Delayed Manifestation of Transurethral Syndrome as a Complication of Transurethral Prostatic Resection

Metabolic encephalopathy as a part of ‘transurethral syndrome’ is an immediate complication following transurethral resection of prostate. It occurs during or few hours after the surgery. However, delayed manifestation of this complication is rare. It is also possible that pretreatment with diuretics can exaggerate this problem by predisposing the patient to electrolyte abnormalities. Here we present a report of such a patient who manifested with neurological complications six days after the prostate surger

A Failure Analysis and Remaining Life assessment of Boiler Water Wall tube

This paper presents failure investigation on the SA210GrC water wall tube by visual Site inspection, tube wall thickness measurements, chemical composition test, Hardness test and microstructure analysis with proper evidence collected to identify the exact cause of the failure. The water wall tube was failed with blister, bulging and creep cracks on outer surface located near to the Soot Blower. On-site wall thickness measurements were performed on some of the water wall tubes located at the same level of the ruptured tube. The tubes have significant wall thinning and erosion from outside. Mild corrosion deposition also seen in the inner side. Microscopic examinations on the failed rupture region and some distance away of the as-received tubes are also conducted in order to determine the failure mechanism and root cause. Failure mechanisms are also discussed and relevant data from few months back to the failure gathered to identify the failure reason. The failure mechanism is identified as a result of the combination of the significant wall thinning of water wall tube due to long term overheating and creep. Corrosion due to oxygen is also a cause of wall thinning. Root cause analysis identified that deaerator was not working efficient to remove dissolved gases was reason behind corrosion. Long term overheating was due to operating temperature above the design one. Finally all the parameters checked and rectified properly. Maintenance of Deaerator has been done to put it in the working condition

Comparison of Induction Therapy Using Antithymocyte Globulin and Using Basiliximab for Live Donor Kidney Transplant Recipients: A Single Centre Prospective Cohort Study

Objective: Acute rejections (AR) have a negative impact on long-term graft survival and are the major predictor of chronic rejection. Induction therapy is used to reduce AR and prevent delayed graft function (DGF). Antithymocyte globulin (ATG) and basiliximab are mainly used for this purpose. In this prospective, cohort study, we analysed and compared the safety and efficacy of ATG and basiliximab in induction therapy for live donor kidney transplant recipients.Methods: Graft survival, AR-free survival, renal function, DGF and tolerability were compared in patients who underwent live-donor transplantation between January 2014 and August 2014 at Muljibhai Patel Urological Hospital, Nadiad, Gujarat, India.Results and Discussion: A total of 85 live-donor kidney transplant recipients who enrolled were followed up for 12 mo. The incidence of AR was greater in the basiliximab group, as compared with the ATG group (25.6% versus 7.1%, p <0.05). The incidence of antibody treated AR was also greater (18.6% versus 2.4 %, p < 0.05). Patient survival rate and graft survival rate were 95.2% and 92.9% in the ATG group, respectively, compared with 90.4%and 90.7% in the basiliximab group, respectively. The incidence of adverse events was higher in the ATG group compared with the basiliximab group (71.4% versus 48.3%, p<0.05).Conclusion: The incidence of AR and antibody-treated AR was significantly higher in the basiliximab group than in the ATG cohort. However, ATG was associated with significantly higher incidence of adverse events and leucopenia than basiliximab. Both the strategies were achieved similar patient and graft survival

Management Of Bilateral Temporomandibular Joint Ankylosis With Micrognathia And Obstructive Sleep Apnea Syndrome Using Interpositional Arthroplasty And Distraction Osteogenesis – A Case Report

