The effect of Manganese (Mn) addition on the Vickers hardness and relative density of nanocrystalline hydroxyapatite (HA) dense bodies were studied. The starting Mn doped HA powders was synthesized via sol-gel method with Mn concentration varies from 2 mol% up to 15 mol% Mn. The Mn doped HA disc samples were prepared by uniaxial pressing at 200MPa and subsequently sintered at 1300 degrees C. Characterization was carried out where appropriate to determine the phases present, bulk density, Vickers hardness of the various content of Mn doped HA dense bodies. The addition of Mn was observed to influence the color appearance of the powders and dense bodies as well. Higher Mn concentration resulted in dark grey powders. It was also found that the hardness and relative density of the material increased as the Mn content increased and influenced by the crystallinity of the prepared Mn doped HA powders.

Background: Migraine is a chronic, often debilitating disease. The treatment of migraine with propranolol (80-240 mg/day) is limited by side effects and lack of tolerability. Ribofl avin (vitamin B2) is the precursor of fl avin mononucleotide and fl avin adenine dinucleotide which are involved in mitochondrial transport chain. The use of ribofl avin in migraine prophylaxis is based on the hypothesis of a defi cient mitochondrial energy reserve as a causal factor in migraine pathogenesis, and on the fi ndings of its safety and effectiveness at high doses (400 mg/day) in the treatment of migraine like headaches in classic mitochondriopathies. Objectives: To compare the effi cacy of lower dose oral ribofl avin at 100 mg/day with oral propranolol 80 mg/day in the reduction of migraine frequency and severity. Methods: One hundred patients diagnosed with migraine were randomized to receive either oral ribofl avin 100 mg/day or propranolol 80 mg/day for a period of 3 months. Patients were issued a migraine diary and explained how to record the frequency of migraine attacks, headache intensity, duration and to report any side effects. Follow-up was at the end of 3 and 6 months. Results: Both study groups showed a reduction of migraine frequency, duration and severity of headache by visual analogue scale (VAS), and disability by migraine disability questionnaire (MIDAS) score at 3 months. No signifi cant difference was seen between the two study groups in most of the measures. Side effects were signifi cantly less in the ribofl avin group (P=0.035). Conclusion: Oral ribofl avin 100mg/day is a safe, equally effective and well tolerated alternative in migraine prophylaxis.

Acquired perforating collagenosis (APC) is a rare dermatological condition characterized by the spontaneous eruption of skin-colored or erythematous papules or nodules that eventually ulcerate and exude collagenous material. The exact etiology of APC remains unclear, although various triggers, including infections, medications, autoimmune diseases, and trauma, have been implicated.

This case report presents a 63-year-old female with a history of diabetes who developed erythematous papules and plaques topped with thick, yellowish, hyperkeratotic, adherent crusts on the upper back following an insect bite. Histopathological examination confirmed the diagnosis of APC, characterized by a cup-shaped invagination in the epidermis containing degenerated collagen bundles and basophilic material. Masson-trichrome staining showed transepidermal elimination of the collagen fibers. Patient was initially prescribed tretinoin 0.1% cream to be applied 2x a day. However, patient was not able to apply prescribed medications. Interestingly, without any specific treatment, the patient’s symptoms gradually improved over 3 months and eventually resolved completely.

This case report highlights the spontaneous resolution of APC in a patient following an insect bite. While most cases of APC require medical intervention, this case demonstrates the potential for spontaneous healing in certain individuals. Further research is needed to understand the factors that influence the course of APC and to identify potential predictors of spontaneous resolution.

Human ; Female ; Middle Aged: 45-64 Yrs Old ; Collagen ; Insect Bites ; Insect Bites And Stings

Human ; Male ; Female ; Infant ; Breast Feeding ; Dermatitis, Atopic ; Milk, Human ; Wound Healing ; Eczema

OBJECTIVE: To compare the efficacy of short-course versus longcourse antibiotic therapy among patients undergoing appendectomy for complicated appendicitis. METHODS: The authors conducted an electronic search of PubMed, Cochrane Library, and EBSCOHost for studies from 2000 to January, 2000 to September, 2018 comparing short-course versus long-course antibiotic therapy in adults undergoing appendectomy for complicated appendicitis. The outcomes considered were the incidence of superficial surgical site infection and intra-abdominal abscess, and duration of hospital stay. Meta-analysis was performed using Review Manager software. RESULTS: A total of 360 patients in two studies were analyzed. Superficial surgical site infection was identified in 5 out of 123 patients in the short-course antibiotic group (4%), and 5 out of 237 patients in the long-course antibiotic group (2.1%) (95% CI 0.38, 5.51, p=0.58). There was a decrease in the incidence of intra-abdominal abscess in the short-course antibiotic group (6.5%), but the difference was not statistically significant (95% CI 0.32, 1.77, p=0.52). The duration of hospital stay was significantly less in the short-course antibiotic group (3.95 days) compared to the long-course antibiotic group (4.6 days) (95% CI -0.66, -0.21; p<0.001). CONCLUSION No difference between the <5-day and ≥5-day antibiotic course in terms of surgical site infection and intra-abdominal abscess was detected. However, the hospital stay of the <5-day group was shorter.
Appendectomy

