RESUMO
OBJECTIVE: To assess the effect of tranexamic acid in head and neck surgical procedures. METHODS: A prospective, double-blind and randomised, parallel group, placebo-controlled clinical trial was conducted. Ninety-two patients undergoing various head and neck surgical procedures were randomised. Subjects received seven infusions of coded drugs (tranexamic acid or normal saline) starting at the time of skin closure. Haematological, biochemical, blood loss and other parameters were observed by the staff, who were blinded to patients' group allocation (case or control). RESULTS: Patients were analysed on the basis of type of surgery. Fifty patients who had undergone surgical procedures, including total thyroidectomy, total parotidectomy, and various neck dissections with or without primary tumour excision, were included in the first group. The second group comprised 41 patients who had undergone hemithyroidectomy, lobectomy or superficial parotidectomy. There was no statistical difference in blood parameters between both groups. There was a reduction in post-operative drain volume, but this was not significant. CONCLUSION: Although this prospective, randomised, placebo-controlled clinical trial found a reduction in post-operative drain volume in tranexamic acid groups, the difference was not statistically significant between the various head and neck surgical procedure groups.
Assuntos
Antifibrinolíticos/uso terapêutico , Perda Sanguínea Cirúrgica/prevenção & controle , Procedimentos Cirúrgicos Otorrinolaringológicos/efeitos adversos , Hemorragia Pós-Operatória/prevenção & controle , Ácido Tranexâmico/uso terapêutico , Adulto , Método Duplo-Cego , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Esvaziamento Cervical/efeitos adversos , Esvaziamento Cervical/métodos , Procedimentos Cirúrgicos Otorrinolaringológicos/métodos , Glândula Parótida/cirurgia , Hemorragia Pós-Operatória/etiologia , Estudos Prospectivos , Tireoidectomia/efeitos adversos , Tireoidectomia/métodos , Resultado do TratamentoRESUMO
The ever shrinking agricultural land availability and the swelling demand of food for the growing population fetch our attention towards utilizing partially reclaimed sodic soils for cultivation. In the present investigation, we compared six treatments, like control (T1), existing farmers' practice (T2), balanced inorganic fertilization (T3) and combined application of green gram (Vigna radiate) with inorganic NPK (T4), green manure (Sesbania aculeate) with inorganic NPK (T5), and farmyard manure with inorganic NPK (T6), to study the influence of nutrient management on soil organic carbon sequestration and soil fertility under long-term rice-wheat cropping system along with its productivity in gypsum-amended partially reclaimed sodic soils of semi-arid sub-tropical Indian climate. On an average, combined application of organics along with fertilizer NPK (T4, T5, and T6) decreased soil pH, ESP, and BD by 3.5, 13.0, and 6.7% than FP (T2) and 3.7, 12.5, and 6.7%, than balanced inorganic fertilizer application (T3), respectively, in surface (0-20 cm). These treatments (T4, T5, and T6) also increased 14.1% N and 19.5% P availability in soil over the usual farmers' practice (FP) with an additional saving of 44.4 and 27.3% fertilizer N and P, respectively. Long-term (6 years) incorporation of organics (T4, T5, and T6) sequestered 1.5 and 2.0 times higher soil organic carbon as compared to the balanced inorganic (T3) and FP (T2) treatments, respectively. The allocation of soil organic carbon into active and passive pools determines its relative susceptibility towards oxidation. The lower active to passive ratio (1.63) in FYM-treated plots along with its potentiality of higher soil organic carbon (SOC) sequestration compared to the initial stock proved its acceptability for long-term sustenance under intensive cropping even in partially reclaimed sodic soils. Among all the treatments, T4 yielded the maximum from second year onwards. Moreover, after 6 years of continuous cultivation, the observed EWY (2011-2012) was found to be 41.9 and 33.1% higher in T4 as compared to FP (T2) and T3, respectively. Thus, for maintaining higher yield coupled with improved SOC sequestration and nutrient availability, T4 followed by T6 treatments would be the suitable options for long-term intensive rice-wheat system in partially reclaimed sodic soils of northern India.
