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.

Mask-less deposition of Au-SnO2 nanocomposites on CMOS MEMS platform for ethanol detection.

Here we report on the mask-less deposition of Au-SnO2 nanocomposites with a silicon-on-insulator (SOI) complementary metal oxide semiconductor (CMOS) micro electro mechanical system (MEMS) platform through the use of dip pen nanolithography (DPN) to create a low-cost ethanol sensor. MEMS technology is used in order to achieve low power consumption, by the employment of a membrane structure formed using deep reactive ion etching technique. The device consists of an embedded tungsten micro-heater with gold interdigitated electrodes on top of the SOI membrane. The tungsten micro-heater is used to raise the membrane temperature up to its operating temperature and the electrodes are used to measure the resistance of the nanocomposite sensing layer. The CMOS MEMS devices have high electro-thermal efficiency, with 8.2 °C temperature increase per mW power of consumption. The sensing material (Au-SnO2 nanocomposite) was synthesised starting from SnO nanoplates, then Au nanoparticles were attached chemically to the surface of SnO nanoplates, finally the mixture was heated at 700 °C in an oven in air for 4 h. This composite material was sonicated for 2 h in terpineol to make a viscous homogeneous slurry and then 'written' directly across the electrode area using the DPN technique without any mask. The devices were characterised by exposure to ethanol vapour in humid air in the concentration range of 100-1000 ppm. The sensitivity varied from 1.2 to 0.27 ppm(-1) for 100-1000 ppm of ethanol at 10% relative humid air. Selectivity measurements showed that the sensors were selective towards ethanol when they were exposed to acetone and toluene.

Reproductive health needs and care seeking behaviour of pavement dwellers of Calcutta.

An unabated growth of street dwellers in the city of Calcutta is reported to be due to twin reasons like, migration of rural poor people as well as uncontrolled fertility among these poor settlers of the city. A community-based study on reproductive health, fertility and related care seeking behaviour was studied among a sample of women of child bearing age living on streets of Calcutta. Besides, the quite common conditions like leucorrhoea (28.5%), menstrual irregularities (12.3%), infertility (2.5%) and STDs (1.3%) were also reported. But most of these illnesses (three-fourth) were uncared for, and the remaining one-fourth sought treatment from govemment institutions, private agencies or even from untrained practitioners (quacks). The reproductive behaviour of street dwelling women was characterised by early marriage, teenage pregnancies, and scarce use of contraceptives (32%) as well as frequent abortions (2.8%). Very few pregnant women received adequate antenatal care (3.8%). Coverage of tetanus toxoid immunisation (68.5%) and proper iron and folic acid supplementation (16.7%) were also poor. Whereas, antenatal care was received mostly from government health institutions (71%), home delivery (ie, on street) was a common practice and conducted mostly by untrained birth attendants (51.8%).

A rapid assessment of anaemia in pregnancy in West Bengal with special reference to care seeking behaviour of mothers.

A cross-sectional study was conducted among the pregnant women in three administrative divisions of West Bengal to undertake a rapid assessment about the magnitude of the problem of anaemia in pregnancy and also to study care seeking behaviour for the same. The findings revealed that the occurrence of anaemia in these three divisions were very high to the extent of 86.39% and popularly known as 'Raktasunyata" or 'Raktalpata' to the common people. As per WHO guidelines (< 40% prevalence) it could be considered as public health problem of very high magnitude. Caregivers prescribed iron supplementation only in 70% of registered pregnant women when 100% coverage of pregnant women with IFA tablet is our national goal. Amongst this group 72.2% were partially consuming these tablets. Main reason for irregular or partial consumption was inability to purchase iron tablets (52.63%). Around 16% mothers were taking rest for 2 hours at daytime during pregnancy. Most important reasons for not consuming iron tablets were that iron was prescribed on the day of study (43.18%) and iron was not prescribed even though mothers were registered (36.23%). Focus group discussion highlighted some factors regarding improvement of the situation.

Studies on 'zinc deficiency syndrome' in black bengal goats (Capra hircus) fed with fodder (Andropogon gayanus) grown on soil treated with an excess of calcium and phosphorus fertilizer.

Overliming and excessive application of superphosphate caused a zinc deficiency in the soil and so reduced the uptake of zinc by fodder plants. Bucks reared on such fodder had significantly (p < 0.01) less zinc in their hair compared with controls and suffered from 'conditioned zinc deficiency syndrome' with a significant (p < 0.01) loss of body weight, stunted growth, alopecia, lethargy, abnormal (kyphotic) gait, anorexia, digestive and respiratory problems. Oral supplementation with zinc sulphate very rapidly improved these conditions to near normality. Histological examination of samples of skin and testis from the zinc-deficient bucks revealed formation of excessive keratin, retention of nuclei in the stratum corneum and reduction in the width of the stratum granulosum in the skin, while samples of testis indicated degenerative changes, including atrophy of the seminiferous tubules, hyperplasia of the germinal epithelium and thickening of the walls of blood vessels.

Clinical use of a concomitant boost technique using a gypsum compensator.

