Journal of Acute Disease

1-12

Authors: Satinder Kakar, Deepa Batra, Ramandeep Singh, Ujjwal Nautiyal

Magnetic microspheres hold great promise for reaching the goal of controlled and site specific drug delivery. Magnetic microspheres as an alternative to traditional radiation methods which uses highly penetrating radiations that is absorbed throughout the body. Its use is limited by toxicity and side effects. Now days, several targeted treatment systems including magnetic field, electric field, ultrasound, temperature, UV light and mechanical force are being used in many disease treatments (e.g. cancer, nerve damage, heart and artery, anti-diabetic, eye and other medical treatments). Among them, the magnetic targeted drug delivery system is one of the most attractive and promising strategy for delivering the drug to the specified site. Magnetically controlled drug targeting is one of the various possible ways of drug targeting. This technology is based on binding establish anticancer drug with ferrofluid that concentrate the drug in the area of interest (tumor site) by means of magnetic fields. There has been keen interest in the development of a magnetically target drug delivery system. These drug delivery systems aim to deliver the drug at a rate directed by the needs of the body during the period of treatment, and target the activity entity to the site of action. Magnetic microspheres were developed to overcome two major problems encountered in drug targeting namely: RES clearance and target site specificity.

22-28

Authors: M. Kalaiselvi, D. Gomathi, G. Ravikumar, K. Devaki, C. Uma

Objective To Ananus comosus (A. comosus), has demonstrated a wide variety of biological activities which make it a good plant source for the treatment of many oxidative stress mediated diseases. The present study was aimed to evaluate therapeutic potential by assaying the activities of oxidative stress parameters in 7, 12 dimethylbenz(α)anthracene induced breast cancer rats. Methods Animals were divided into five groups of six animals. Group I served as control, group II induced mammary carcinogenesis by 7, 12 dimethylbenz(α)anthracene, group III and IV are treatment groups (plant extract 250 mg/kg body weight and standard drug 10 mg/kg body weight) and group V served as animals treated with plant extract alone. All the animals were sacrificed after 30 days treatment and breast tissues are used for the analysis of protein content, enzymic and non-enzymic antioxidants using standard protocols. Results The oral administrations of ethanolic peel extract of A. comosus (250 mg/kg body weight) to breast cancer bearing rats for 30 days demonstrated a significant (P<0.05) increased in body weight, tissue weight, protein content, enzymatic and non enzymatic levels. The altered activities of lipid peroxidation and tumor weight in breast tissue of control and experimental cancer bearing rats were significantly (P<0.05) were reverted to near normal levels by the administration of ethanolic extract suggesting that the extract have quenching capacity against free radicals thereby exhibiting anticancer potential of A. comosus in breast cancer bearing rats. Conclusions Thus, modulatory effects of A. comosus on attenuating the lipid peroxidation and upregulation of oxidative stress key enzymes like enzymatic and non-enzymatic antioxidants, protein content afford a pledge for widespread use for the treatment of breast cancer in the future.

33-36

Authors: Dinesh K. Patel, Sairam Krishnamurthy, S. Hemalatha

Objective: To investigate glucose utilization capacity of bioactivity guided fractions of Hybanthus enneaspermus (H. enneaspermus) and Pedalium murex (P. murex) in isolated rat hemidiaphragm. Methods: Dried coarsely powdered plant material was extracted in ethanol using soxhlation technique, further extract was fractionated using solvents of varying polarity. Glucose utilization capacity of bioactivity guided fractions using isolated rat hemidiaphragm was performed in the present study. Results: The entire tested fraction showed increased glucose uptake capacity, and was found to be maximum in case of chloroform fraction of P. murex extract (CHPM) which was quite comparable to standard insulin (P<0.05). Conclusions: In vitro glucose uptake by hemidiaphragm study showed increased utilization of the glucose by hemidiaphragm in the presence of different fractions. From these findings we can conclude that that different fraction of both plant materials had some extra pancreatic mechanism like glucose uptake by peripheral tissues.