Assuntos
Agricultura/métodos , Sequestro de Carbono , Monitoramento Ambiental , Carbono/análise , Produtos Agrícolas/crescimento & desenvolvimento , Produtos Agrícolas/metabolismo , Fertilizantes/análise , Índia , Esterco , Oryza/crescimento & desenvolvimento , Oryza/metabolismo , Sesbania , Solo/química , Triticum/crescimento & desenvolvimento , Triticum/metabolismo , Clima TropicalRESUMO
Aluminum is a light weight and toxic metal present ubiquitously on earth, which has gained considerable attention due to its neurotoxic effects. It also has been linked ecologically and epidemiologically to several neurological disorders, including Alzheimer's disease (AD), Parkinson's disease (PD), Guamanian-Parkinsonian complex and Amyotrophic lateral sclerosis (ALS). The mechanism of aluminum neurotoxicity is poorly understood, but it is well documented that aluminum generates reactive oxygen species (ROS). Enhanced ROS production leads to disruption of cellular antioxidant defense systems and release of cytochrome c (cyt-c) from mitochondria to cytosol resulting in apoptotic cell death. Quercetin (a natural flavonoid) protects it from oxidative damage and has been shown to decrease mitochondrial damage in various animal models of oxidative stress. We hypothesized that if oxidative damage to mitochondria does play a significant role in aluminum-induced neurodegeneration, and then quercetin should ameliorate neuronal apoptosis. Administration of quercetin (10 mg/kg body wt/day) reduced aluminum (10 mg/kg body wt/day)-induced oxidative stress (decreased ROS production, increased mitochondrial superoxide dismutase (MnSOD) activity). In addition, quercetin also prevents aluminum-induced translocation of cyt-c, and up-regulates Bcl-2, down-regulates Bax, p53, caspase-3 activation and reduces DNA fragmentation. Quercetin also obstructs aluminum-induced neurodegenerative changes in aluminum-treated rats as seen by Hematoxylin and Eosin (H&E) staining. Further electron microscopic studies revealed that quercetin attenuates aluminum-induced mitochondrial swelling, loss of cristae and chromatin condensation. These results indicate that treatment with quercetin may represent a therapeutic strategy to attenuate the neuronal death against aluminum-induced neurodegeneration.
Assuntos
Alumínio/toxicidade , Hipocampo/efeitos dos fármacos , Doenças Neurodegenerativas/tratamento farmacológico , Neurônios/efeitos dos fármacos , Fármacos Neuroprotetores/farmacologia , Quercetina/farmacologia , Alumínio/sangue , Animais , Antioxidantes/farmacologia , Apoptose/efeitos dos fármacos , Apoptose/fisiologia , Caspase 3/metabolismo , Núcleo Celular/efeitos dos fármacos , Núcleo Celular/patologia , Núcleo Celular/fisiologia , Cromatina/efeitos dos fármacos , Cromatina/metabolismo , Cromatina/patologia , Citocromos c/metabolismo , Fragmentação do DNA/efeitos dos fármacos , Modelos Animais de Doenças , Avaliação Pré-Clínica de Medicamentos , Hipocampo/patologia , Hipocampo/fisiopatologia , Masculino , Mitocôndrias/efeitos dos fármacos , Mitocôndrias/patologia , Mitocôndrias/fisiologia , Doenças Neurodegenerativas/patologia , Doenças Neurodegenerativas/fisiopatologia , Neurônios/patologia , Neurônios/fisiologia , Ratos Wistar , Espécies Reativas de Oxigênio/metabolismo , Superóxido Dismutase/metabolismoRESUMO
Killian polyp is predominantly found in children and any sinonasal tumor in elderly presenting with epistaxis and pain usually indicates malignant growth until proved otherwise. We present an unusual case of Killian polyp in an elderly patient that behaved as a malignant tumor. This case report reminded us that paranasal sinuses are still dark hollow mysterious cavities, and we should take utmost clinical acumen in managing such cases.
