Efficacy of Prophylactic use of Ciprofloxacin and Metronidazole in Mild and Moderately Severe Acute Pancreatitis.

INTRODUCTION: There are new concepts and developments in the diagnosis and management of acute pancreatitis. Current evidence suggests that there is no role of prophylactic antibiotics use in acute pancreatitis. However, it is still a common practice to administer prophylactic antibiotics in a country like Nepal. So, we have conducted a study in mild and moderately severe acute pancreatitis to study the efficacy of prophylactic antibiotics. METHODS: A case control study was conducted among 76 patients comparing efficacy of prophylactic antibiotics versus no antibiotics in patients with mild and moderately severe acute pancreatitis. RESULTS: The two most common etiology of acute pancreatitis in AG and NAG were alcohol 21 (55.2%) vs. 24 (63.1%) and biliary 10 (26.3%) vs. 4 (10.5%) respectively. Pancreatic necrosis was seen in five (13.1 %) in AG and four (10.5%) in NAG. Four (10.5%) developed extra pancreatic complications in AG and five (13.1%) in NAG. There was one (2.6%) death in AG and no death in NAG. Abdominal pain improvement seen in AG vs. NAG was 3.2 days vs. 2.4 days (P=0.002). The hospital stay was 7.7±2.23 days in AG and 7.5±1.85 days in NAG (P=0.65). CONCLUSIONS: The routine use of prophylactic antibiotics for mild and moderately severe acute pancreatitis is not associated with improvement in meaningful clinical outcomes.

Computational identification of miRNAs and their target genes from expressed sequence tags of tea (Camellia sinensis).

MicroRNAs (miRNAs) are a newly identified class of small non-protein-coding post-transcriptional regulatory RNA in both plants and animals. The use of computational homology based search for expressed sequence tags (ESTs) with the Ambros empirical formula and other structural feature criteria filter is a suitable combination towards the discovery and isolation of conserved miRNAs from tea and other plant species whose genomes are not yet sequenced. In the present study, we blasted the database of tea (Camellia sinensis) ESTs to search for potential miRNAs, using previously known plant miRNAs. For the first time, four candidate miRNAs from four families were identified in tea. Using the newly identified miRNA sequences, a total of 30 potential target genes were identified for 11 miRNA families; 6 of these predicted target genes encode transcription factors (20%), 16 target genes appear to play roles in diverse physiological processes (53%) and 8 target genes have hypothetical or unknown functions (27%). These findings considerably broaden the scope of understanding the functions of miRNA in tea.

Comparison of HoLEP and TURP in terms of efficacy in the early postoperative period and perioperative morbidity.

OBJECTIVES: We conducted this study to compare the safety and efficacy of transurethral resection of the prostate (TURP) and holmium laser prostatectomy. METHODS: A total of 30 patients eligible for surgery for symptomatic benign prostatic hyperplasia were included in the study. They were randomized into two groups of 15 each. The patients were evaluated at 3 weeks, 3 and 9 months. RESULTS: Preoperative parameters were comparable between the 2 groups. The mean operative time was longer in the holmium laser enucleation of prostate (HoLEP) group (53 +/- 9.84 vs. 43 +/- 9.36 min; p = 0.001). The intraoperative adverse events were comparable. The mean traction time (26.80 +/- 5.9 vs. 19.60 +/- 3.6 h; p = 0.0001), irrigation time (30 +/- 7.68 vs. 19.40 +/- 1.15 h; p = 0.0001), and duration of indwelling catheter (78.20 +/- 17.84 vs. 46.42 +/- 14.25 h; p = 0.0001) were significantly less in the HoLEP group as compared to the TURP group. Two patients (13.66%) in the TURP group had significant hematuria. Two patients in the HoLEP group vs. none in the TURP group developed urinary incontinence (p < 0.05). Significant improvements were observed in IPSS score, PFRs and PVRs in both the groups and maintained at 9 months. CONCLUSIONS: HoLEP is safe and effective in the surgical management of benign prostatic hyperplasia, with the advantage of reduced intraoperative hemorrhage and perioperative morbidity.

Metabolite profiling and characterization of somaclonal variants in tea (Camellia spp.) for identifying productive and quality accession.