PURPOSE: To develop a clinical procedure to treat field within a field (concomitant boost) portals with a single compensated field. METHODS AND MATERIALS: An ordinary manual cerrobend block former was used to produce styrofoam molds from simulator film data. A special gypsum compound was poured into the molds. The compensator block is independently mounted to the treatment machine via a custom-made compensator holder. RESULTS: Measurements confirm that the inhomogeneous dose distribution has been reliably delivered via this technique. The accuracy of placement of the high dose region is sufficient for clinical use. CONCLUSION: The procedure enables the concomitant boost effect to be easily implemented in the clinic without increasing clinical setup time.

Utilization of maternal services in west Bengal.

A study was conducted in selected blocks of West Bengal to assess the utilization of available maternal health services specially immunization, antenatal care and other services. Coverage with two doses of tetanus toxoid levels varied between 58.6 to 86.7% but it fell far short of Universal Immunization Programme target of 100%. Drop out rates were slightly higher in the rural areas. It was observed that in 5 out of 7 blocks more than 55% of the deliveries were conducted either at hospital or Primary Health Centre by health personnel. However, untrained dais predominated over the trained dais in conducting deliveries in most of the areas. This indicates the poor availability or utilization of the latter.

PIP: Between January and September 1990 in India, medical officers trained in the Universal Immunization Programme and paramedics interviewed 1458 women from 7 rural and urban blocks in northern and southern West Bengal to determine utilization of immunization and prenatal care services by pregnant women and to learn where they delivered and who attended the deliveries. The coverage of pregnant women with 2 doses of tetanus toxoid ranged from 58.6% in Hilli block to 86.7% in North Calcutta. Poor information, education, and communication activities in Hilli likely explained the low coverage. The block with the highest percentage of tetanus toxoid dropouts was Mogra block of Hooghly district (11.3%). The lowest percentage of dropouts occurred in Greater Calcutta (Dhakuria) (3.3%). Institutional deliveries were more common in Calcutta (88.1% in North Calcutta and 69.5% in Dhakuria) than the other blocks (e.g., 38.5% in Hilli). The women in the Calcutta blocks to closer to teaching and nonteaching hospitals and private nursing homes than those in the other blocks. Health personnel attended more than 55% of deliveries in all blocks except Hilli (38.5%) and Tamluk (5.9%). The percentage of health personnel deliveries was especially high in Dhakuria (88.5%) and North Calcutta (69.6%). Untrained traditional birth attendants (dais) were present at a higher percentage of deliveries than were trained dais in all blocks, suggesting poor availability or utilization of trained dais. Untrained dais or other untrained people were present at most deliveries (87.6%) in Tamluk. The study only examined utilization of prenatal care services in 4 blocks. The percent using these services was 81.1% in Mogra, 73.9% in Pandua, 61.4% in Balurghat, and 54.9% in Tamluk.

Effect of pentylenetetrazol on the carbaryl-induced changes of serotonin metabolism in rat-brain hypothalamus.

Carbaryl (200 mg/kg or 400 mg/kg, p.o.) significantly elevated serotonin (5-HT) (57-109%) and 5-hydroxyindoleacetic acid (5-HIAA) (60-78%) levels at 1.0 h in the hypothalamic region of adult male rat brain. Further, administration of carbaryl (200 mg/kg, p.o.) for different time intervals (0.5 h, 1.0 h, and 2.0 h) revealed that both 5-HT and 5-HIAA levels elevated maximally at 0.5 h in hypothalamus. These regional 5-HT and 5-HIAA levels were not significantly affected with pentylenetetrazol (PTZ) at any time after its treatment. But simultaneous administration of carbaryl (200 mg/kg, p.o.) and PTZ (60 mg/kg, s.c.) reduced the carbaryl-induced elevation of both 5-HT and 5-HIAA levels. Measurement of (i) probenecid-induced (200 mg/kg, i.p.) accumulation and (ii) pargyline-induced (75 mg/kg, i.p.) depletion of hypothalamic 5-HIAA level in the absence or presence of carbaryl (200 mg/kg, p.o.) and/or PTZ (60 mg/kg, s.c.) revealed that (a) carbaryl enhanced the synthesis as well as the breakdown of 5-HT, (b) PTZ had no effect on either of these processes of 5-HT, and (c) carbaryl-induced increased catabolism of 5-HT became normal in the presence of PTZ.

Carbaryl-induced elevation of corticosterone level and cholinergic mechanism.

Administration of a single dose (200 mg/kg, p.o.) of carbaryl to rats produced a significant rise in adrenal and plasma corticosterone levels and an increase of tyrosine alpha-ketoglutarate transaminase activity in the liver cytosol. Synaptosomal acetylcholinesterase activity of the hypothalamic and the striatal regions of rat brain was decreased by carbaryl treatment under similar conditions. Pretreatment (0.5 h) with atropine sulphate (10 mg/kg, i.p.) failed to counteract the carbaryl-induced elevation of adrenal and plasma corticosterone levels and hence the liver tyrosine alpha-ketoglutarate transaminase activity. Present results suggest that the carbaryl-induced rise in the corticosterone level in the adrenal gland and plasma is not due to a cholinergic mechanism.