RESUMO
Numerous epidemiological studies have shown an association between pesticide exposure and the increased risk of developing Parkinson's disease. Previously we have reported that Dichlorvos exposure can induce oxidative stress, resulting in over-expression of pro-apoptotic genes and finally caspase-dependent nigrostriatal dopaminergic neuronal cell death in rat brain. Here, we examined the effect of caspase inhibition on PC12 cell death induced by Dichlorvos (30 µM). Reactive oxygen species (ROS) generation followed by protein carbonylation, lipid peroxidation, decreased antioxidant defenses (decreased Mn-superoxide dismutase (MnSOD) activity and decreased glutathione levels) and subsequent caspase activation mediated the apoptosis. Inhibition of caspase cascade with Boc-aspartyl(OMe)-fluoromethylketone (BAF) enhanced the Dichlorvos-induced PC12 cell death, as assessed by the increased cellular efflux of lactate dehydrogenase (LDH). This increase in cell death was accompanied by a marked increase in poly(ADP-ribose) polymerase-1 (PARP1) activity, increased oxidative stress, a reduction in the mitochondrial membrane potential and reduced cellular NAD and ATP levels. Pretreatment of cells with PJ34, a PARP1 inhibitor prevented the cells from undergoing cell death and preserved intracellular NAD and ATP levels. Subsequent release of the apoptosis-inducing factor (AIF) from mitochondria and its translocation into the nucleus was also prevented by PJ34 pretreatment. In conclusion, the results of the present study show that caspase inhibition without concurrent inhibition of PARP1 is unlikely to be effective in preventing cell death because in the presence of the caspase inhibitor, caspase-independent cell death predominates due to PARP activation. These results suggest that combined therapeutic strategies directed at multiple cell death pathways may provide superior neuroprotection than those directed at a single mechanism.
Assuntos
Clorometilcetonas de Aminoácidos/farmacologia , Inibidores de Caspase/farmacologia , Morte Celular/efeitos dos fármacos , Diclorvós/toxicidade , Inseticidas/toxicidade , Neurônios/efeitos dos fármacos , Trifosfato de Adenosina/metabolismo , Animais , Fator de Indução de Apoptose/metabolismo , Sobrevivência Celular/efeitos dos fármacos , Dopamina/metabolismo , NAD/metabolismo , Neurônios/fisiologia , Estresse Oxidativo/efeitos dos fármacos , Estresse Oxidativo/fisiologia , Células PC12 , Fenantrenos/farmacologia , Poli(ADP-Ribose) Polimerase-1 , Inibidores de Poli(ADP-Ribose) Polimerases , Poli(ADP-Ribose) Polimerases/metabolismo , Ratos , Espécies Reativas de Oxigênio/metabolismoRESUMO
Aluminum phosphide (ALP), a widely used fumigant and rodenticide, leads to high mortality if ingested. Its toxicity is due to phosphine that is liberated when it comes in contact with moisture. The exact site or mechanism of action of phosphine is not known, although it is widely believed that it affects mitochondrial oxidative phosphorylation. Basic serum biochemical parameters, activity of mitochondrial complexes, antioxidant enzymes and parameters of oxidative stress were estimated in the platelets of 21 patients who developed severe poisoning following ALP ingestion. These parameters were compared with 32 healthy controls and with 22 patients with shock due to other causes (cardiogenic shock (11), septic shock (9) and hemorrhagic shock (2)). The serum levels of creatine kinase-muscle brain and lactate dehydrogenase were higher in patients poisoned with ALP, whereas a significant decrease was observed in the activities of mitochondrial complexes I, II and IV. The activity of catalase was lower but the activities of superoxide dismutase and glutathione peroxidase were unaffected in them. A significant increase in lipid peroxidation and protein carbonylation was observed, whereas total blood thiol levels were lower. In patients severely poisoned with ALP, not only cytochrome c oxidase but also other complexes are involved in mitochondrial electron transport, and enzymes are also inhibited.
Assuntos
Compostos de Alumínio/intoxicação , Plaquetas/efeitos dos fármacos , Fosfinas/intoxicação , Rodenticidas/intoxicação , Adolescente , Adulto , Idoso , Plaquetas/metabolismo , Catalase/sangue , Creatina Quinase Forma MB/sangue , Complexo de Proteínas da Cadeia de Transporte de Elétrons/sangue , Feminino , Glutationa Peroxidase/sangue , Humanos , L-Lactato Desidrogenase/sangue , Masculino , Pessoa de Meia-Idade , Estresse Oxidativo/efeitos dos fármacos , Superóxido Dismutase/sangue , Adulto JovemRESUMO
Polyp and mucocele are the commonest sinonasal tumours and schwannoma is rarely found in the paranasal sinuses. We report a case of a 64-year-old man presenting with progressive nasal obstruction and numbness on left cheek for the past 2 months. High-resolution CT found a soft tissue mass in the maxillary antrum with bony destruction. Clinical features, radiological scan and nasal endoscopic examination were suggestive of a malignant tumour. Tumour was excised through Caldwell-Luc's approach and histopathological examination found a mixed schwannoma.