A study has been undertaken to characterize 15 field grown somaclonal variants derived from cotyledonary tissues of UPASI-10 using morphological, physiological and biochemical characters. Although variants were derived from UPASI-10, a very few variants possessed unique "Chinery" characters while others exhibited "Assam" characters. However, no variant showed identical morphological characters aligning with the parent. Somaclonal variants showed distinct variation in terms of photosynthetic carbon assimilation, stomatal conductance and diffusion resistance. Proline accumulation and water use efficiency showed marginal variations among the variants. SE 8 and SE 10 recorded higher values of membrane stability index denoting their tolerant nature against stress. Class interval analysis based on physiological parameters grouped these plants into three clusters. Three variants grouped under good category representing higher values of productivity index followed by five variants under moderate category. Green leaf constituents and quality profile of made tea produced with crop shoots of variants exhibited wide variation. Center point radar graph analysis of quality constituents grouped these plants into three clusters. Variants SE 2 and SE 13 were segregated distinctly representing their black tea characters. When considering both the quality and productivity indices, SE 3 and SE 7 fall under moderate category and in future these two variants may be subjected to further quality tests for commercial exploitation.

Electrofocusing of methanolic extracts for identification of individual flavonol biomolecules in Camellia species.

An effort has been made to isolate individual catechin compounds from green tea leaves in their pure form by electrophoresis. In the present study total polyphenol extraction was carried out initially and estimated through spectrophotometric and HPLC methods. Extracted polyphenol was separated on 0.7% agarose gel and visualized at 360 nm. Fragmented individual compounds were gel eluted with methanol and confirmed as (-)-epigallocatechin (EGC), (-)-epicatechin (EC), (-)-epicatechin gallate (ECG), and (-)-epigallocatechin gallate (EGCG) by HPLC. The method developed describes a suitable method for the isolation of valuable molecules in tea.

A modified technique of anterior peribulbar anaesthesia.

A modified technique of peribulbar anaesthesia consisting of a single injection of anaesthetic solution with a 26G, half inch insulin needle was evaluated in 50 eyes. The operative procedures included extracapsular cataract extraction with intraocular lens implantation in 20 eyes, intracapsular lens extraction in 20 eyes, and trabeculectomy in 10 eyes. Complete anaesthesia was obtained in 45 eyes (90%). No significant complications were observed except for mild to moderate conjunctival chemosis in 40 eyes (80%). The technique is easy to learn, safe, effective and relatively economical.

Safety and efficacy of mezlocillin: a single-drug therapy for penetrating abdominal trauma.

This study was done to determine if a single drug, mezlocillin (Mezlo), is as safe and as effective as combined clindamycin (Clind) and gentamicin (Gent) in the treatment of penetrating abdominal wounds. One hundred seventy-three patients received either Mezlo or Clind/Gent combined therapy as assigned by computer-generated randomization. Of these, 147 patients were evaluable. Of 73 patients treated with Clind/Gent the mean duration of hospital stay was 8.9 +/- 4.0 days. Infectious complications developed in 18 patients of whom five failed to respond promptly, but only one required change in therapy. Of 74 patients treated with Mezlo, the mean duration of hospital stay was 9.1 +/- 5.0 days. Infectious complications occurred in 17, in whom four patients failed to eliminate their infections, and two needed changes in antibiotic therapy. None of the patients in either antibiotic group failed because of Enterococcus or Pseudomonas infections. There were no deaths. Twelve isolates of Bacteroides were found in peritoneal fluid cultures and all these patients had colon injuries. The overall therapeutic response was excellent to good in 94% on Clind/Gent and 93% on Mezlo. Azotemia developed in one patient on Clind/Genet and one on Mezlo but no other adverse reactions occurred. The differences shown between the two groups were not statistically significant. We conclude that a single drug mezlocillin is as safe and as effective in the treatment of abdominal trauma as combined clindamycin and gentamicin.

The pros and cons of outpatient breast biopsy.

A review of the 130 breast biopsies performed on women during the past three years at the Martin Luther King, Jr, General Hospital showed that 90 were performed on outpatients and 40 on inpatients. Of the 90 outpatient procedures, 61 were under local anesthesia and 29 under general. Only three outpatient biopsy specimens were malignant and required subsequent patient admission to the hospital for mastectomy at an interval of 9 to 14 days. In all three, the axillary nodes were uninvolved. In two, no residual tumor was found in the mastectomy specimen.