40-43

Authors: Milivoje Vuković, Neboj ša Moljević, Sini ša Crnogorac

Objective: To investigate the conventional technique involves treatment of femoral hernia an approximation inguinal ligament to pectineal ligament. In technique which uses mesh closure for femoral canal without tissue tension. Method: A prospective study from January 01. 2007-May 30. 2009. We analyzed 1 042 patients with inguinal hernia, of which there were 83 patients with 86 femoral hernia. Result: Femoral hernias were present in 7.96% of cases. Males were 13 (15.66%) and 70 women (84.34%). The gender distribution of men: women is 1:5.38. Urgent underwent 69 (83%), and the 14 election (17%) patients. Average age was 63 years, the youngest patient was a 24 and the oldest 86 years. Ratio of right: left hernias was 3.4:1. With bilateral femoral hernias was 3.61% of cases. In 7 patients (8.43%) underwent femoral hernia repair with 9 Prolene plug. Conclusions: The technique of closing the femoral canal with plug a simple. The plug is made from monofilament material and is easily formed. This technique allows the reduction of recurrence and can be used safely, quickly and easily in elective and emergency situations.

48-51

Authors: Nora Burda , Vilma Mema , Ejup Mahmudi , Brikena Selimi , Sulejman Zhugli , Basri Lenajni , Illaz Bunjaku

Objective: The purpose of the study is to prescribe and analyze the correlation of dry eye and Diabetes Mellitus Tip II, at Polyclinic of Specialties Nr. 2 Ophthalmology service ,between May 2011 and June 2012. Methods: A total number of 223 patients diagnosed with Diabetes Mellitus Tip II underwent ocular examinations including 120 male and 103 female, aged from 24-73 years old. To confirm the presence of diabetes among these patients fasting blood glucose level was performed (normal limit < 110 mg/dL). History of disease, duration of diabetes, age, and sex was obtained by reviewing the medical records and direct patient interview. Also the patients complains: tearing photophobia, red eye , itching ,foreign body sensation, blurred vision was recorded. From the study were excluded all conditions which affects the tear film stability and contact lens wearer. Results: A total of 118 patients (58 male /61 female) were diagnosed with dry eye syndrome of varying degrees.. The diagnosis was made by heaving two or more positive tests performed as mentioned above, and referring to patients complains. Fourteen patients represent pinpoint corneal dye with fluorosceini , forty-six patients was positive to cotton swab test diminution of corneal sensitivity, eighty-nine patients was positive to Schirmmer test less than 10 mm, positive TBUT test less than 9 s was found to be the amount of seventy-one patients. Positive tear meniscus at inferior lid margin was found at fifty-six patients. Dry eye is a disorder of tear film because of tear deficiency or excessive tear evaporation which causes damage to the inter palpaberal ocular surface and is associated with symptoms of ocular discomfort. This ocular disorder is very common among general population with 28% of the adults having dry eye syndrome. Early diagnosis and timely treatment, complications as secondary microbial infection and corneal ulceration could be avoided.Conclusions: In our study the Dry Eye Syndrome showed to have a high correlation with Diabetes Mellitus Tip II ( about 52.9%). Prevalence of Dry Eye was significantly higher at patients with longer duration of diabetes. Dry Eye seems to be an important contributing factor related to corneal abnormalities. Age and sex not seem to play any important role in this condition. Good glycemic control is important for prevention and control of Dry Eye Syndrome.