Assuntos
Neoplasias do Seio Maxilar/diagnóstico , Neurilemoma/diagnóstico , Biópsia , Diagnóstico Diferencial , Humanos , Masculino , Neoplasias do Seio Maxilar/patologia , Neoplasias do Seio Maxilar/cirurgia , Pessoa de Meia-Idade , Neurilemoma/patologia , Neurilemoma/cirurgia , Tomografia por Raios XRESUMO
Worldwide, tonsillitis is very common. The most common etiology is cross-infection with bacteria and viruses. These cases are managed with antibiotics and anti-inflammatory drugs without any further investigation because the diagnosis is based on simple clinical examination. Usually, leukemia presents with bleeding, weight loss, lymphadenopathy, fever, and frequent infection. Tonsillitis is a rare first presentation of leukemia. We present 3 cases in which the diagnosis of leukemia was made on routine examination, and in 1 case diagnosis was suspected during tonsillectomy.
Assuntos
Leucemia Mieloide Aguda/complicações , Leucemia Mieloide Aguda/diagnóstico , Tonsilite/etiologia , Adulto , Criança , Feminino , Humanos , Leucemia Mieloide Aguda/tratamento farmacológico , Masculino , Tonsilite/cirurgiaRESUMO
Otoacoustic emissions have been advocated in the management of otitis media with effusion. However, otoacoustic emissions cannot differentiate different types of hearing loss. This study was conducted to find factor that can differentiate otitis media with effusion from other common causes of hearing loss in children. Children were enrolled in the study and divided in four groups consisting of 25 ears each after pure tone and impedance audiometry: (1) Otitis media with effusion group, (2) Normal ear group, (3) Sensory-neural hearing loss group, (4) Chronic suppurative otitis media group. Otoacoustic emissions were recorded and results were analyzed statistically. The normal hearing group had significant difference from other groups but total band reproducibility of transient evoked otoacoustic emissions did not show any statistical difference in the cases groups. In distortion product otoacoustic emissions, group 1 showed significant difference from group 3 and group 1 had significant difference from all other groups at 4 kHz. The study did not find any factor that differentiates otitis media with effusion from other diseases. Although, distortion product otoacoustic emissions can indicate otitis media with effusion but impedance audiometry should be the main tool in the management of otitis media with effusion.
Assuntos
Ataxia Cerebelar/patologia , Marcha Atáxica , Doença de Hashimoto/diagnóstico , Hipotireoidismo/complicações , Adulto , Feminino , Marcha Atáxica/complicações , Marcha Atáxica/diagnóstico , Doença de Hashimoto/complicações , Doença de Hashimoto/tratamento farmacológico , Humanos , Hipotireoidismo/diagnóstico , Imageamento por Ressonância Magnética , Testes de Função Tireóidea , Tiroxina/uso terapêutico , Resultado do TratamentoRESUMO
The present study was carried out to elucidate the effects of coenzyme Q(10) (CoQ(10)) against cognitive impairments induced by dichlorvos (DDVP). We have previously shown organophosphate, DDVP-induced impairments in neurobehavioral indices viz. rota rod, passive avoidance, and water maze tests. In addition to this, we have also reported that chronic DDVP exposure leads to decreased mitochondrial electron transfer activities of cytochrome oxidase along with altered mitochondrial complexes I-III activity. Administration of CoQ(10) (4.5 mg/kg, i.p. for 12 weeks prior to DDVP administration daily) to DDVP-treated rats improved cognitive performance in passive avoidance task and Morris water maze test. Furthermore, CoQ(10) treatment also reduced oxidative stress (as evident by reduced malondialdehyde, decreased ROS and increased Mn-SOD activity) in DDVP-treated rats' hippocampus region, along with enhanced activity of complexes I-III and complex IV. Electron microscope studies of rat hippocampus mitochondria revealed that CoQ(10) administration leads to near normal physiology of mitochondria with well-defined cristae compared with DDVP-treated animals where enlarged mitochondria with distorted cristae are observed. CoQ(10) administration also attenuated neuronal damage in hippocampus as evident from histopathological studies. These results demonstrate the beneficial effects of CoQ(10) against organophosphate-induced cognitive impairments and hippocampal neuronal degeneration.