Staphylococcus aureus aregram positive cocci which colonizethe skin and mucous membranes particularly the anterior nares. Prevalence of nosocomial infections associated with methicillin resistant S. aureus have been reported in hospitals (HA-MRSA) for over five decades. Recently,community-acquired MRSA (CA-MRSA) has emerged as a cause of skin and soft tissue infections in healthy individuals. These strains are sensitive to antimicrobials, carry genes for Panton-Valentine leukocidin (PVL) toxin and belong to the staphylococcal cassette chromosome (SCC) mec type IV or V. The suspected mode of transmission involves close contact with carriers leading to skin or nasal colonization that resultin subsequent active infection. Molecular typing is used to determine the mode of transmission of CA-MRSA in the community.General typing methods such as pulsed-field gel electrophoresis (PFGE) and multilocus sequence typing (MLST) and specific methods for Staphylococci such as SCCmec typing and spa typing have the capability to characterize bacterial chromosomes and mobile genetic elements. Combination of these molecular typing methods is necessary as each method has its own advantages with respect to discriminatory power, rapidity, cost effectiveness, reproducibility, and ease of performance.
CA-MRSA ; prevalence ; transmission ; PVL toxin ; SCCmec ; spa typing ; PFGE ; MLST

BACKGROUND AND OBJECTIVE: Haematopoietic stem cell transplant is a potentially curative treatment option in various benign and malignant haematological diseases. Patients undergoing stem cell transplant procedure require blood transfusion on a daily basis. Currently, there is paucity of data from developing countries on transfusion practices. This audit was undertaken to determine the consumption of packed red blood cells (PRBCs) transfusion in the bone marrow transplant unit of the Aga Khan University Hospital. SUBJECTS AND METHODS: A retrospective audit was conducted for packed red cell transfusion ordering practice over a period from June 2014~June 2015. All consecutive patients, admitted for stem cell transplant procedure for various underlying diseases were included. Outcome measures used in this study were (i) cross match to transfusion (C: T) ratio and (ii) transfusion trigger. RESULTS: During the study period, n=25 patients underwent haematopoietic stem cell transplant. There were n=19 males and n=6 females. One patient was less than 15 years of age while rests were adults. Median age±SD was 26.5±14.5 years (12~54 years). The underlying diagnosis included Aplastic anemia (n=8), Thalassemia major (n=3), Multiple Myeloma (n=4), Acute leukemia (n=5), Hodgkin’s lymphoma (n=4), PRCA (n=1). Grand total consumption of PRBCs during the study period was 204 while 258 products were crossmatch. The C:T ratio was 1.26. The transfusion trigger was Hb level of less than 8 gms/dl. CONCLUSION: The results of our BMT unit indicate that the C:T ratio and transfusion trigger is comparable to the international benchmark.
Adult ; Anemia, Aplastic ; Benchmarking ; beta-Thalassemia ; Blood Transfusion ; Bone Marrow ; Developing Countries ; Diagnosis ; Erythrocytes ; Female ; Humans ; Leukemia ; Lymphoma ; Male ; Multiple Myeloma ; Outcome Assessment (Health Care) ; Retrospective Studies ; Stem Cells* ; Tertiary Healthcare*

No abstract available.
Consensus* ; Hematopoietic Stem Cell Transplantation*

Administration of additional 'rescue' hCG immediately after IUI appeared to intensify considerably the pregnancy rate in IUI cycles. With a strong confirmatory result, it might eventually lead to avoidance of expensive artificial reproductive techniques i.e. IVF or ICSI in selected couples undergoing infertility treatment. 'Rescue' hCG post-IUI in couple with repeated failed conventional IUI may be recommended as it appeared to be safe with minimal detrimental effect.

Presently, treatment of PD focuses on symptomatic therapy, that is to control motor symptoms, at the lowest possible dose, so as nor to develop early drug resistance, and consequent extrapyramidal symtoms. However, there has been no clinical trial, to date that has provided definitive evidence of pharmacological neuroprotection. Among the drugs with possible neuroprotective effects are the dopamine agonists.
OBJECTIVE: The objective of this study is to determine the efficacy and safety of Rotigotine transdermal patch in the treatment of early Parkinson's disease in terms of improvement in the functional capacity and the incidence of adverse effects in patients treatment with the said drug .
METHODOLOGY: Literature search of all randomized controlled trials, published from 1999-2009 comparing rotigotine patch with placebo, in patients with Parkinson's disease. Types of outcome measures- The primary outcome studied was the number of responders described as those with> 20% decrease in UPDRS Scores. The secondary outcome include the mean change in UPDRS score and the total incidence of adverse effects on patients on rotigotine patch.
RESULTS: The use of Rotigotine patch in early Parkinson's disease shows as trend toward benefit and was statistically significant (OR 0.33) in terms of number of patients who showed a significant change in UPRDS scores. In terms of UPDRS scoring, there was significant improvement for those who took Rotigotene (MD 5.2.5). However, incidence of adverse effects was higher in the Rotigotine group compared to the placebo group (OR 3.13)
CONCLUSION: The evidence from this review supports the use of Rorigotine patch for the treatment of early Parkinson's disease. This has shown to produce clinical improvement in parkinsonian symptoms as measured by the significant decrease in the UPDRS Scores on follow-up. However, adverse events were similar to those found with other dopamine agonists.

Human ; Dopamine Agonists ; Drug Resistance ; Neuroprotection ; Neuroprotective Agents ; Parkinson Disease ; Parkinsonian Disorders ; Tetrahydronaphthalenes ; Thiophenes ; Transdermal Patch