Temporomandibular joint (TMJ) Ankylosis posses many problems like inability to open the mouth, poor oral hygiene, difficulty in eating proper food, unaesthetic appearance due to growth retardation and in severe cases difficulty in breathing specially during night depending on the time of occurance of injury. If the TMJ Ankylosis occurs the early stage of life it affects both the form and function of the patient. One of the most common treatments used to treat temporomandibular joint (TMJ) ankylosis is interpositional arthroplasty (IPA). When patients come with severe mandibular dysplasia either orthognathic surgery or distraction osteogenesis (DO) can be considered. Simultaneous IPA with DO has been used by many surgeons correct TMJ ankylosis associated with facial asymmetry/micrognathia as as it enables them to simultaneously reconstruct the neocondyle and correct facial malformations eliminating the need for second surgery. Here we have narrated a case of an young male patient suffering from bilateral TMJ Ankylosis with micrognathia treated by simultaneous IPA and DO and regular follow up was done.   &nbsp

Pregnancy Outcomes in HIV-Infected Women: Our Experience at a Tertiary Health-Care Center, Ahmedabad, Western India

Background: HIV prevalence has been increasing among pregnant women in many regions within the country. Illiteracy, early marriage, violence and sexual abuse against women are the major socioeconomic reasons for their vulnerability to HIV infection. Estimating the HIV seroprevalence in a low risk population such as pregnant women provide essential information for monitoring trend of HIV in general population and assist in prevention from mother to child transmission.  Methods: This study is a retrospective computer based data analysis, conducted at Sheth V.S. General and Sheth C.M. Hospital, Smt. N.H.L Municipal Medical College, Ahmedabad, a tertiary health care center in Gujarat, India between January 2012 to December 2019. This study includes 68330 pregnant women who attended antenatal clinic or directly admitted in labor room in emergency. Blood sample collected after pretest counselling and informed consent, tested for HIV antibodies as per NACO guidelines. HIV sero-positive mothers and babies were managed at ART center of our institute according to latest guidelines of the same. Results: Out of 68330 pregnant women, 166 found to be HIV-positive with seroprevalence rate of 0.24%. Majority of seropositive women (49.4%) were in the age group of 25-30 Years. Out of 150 live births, 3 babies were found to be HIV sero-positive result at 18 months and were managed with ART according to latest NACO guidelines. Conclusions: Mother to child transmission of HIV infection during pregnancy, delivery or breast feeding is responsible for more than 90% of pediatrics AIDS. Proper antenatal screening, interventions and preventive strategies during pregnancy, delivery and breastfeeding will bring down the mother to child transmission of HIV. A multidisplinary team approach to management involving an HIV physician, experienced obstetrician, and neonatologist are essential to optimize maternal and fetal outcome

Macrophage-derived human resistin is induced in multiple helminth infections and promotes inflammatory monocytes and increased parasite burden.

Parasitic helminth infections can be associated with lifelong morbidity such as immune-mediated organ failure. A better understanding of the host immune response to helminths could provide new avenues to promote parasite clearance and/or alleviate infection-associated morbidity. Murine resistin-like molecules (RELM) exhibit pleiotropic functions following helminth infection including modulating the host immune response; however, the relevance of human RELM proteins in helminth infection is unknown. To examine the function of human resistin (hResistin), we utilized transgenic mice expressing the human resistin gene (hRetnTg+). Following infection with the helminth Nippostrongylus brasiliensis (Nb), hResistin expression was significantly upregulated in infected tissue. Compared to control hRetnTg- mice, hRetnTg+ mice suffered from exacerbated Nb-induced inflammation characterized by weight loss and increased infiltration of inflammatory monocytes in the lung, along with elevated Nb egg burdens and delayed parasite expulsion. Genome-wide transcriptional profiling of the infected tissue revealed that hResistin promoted expression of proinflammatory cytokines and genes downstream of toll-like receptor signaling. Moreover, hResistin preferentially bound lung monocytes, and exogenous treatment of mice with recombinant hResistin promoted monocyte recruitment and proinflammatory cytokine expression. In human studies, increased serum resistin was associated with higher parasite load in individuals infected with soil-transmitted helminths or filarial nematode Wuchereria bancrofti, and was positively correlated with proinflammatory cytokines. Together, these studies identify human resistin as a detrimental factor induced by multiple helminth infections, where it promotes proinflammatory cytokines and impedes parasite clearance. Targeting the resistin/proinflammatory cytokine immune axis may provide new diagnostic or treatment strategies for helminth infection and associated immune-mediated pathology