Assuntos
Transtornos Cognitivos/tratamento farmacológico , Transtornos Cognitivos/prevenção & controle , Diclorvós/toxicidade , Degeneração Neural/tratamento farmacológico , Degeneração Neural/prevenção & controle , Ubiquinona/análogos & derivados , Vitaminas/uso terapêutico , Animais , Aprendizagem da Esquiva/efeitos dos fármacos , Transtornos Cognitivos/induzido quimicamente , Modelos Animais de Doenças , Esquema de Medicação , Hipocampo/efeitos dos fármacos , Hipocampo/metabolismo , Hipocampo/patologia , Masculino , Aprendizagem em Labirinto/efeitos dos fármacos , Mitocôndrias/metabolismo , Mitocôndrias/ultraestrutura , Degeneração Neural/induzido quimicamente , Degeneração Neural/patologia , Estresse Oxidativo/efeitos dos fármacos , Bombas de Próton/metabolismo , Ratos , Ratos Wistar , Ubiquinona/administração & dosagem , Ubiquinona/farmacologia , Ubiquinona/uso terapêutico , Vitaminas/administração & dosagem , Vitaminas/farmacologiaRESUMO
OBJECTIVE: To evaluate the effect of different lipid fractions on auditory brainstem evoked responses in hyperlipidaemia. METHOD: We conducted a single institution (medical college), prospective, cross-sectional study of 25 hyperlipidaemic patients and 25 normolipidaemic controls, all with a normal hearing threshold on pure tone audiometry. Brainstem evoked response audiometry results were recorded in both groups. The hyperlipidaemic group were further divided into two subgroups, based on the serum value of each lipid fraction: those with less than and those with greater than the mean serum value. These two subgroups were further compared with the control group. RESULTS: The hyperlipidaemic and normolipidaemic groups had statistically significant differences for all audiometry waves apart from the wave I and the III-V interpeak latencies. The subgroups had a statistically significant difference in brainstem evoked responses. We found a statistically significant association between low-density lipoproteins and many waveforms in the hyperlipidaemic group. CONCLUSION: We found that low-density lipoproteins were significantly associated with many waveforms in hyperlipidaemic patients. Thus, low-density lipoproteins may be important in auditory dysfunction.
Assuntos
Potenciais Evocados Auditivos do Tronco Encefálico/fisiologia , Perda Auditiva Neurossensorial/sangue , Hiperlipidemias/fisiopatologia , Lipoproteínas LDL/sangue , Adulto , Análise de Variância , Audiometria de Tons Puros , Limiar Auditivo , Estudos Transversais , Feminino , Perda Auditiva Neurossensorial/fisiopatologia , Humanos , Modelos Lineares , Masculino , Pessoa de Meia-Idade , Estudos ProspectivosRESUMO
OBJECTIVE: To investigate the hypothesis of cochlear and retrocochlear damage in scrub typhus, using evoked response audiometry. STUDY DESIGN: Prospective, randomised, case-control study. METHODS: The study included 25 patients with scrub typhus and 25 controls with other febrile illnesses not known to cause hearing loss. Controls were age- and sex-matched. All subjects underwent pure tone audiometry and evoked response audiometry before commencing treatment. RESULTS: Six patients presented with hearing loss, although a total of 23 patients had evidence of symmetrical high frequency loss on pure tone audiometry. Evoked response audiometry found significant prolongation of absolute latencies of wave I, III, V, and wave I-III interpeak latency. Two cases with normal hearing had increased interpeak latencies. These findings constitute level 3b evidence. CONCLUSION: Findings were suggestive of retrocochlear pathology in two cases with normal hearing. In other patients, high frequency hearing loss may have led to altered evoked response results. Although scrub typhus appears to cause middle ear cochlear and retrocochlear damage, the presence of such damage could not be fully confirmed by evoked response audiometry.
