Background: It is essential to understand the aetiopathogenesis of gallstone disease. This study was undertaken to determine the chemical composition of gallstones from patients living in Al-Jouf Province of Saudi Arabia. Methods: This was a descriptive study where 46 gallstones from Al-Jouf Province of Saudi Arabia were analysed by semiquantitative titrimetric and colourimetric methods. The proportion of different types of gallstones was described using 95% confidence interval based on exact method. Results: Gallstones were found more frequently in female patients (60.9%) than males (39.1%), and these stones were composed of pure cholesterol (54.3%), pure bilirubin (2.2%), or mixed stones (43.5%). The most common chemical constituent was cholesterol (82.6%), while bilirubin was seen in 26.1% of the stones. Calcium was present in 32.6% of the stones in the form of calcium salts of bilirubin and carbonate. Bilirubin-containing stones were slightly more frequent in males than in females, while cholesterol-containing stones were less frequent in males. Conclusion: The findings indicate that gallstones in the Al-Jouf Province develop more frequently in the age group of the third decade of life, with more risk among females than males, and are predominated by cholesterol together with calcium bilirubinate and calcium carbonate.

Aims: The activation of cellular and humoral immunity depends upon nature of antigens. Complex proteins like bacterial outer membrane proteins (OMP) usually successfully activate both humoral and cellular immunity. Whereas antigens like bacterial lipopolysaccharides (LPS) usually elicit T-independent immunity i.e. humoral immunity without the activation of cellular immune wing. The present study was under taken to evaluate the comparative immunologic behavior of both the important molecules (bacterial lipopolysaccharide and outer membrane proteins) of Pasteurella multocida alone and in combination in bovine calves in field conditions. Methodology and results: Pasteurella multocida was isolated, purified and identified from an outbreak by mean of culture and biochemical methods. The pathogenicity of the confirmed isolates was done in rabbits (Oryctolagus cuniculus) on the principles of Koch’s postulates. Alum based vaccine against P. multocida was prepared and antibody titer against Outer membrane protein (OMP) and lipopolysaccharides (LPS) were determined by complement fixation test (CFT). The results showed that the antibody titer against OMP and LPS in whole culture vaccine is significantly higher than the respective tested vaccines. These results concluded that OMP no doubt is an active T-dependent immunogenic molecule but its immunogenicity increases many times when combined with LPS in whole culture vaccine. Conclusion, significance and impact of study: Lipopolysaccharides (LPS) in combination with outer membrane proteins (OMP) synergistically boost the humoral immune response in vaccinated animal.

Unused and discarded latex collection containers (LCCs) are the major breeding habitats of Aedes albopictus in the rubber plantations of Kerala, India. Platynectes sp. (Family: Dytiscidae) was observed to invade these habitats during the monsoon season and voraciously devour the larval instars of this major vector species of arbo-viral diseases. Field observations showed a reduction of 70.91% (p = 0.0017) and 100% in Aedes larval density, on the first and four days post release of eight beetles per LCC respectively. In laboratory, a beetle was found to devour 17.75 + 5.0 late larval instars of Ae. albopictus per day. Our findings indicate Platynectes sp. could be a potential bio-control agent against Ae. albopictus, the vector of chikungunya/dengue fevers, in rubber plantations.

Acute promyelocytic leukemia (APML) is considered to be sensitive to all-trans-retinoic acid (ATRA) which acts as a differentiating agent. ATRA is considered to be a well-tolerated agent and is known to achieve complete remission in acute promyelocytic leukemia. However, a few cases on long term all-trans-retinoic acid (ATRA) use can develop pseudotumor cerebri. Out of 32 patients with APML who were treated in our Centre over a 4-year-period, we encountered 6 patients who developed ATRA-related pseudotumor cerebri while on maintenance treatment. The patients ranged from 12 to 40 years of age. 3 patients complained of unbearable headache, 2 of diplopia and 1 of gross reduction in visual acuity. CT scans and MRI did not reveal any intracranial lesions. Cerebrospinal fluid (CSF) examination was normal with CSF manometry revealing a high CSF pressure (average of 345mmH2O). Fundoscopy revealed papilledema in 5 patients and optic atrophy in 1 patient. The patients were successfully managed with decrease dose/discontinuation of ATRA, use of acetazolamide, corticosteroids and therapeutic CSF drainage.