56-60

Authors: Kaylene J Logan, Patrice M. Weiss, Catherine Hagan-Aylor, Bob Herbertson

Objective: To compare our institution with national benchmark times, and identify rate-limiting steps in the process by conducte a retrospective review of the turnaround times in 2009 at the Carilion Clinic Breast Care Center (CCBCC). To evaluate patient satisfaction with the turn around times. Methods: A retrospective chart review was performed to evaluate the time intervals from abnormal screening mammogram to diagnostic mammogram, diagnostic mammogram to biopsy, biopsy to MRI, and MRI to surgery of all patients seen for breast cancer in 2009. A patient survey was mailed out to all patients (131) managed from abnormal screening to surgery in 2009, assessing their satisfaction with the turnaround times from screening mammogram to call back, call back to diagnostic mammogram, diagnostic mammogram to biopsy, biopsy to results call, biopsy result to MRI appointment, MRI appointment to surgery consult, and surgery consult to surgery; and assessing possible reasons why patients may perceive the process to be delayed. The MEANS procedure was applied to evaluate the turnaround times, and a Box and Whisker Plot statistical comparison was made between patient satisfaction and turnaround times. Results: The mean turnaround time at the CCBCC in 2009 from abnormal screening mammogram to surgery was 45 d. This falls within the 75th %ile of the National Quality Measures for Breast Centers (NQMBC), established by the National Consortium of Breast Centers (NCBC). Of 131 surveys mailed out, 57 were returned (44%). The patient satisfaction rates for each interval ranged from 96%-100%, with an overall satisfaction rate of 98% for abnormal screening mammogram to surgery. Discussion: The CCBCC ranks at the 75%ile in overall turnaround times; however, this turnaround time included an interval of MRI, not previously measured in NQMBC benchmark. Rate-limiting steps were identified as the time from screening mammogram to diagnostic mammogram, and biopsy to surgery-specifically, the sub-interval MRI to surgery. Since 2009, the CCBCC has already improved the process for obtaining insurance approval and preauthorization for MRIs; and has added an additional breast surgeon to share the burden of benign cases, and a nurse practitioner to see post-op and follow up patients, improving the accessibility to the primary breast surgeon specialist. Consideration should be given to future time interval studies that evaluate breast cancer turnaround time including MRI to help establish benchmarks.

66-69

Authors: Siti Hajar Mat Abu, Hanizasurana Hashim, Tara Mary George, Norfariza Ngah, Adil Hussein

Fifty-seven years old Malay lady, post menopausal with co-morbid of diabetes mellitus and hypertension presented with three months history of bilateral painful red eyes associated with double vision. Examination revealed both eyes proptosis, corkscrew vessels with present of bruit, secondary narrow angle with raised intraocular pressure, 6th cranial nerve palsy, and bilateral venous stasis retinopathy. CT angiogram showed bilateral dilated superior ophthalmic veins with cerebral angiogram findings of bilateral indirect carotid cavernous fistula involving small meningeal vessels. Indirect or dural cavernous sinus Fistula can easily be missed or misdiagnosed. Trivial injury especially in the predisposing patient can initiate the occurrence.

73-75

Authors: Fesih Aktar, Sinan Akbayram, Necmettin Akdeniz, Sirac Aktar, Cihangir Akg ün, Murat Doğan, H üseyin Çaksen, Ahmet Faik Oner

Herpes zoster (HZ) is often associated with painful erythematous vesicular eruptions of the skin or mucous membranes. Approximately 10% to 30% of the population will suffer from HZ during their lifetime. HZ is infrequent in healthy children. However, diminished cellular immunity seems to increase risk of reactivation because incidence increases with age and in immunocompromised states. We report a 7-year-old girl with acute myeloblastic leukemia HZ infection on the right palmar, elbow and forearm region (C7, C8 and T1 dermatomes). We want to indicate unusual localization of HZ on the acute myeloblastic leukemia child patient.

79-81

Authors: Rachita Sarangi, Surjeet Sahoo, Satyasunder Mohapatra

Psychotic manifestations are uncommon in neurocysticercosis. This article describes a ten year girl presented with manic– psychotic manifestation for which she was under treatment with antipsychotics for eight months. Eventually she developed generalized tonic clonic seizure and CT scan of brain revealed small isodense right posterior parietal lesion of 5 mm size with perifocal edema. CECT revealed intense nodular post contrast enhancement. This highlights the possible misdiagnosis of a case of neurocysticercosis as an organic psychotic disorder so it should be considered as a differential diagnosis in patients with neurological as well as psychiatric manifestations in endemic area like India.