Assuntos
Audiometria de Resposta Evocada/métodos , Doenças Retrococleares/diagnóstico , Tifo por Ácaros/diagnóstico , Adolescente , Adulto , Audiometria de Tons Puros , Limiar Auditivo/fisiologia , Estudos de Casos e Controles , Criança , Doenças Cocleares/complicações , Doenças Cocleares/diagnóstico , Doenças Cocleares/fisiopatologia , Feminino , Perda Auditiva de Alta Frequência/diagnóstico , Perda Auditiva de Alta Frequência/etiologia , Perda Auditiva Neurossensorial/diagnóstico , Perda Auditiva Neurossensorial/etiologia , Humanos , Masculino , Estudos Prospectivos , Doenças Retrococleares/complicações , Doenças Retrococleares/fisiopatologia , Tifo por Ácaros/complicações , Tifo por Ácaros/fisiopatologia , Adulto JovemRESUMO
The objective of this study was to elucidate an association between Apo- Eε4 allele and CSF biomarkers Aß42 and tau for the diagnosis of Alzheimer's Disease (AD) patients. Aß42 and tau protein concentrations in CSF were measured by using ELISA assays. The levels of Aß42 were found to be decreased where as tau levels increased in AD patients. Moreover in AD patients Apo-Eε4 allele carriers have shown low Aß42 levels (328.86 ± 99.0 pg/ml) compared to Apo-Eε4 allele non-carriers (367.52 ± 5 7.37 pg/ml), while tau levels were higher in Apo-Eε4 allele carriers (511 ± 44.67 pg/ml) compared to Apo-Eε4 allele non-carriers (503.75 ± 41.08 pg/ml). Combination of Aß42 and tau resulted in sensitivity of 75.38% and specificity of 94.82% and diagnostic accuracy of 84.30% for AD compared with the controls. Therefore low Aß42 and elevated tau concentrations in CSF may prove to be a better diagnostic marker for AD along with the Apo-Eε4 allele.
Assuntos
Doença de Alzheimer/líquido cefalorraquidiano , Doença de Alzheimer/genética , Peptídeos beta-Amiloides/líquido cefalorraquidiano , Apolipoproteína E4/genética , Fragmentos de Peptídeos/líquido cefalorraquidiano , Proteínas tau/líquido cefalorraquidiano , Alelos , Biomarcadores/líquido cefalorraquidiano , Ensaio de Imunoadsorção Enzimática , Feminino , Predisposição Genética para Doença , Heterozigoto , Humanos , Masculino , Pessoa de Meia-Idade , Reação em Cadeia da PolimeraseRESUMO
BACKGROUND: Healthcare liquid wastes are the reservoirs of harmful infectious agents such as the pathogens and multiple drug resistant microorganisms. Potential infectious risks include the spread of infectious diseases and microbial resistance from health-care establishments into the environment and thereby posing risks of getting infections and antibiotic resistance in the communities. OBJECTIVES: The objectives of this study were to assess the bacterial load of healthcare liquid waste generated in central hospitals and to explore the antimicrobial resistance pattern of these bacterial isolates. MATERIALS AND METHODS: A descriptive study was carried out in 10 conveniently selected central hospitals of Nepal during the period of May to December 2008. Effluent specimens from each hospital were subjected to total viable count studies by spread plate method in nutrient agar plate and incubated for 24 hours at 37 °C using standard laboratory protocol. Similarly, all the specimens were cultured in Mac Conkey Agar media supplemented with 30 µg/ml of Chloramphenicol and 20 µg/ml of Gentamycin for the enumeration of multiple drug resistant (MDR) bacteria, which were further subjected to in-vitro antibiotic susceptibility test by modified Kirby Bauer disc diffusion technique for resistance patterns. RESULTS: Total viable counts of hospital effluents significantly exceeded the standard heterotrophic plate count (p=0.000). Similarly, the numbers of multiple drug resistant bacteria were alarmingly high in three (more than 30% in 2 and 50% in 1) hospitals of this study. Drug resistant hospital effluent isolates showed simultaneous resistance for most of the antibiotics including Penicillin, Cephalosporin, Cotrimoxazole, Gentamycin and Quinolones. CONCLUSION: Healthcare liquid wastes were laden with MDR bacteria and seemed to pose a huge public health threat in the transfer of such resistance to the bacterial pathogens causing community acquired infections, thereby limiting our antibiotic pool.