Aims: The study was carried out firstly, to evaluate the prevalence of extended spectrum beta lactamase (ESBL), multidrug resistant Klebsiella pneumoniae isolates from Punjab, Pakistan and secondly, to characterize the genotypes of their beta lactamase producing enzymes and optimization of PCR based method for rapid and authentic detection of antibiotic resistant gene. Methodology and results: Two hundred of K. pneumonia strains were isolated from different clinical samples. Blood and MacConkey Agar were used to isolate and identify bacterial microorganisms while Muller Hinton Agar was used to evaluate the antimicrobial susceptibility against different antibiotics as per CLSI 2012 guidelines. ESBL producing bacteria were screened by double disk synergy /combination disk test. PCR was optimized and performed for resistant gene (CTX-M). The results showed that most of the isolates were resistant to multiple antibiotic including cephalosporin, aztreonam, sulphamethoxazole/trimethoprim, ciprofloxacin, doxycyclin and were sensitive to imipenam and amikacin. Frequency of CTX-M gene in ESBL producing K. pneumoniae was 94%. Conclusion, significance and impact of study: Based on the finding of this study it is suggested that prevalence of CTX-M gene (95%) is very high among ESBL producing isolates. Therefore, PCR based method may help clinicians for rapid detection and treatment of patients by choosing right medication against the resistant bacteria as early as possible.

Background: The menace of substance abuse is not only a socially unacceptable reality, but in its entirety is a disease and emerging as a major public health challenge. Objective: To study the socio-demographic and clinical profile of patients attending the drug de-addiction centre. Methods: A descriptive study was undertaken in a drug de-addiction centre at the Police Hospital in Srinagar, and all patients (198) who were admitted during this period were interviewed. Results: The mean (SD) age of patients was 26.8 years (SD 7.37), and over half (56%) belonged to the lower-middle social class. Poly-substance abuse was seen in 91.9%; medicinal opioids and cannabis were the most common substances abused. Most common age of initiation was 11–20 years (76.8%), with peer pressure and relief from a negative mood state being the most common reasons given for starting the drug(s). Prevalence of a co-morbid psychiatric disorder was high, on the order of 49.5%. A high rate of volatile substance use was observed among adolescents (54.5%). Conclusion: A pattern of poly-substance abuse was found to be quite common in patients, and use of volatile substances at a very young age emerged as a new trend. The dreadful repercussions of substance abuse justify the urgency to evolve a comprehensive strategy.
Substance-Related Disorders ; Heroin Dependence ; Social Problems ; India

Background: Globally, ischemic stroke outnumber hemorrhagic strokes. However, it was observed that hemorrhagic stroke is more common in Kashmir valley. The present study was conducted to substantiate this notion, and to identify the possible risk factors. Methods: This prospective study was conducted on 6,906 patients with fi rst ever stroke admitted to S. M. H. S. Hospital, an associated teaching hospital of the Government Medical College, Kashmir, from January 1996 to June 2009. Other than clinical history, examination and routine biochemistry, cranial CT scan (non-contrast) was performed in all the cases within three days of the stroke onset. MRI brain, CSF analysis, screening for cardiovascular disorders, prothrombotic states and collagen profi le were performed wherever deemed necessary. Results: There was predilection of stroke among the males and rural population. Eighty three percent of patients developed fi rst-ever stroke in sixth and seventh decade. Fifty four percent of cases had a Glasgow coma score of >10 on admission. Intracerebral hemorrhage was observed in 64.7% patients with male preponderance. Putamen (53.5%) was the most common, site of hemorrhage, followed by thalamus (29.7%). Hypertension, smoking and multiple risk factors were observed in 92.3%, 70.3% and 67.9% cases respectively. Poor antihypertensive medication compliance was observed in 55.9% cases. Conclusions: Intracerebral hemorrhage was the commonest stroke-type observed in Kashmir accounting for close to two third of strokes with male preponderance.

Floating arm injury represents a common yet complicated injury of the childhood severely associated with limb deformation and even morbidity, if not precisely addressed and credibly operated. Here, we report a rare floating upper limb case of a 9-year-old boy with multiple injuries of ipsilateral proximal humeral, supracondylar and distal radial limb. This is the first report to document such a combined floating elbow and floating arm injury in the same limb. In this report, we discuss the surgical procedures used and recovery of the patient monitored to ascertain the effectiveness of the method in limb reorganisation.
Accidental Falls ; *Bone Wires ; Child ; Fracture Fixation ; Humans ; *Humeral Fractures ; Male ; Multiple Trauma ; Radiography ; *Radius Fractures ; *Upper Extremity/diagnostic imaging/injuries/surgery