance test (OGTT) and normoglycemic effect of alcoholic extract of Hybanthus enneaspermus (AHE) were evaluated at a dose of 125, 250 and 500 mg/kg p.o. while hypoglycemic activity and effect on body weight were tested at 250 and 500 mg/kg p.o. per day for 21 days in Streptozotocin (STZ) induced diabetic rats. Further, glucose uptake by hemidiaphram was also evaluated. The total polyphenolic and flavonoid were determined and their correlation with various antioxidant assays was also determined.

Results

The results showed high level of phenolic content in AHE. AHE also exhibited higher total antioxidant capacity, good reducing power and a significant scavenger of reactive oxygen species like DPPH radical, nitric oxide, hydrogen peroxide and deoxyribose. Furthermore there was a significant increase in the body weight and decrease in the blood glucose level on treatment with the AHE. AHE increased glucose uptake on isolated rat hemi-diaphragm compared to control group.

Conclusions

AHE reduce blood glucose level in STZ-induced diabetic model. It does not show significant effect in normoglycemic study but showes significant effect in OGT. AHE has significant antioxidant activity, which may be attributed to high phenolic content.     

Pedalium murex Linn (Pedaliaceae) fruits: a comparative antioxidant activity of its different fractions

Objective

To examine the antioxidant activity and total phenolic content of different solvent fractions of Pedalium murex (P. murex) Linn fruits (Family: Pedaliaceae) as well as the correlation between the total antioxidant capacity and total phenolic content.

Methods

In the present study, the antioxidant activities of P. murex were evaluated using six in-vitro assays, namely total antioxidant assay, DPPH assay, reducing power, nitric oxide scavenging, hydrogen peroxide scavenging and deoxyribose scavenging assays, and total phenol contents were also investigated.

Results

The ethyl acetate (EA) fraction was found to have high levels of phenolic content (298.72±2.09 mg GAE/g). The EA fraction exhibit higher total antioxidant capacity, higher percentage of DPPH radical scavenging activity (135.11±2.95µg/mL), nitric oxide (200.57±4.51µg/mL), hydrogen peroxide (217.91±6.12 µg/mL), deoxyribose (250.01±4.68µg/mL) and higher reducing power. Correlation coefficient (r²=0.914) was found to be significant between total phenolic content and total antioxidant activity.

Conclusions

In general, the results indicate that the EA fractions are rich in phenolic antioxidants with potent free radical scavenging activity implying their importance to human health.     

香港大学玛丽医院脑内科临床运作模式浅析

玛丽医院是香港最好的公立医院,患者享受几乎全免费的诊疗。脑内科的临床运作模式,可基本代表香港医疗体系的特点。医护和辅助人员都具有高度的责任感,各司其职,注重科室间的交流与合作,主动进行医患沟通。诊疗常规严格遵循最新的临床指南,紧跟循证医学证据。病例数少而精,随访出成果。     

Interactive role of endothelial nitric oxide synthase gene polymorphisms in T2D with CAD and CAD patients of Punjab (North-West India)

Dysregulation of endothelial nitric oxide synthase (eNOS) activity causes the reduction in the production of nitric oxide (NO) which is an early indicator of type 2 diabetes (T2D) and cardiovascular complications. The present study evaluates the association of ?786 T?>?C, 894 G?>?T, and 4a/b polymorphisms of eNOS gene in total of 1223 individuals enrolling 307 coronary artery disease (CAD) cases, 486 T2D cases with (n?=?170) and without (n?=?316) CAD as the secondary macrovascular complication, and 430 healthy controls from Punjab (North-West India). Genotyping of ?786 T?>?C and 894 G?>?T polymorphisms was done with polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP), and the genotyping of 4a/b insertion/deletion polymorphism was done by PCR. The minor allele frequency (MAF) of ?786 T?>?C polymorphism was higher in CAD (21.8 %), T2D + CAD (22.4 %), and T2D cases (18.4 %) as compared to healthy controls (17.6 %). However, in single-locus analysis, no significant results were obtained for eNOS polymorphisms in any of the studied groups. Significant association of C-b-G haplotype with the risk of both CAD [P?=?0.003, odds ratio (OR)?=?1.89 (1.04–3.45)] and T2D [P?=?0.019, OR?=?1.69 (0.92–3.13)] was observed. Diplotype analysis showed that TbG/CbG haplotype combination conferred risk towards CAD and T2D [P?=?0.01, OR?=?2.04 (1.18–3.57); P?=?0.006, OR?=?2.13 (1.22–3.57), respectively]. Furthermore, phenotypic parameters like waist circumference, high-density lipoprotein, and waist to height ratio are significantly associated with 894 G?>?T genotypes among CAD patients. In conclusion, the eNOS polymorphisms did not provide any conclusive result individually; however, their interactive effect gives some insights towards eNOS role in the population of Punjab.     

UPPER GASTROINTESTINAL MUCOSA IN CHRONIC RENAL FAILURE – AN ENDOSCOPIC AND HISTOLOGICAL EVALUATION

Over a three year period, 98 patients of moderate to severe chronic renal failure (S creatinine > 5 mg/dl) admitted in our centre were evaluated for upper GI lesions. All patients underwent upper GI endoscopy. In 68% upper GI mucosa was affected. Various lesions encountered were gastritis (25.5%), duodenitis (10.2%), gastroduodenitis (21.4%), telengiectasia (5.1%), and peptic ulcer in 6.1%. In 74 patients three biopsies, one each from antrum, fundus and duodenum were taken. 45.9% of these had chronic gastritis and 14.8% chronic duodenitis. Prevalence of H pylori on histology was 17.56%. 20 patients (9.6%) developed upper GI bleed during hospitalisation. In 17 (85%) patients, where endoscopy could be done, gastritis/duodenitis/oesophagitis were the common underlying lesions.KEY WORDS: Endoscopy, GI mucosa, GI bleed, H pylori.