Assuntos
Antibacterianos/farmacologia , Bactérias/efeitos dos fármacos , Farmacorresistência Bacteriana Múltipla , Hospitais/estatística & dados numéricos , Resíduos de Serviços de Saúde/análise , Bactérias/isolamento & purificação , Técnicas Bacteriológicas , Estudos Transversais , Humanos , Nepal/epidemiologiaRESUMO
BACKGROUND: The management of healthcare liquid waste is an overlooked problem in Nepal with stern repercussions in terms of damaging the environment and affecting the health of people. This study was carried out to explore the healthcare liquid waste management practices in Kathmandu based central hospitals of Nepal. METHODS: A descriptive prospective study was conducted in 10 central hospitals of Kathmandu during the period of May to December 2008. Primary data were collected through interview, observation and microbiology laboratory works and secondary data were collected by records review. For microbiological laboratory works,waste water specimens cultured for the enumeration of total viable counts using standard protocols. RESULTS: Evidence of waste management guidelines and committees for the management of healthcare liquid wastes could not be found in any of the studied hospitals. Similarly, total viable counts heavily exceeded the standard heterotrophic plate count (p=0.000) with no significant difference in such counts in hospitals with and without treatment plants (p=0.232). CONCLUSIONS: Healthcare liquid waste management practice was not found to be satisfactory. Installation of effluent treatment plants and the development of standards for environmental indicators with effective monitoring, evaluation and strict control via relevant legal frameworks were realized.
Assuntos
Hospitais , Eliminação de Resíduos de Serviços de Saúde/métodos , Política Organizacional , Poluição Química da Água , Humanos , Eliminação de Resíduos de Serviços de Saúde/instrumentação , Eliminação de Resíduos de Serviços de Saúde/estatística & dados numéricos , Nepal , Estudos Prospectivos , Saúde Pública , Garantia da Qualidade dos Cuidados de Saúde , Estatística como Assunto , Inquéritos e Questionários , Microbiologia da Água , Organização Mundial da SaúdeRESUMO
BACKGROUND: Cisplatin-induced ototoxicity shows high interindividual variability and is often accompanied by transient or permanent tinnitus. It is not possible to identify the susceptible individuals before commencement of the treatment. We conducted a prospective, randomized and observational study in a tertiary care centre and evaluated the effects of different doses of cisplatin on hearing. MATERIALS AND METHODS: Fifty-seven patients scheduled for cisplatin-based chemotherapy were included in the study. All patients were divided into three groups depending on the dose of cisplatin infused in 3 weeks. RESULTS: The subjective hearing loss was found in seven patients, while six patients had tinnitus during the chemotherapy. The hearing loss was sensorineural, dose dependent, symmetrical, bilateral and irreversible. Higher frequencies were first to be affected in cisplatin chemotherapy. CONCLUSION: As use of high-frequency audiometry is still limited in research work only, we need a strict protocol of adding high-frequency audiometry in the cisplatin-based chemotherapy regimen.
Assuntos
Antineoplásicos/administração & dosagem , Audiometria , Cisplatino/administração & dosagem , Perda Auditiva/induzido quimicamente , Zumbido/induzido quimicamente , Adulto , Idoso , Relação Dose-Resposta a Droga , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias/tratamento farmacológico , Adulto JovemRESUMO
Secondary tuberculosis of pharynx is a rare condition as pharynx is not a common site for clinically manifest tuberculosis. A rare and unusual case of secondary oropharyngeal tuberculosis in a 40 years male patient, who presented with an ulceroproliferative lesion of oropharynx extending to nasopharynx and laryngopharynx is being reported.
RESUMO
Cervical neuroblastoma is relatively uncommon. It present, most often as a firm mass in the lateral neck. Primary neuroblastomas of the neck usually arise in the cervical sympathetic ganglia. They are the sixth most common head and neck extracranial neoplasms. Neuroblastoma is the most common malignancy in children under 1 year of age. No known cause of Neuroblastoma has been reported.
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A case of invasive multiple paranasal sinus aspergillosis with bony involvement is reported. A young immunocompetent lady presented with bilateral nasal obstruction due to polyps. Radiologically and histopathologically a fungal cause was kept a possibility, and the diagnosis of Aspegillus fumigatus was established by demonstration of acute angle branching septate hyphae on direct wet mount and repeated isolation in culture. Patient responded favourably to surgical excision of polyps and oral itraconazole post operatively.