Aligners vs. Braces: Choosing the Right Treatment

In recent times, there have been notable strides in orthodontic treatments, presenting a multitude of choices for individuals seeking straighter teeth and a more appealing smile. To cater to the increasing demand for aesthetic alternatives to traditional braces, researchers have developed various options. These alternatives encompass ceramic or composite braces, lingual orthodontics, and transparent aligners. Among these alternatives, Invisalign aligners stand out as custom-made, transparent, and thin plastic aligners designed to gradually reposition teeth. This survey aims to evaluate disparities in the quality of life experienced by individuals undergoing treatment with clear aligners versus those receiving conventional orthodontic care

Socioeconomic predictors and consequences of depression among primary care attenders with non-communicable diseases in the Western Cape, South Africa:Cohort study within a randomised trial

Background: Socioeconomic predictors and consequences of depression and its treatment were investigated in 4393 adults with specified non-communicable diseases attending 38 public sector primary care clinics in the Eden and Overberg districts of the Western Cape, South Africa.   Methods: Participants were interviewed at baseline in 2011 and 14 months later, as part of a randomised controlled trial of a guideline-based intervention to improve diagnosis and management of chronic diseases. The 10-item Center for Epidemiologic Studies Depression Scale (CESD-10) was used to assess depression symptoms, with higher scores representing more depressed mood. Results: Higher CESD-10 scores at baseline were independently associated with being less educated (p=0.004) and having lower income (p=0.003). CESD-10 scores at follow-up were higher in participants with less education (p=0.010) or receiving welfare grants (p=0.007) independent of their baseline scores. Participants with CESD-10 scores of 10 or more at baseline (56% of all participants) had 25% higher odds of being unemployed at follow-up (p=0.016), independently of baseline CESD-10 score and treatment status. Among participants with baseline CESD-10 scores of 10 or more, antidepressant medication at baseline was independently more likely in participants who had more education (p=0.002), higher income (p<0.001), or were unemployed (p=0.001). Antidepressant medication at follow up was independently more likely in participants with higher income (p=0.023), and in clinics with better access to pharmacists (p=0.053) and off-site drug delivery (p=0.013).  Conclusions: Socioeconomic disadvantage appears to be both a cause and consequence of depression, and may also be a barrier to treatment. There are opportunities for improving the prevention, diagnosis and treatment of depression in primary care in inequitable middle income countries like South Africa.  Trial registration: The trial is registered with Current Controlled Trials (ISRCTN20283604) and the Office for Human Research Protections Database (IRB00001938, FWA00001637)

A Study of Pharmaceutical Product Registration Process in Cambodia– A First Step Towards Developing a Product-Mix

The Pharmaceutical market in Cambodia attracts high competition due to the fewer entry barriers in the market. The Cambodian medicine requirements are highly dependent on the import of medicines from countries like India, China, Bangladesh, Thailand, Vietnam, and some European countries. India is one of the leading suppliers and contributors to medicine imports in Cambodia due to its cost-effective generic products. In such a competitive market pharmaceutical companies need to constantly introduce new products and dosage forms to be ahead of the competition and capture market share. Any pharmaceutical product imported into Cambodia must be registered at MOH –Cambodia before entering the country. Hence pharmaceutical companies need to focus on the product registration process first, to introduce new products in the market. This descriptive qualitative research concentrates on the first step of creating product-mix offerings –i.e., the new product registration process. The data was collected from one-to-one personal written interviews with the field experts. The current pharmaceutical product registration guideline in Cambodia takes approximately 7 months to register a new POM product. However, companies can opt for fast-track approval by paying an additional official fee determined by the regulators