Critical care aspects of malaria.

Malaria remains a major health problem in much of Asia and Africa. A steady number of cases of imported malaria are also seen in many countries of the developed world. Plasmodium falciparum malaria and to some extent malaria caused by other species of Plasmodium can lead to many complications such as acute respiratory distress syndrome (ARDS), cerebral malaria, acute renal failure, severe anemia, thrombocytopenia, and bleeding complications.

Pulmonary arterial hypertension in human immunodeficiency virus infection.

Because of the improvement in survival rates of human immunodeficiency virus (HIV)-infected patients after the introduction of combined antiretroviral therapy, pulmonary arterial hypertension (PAH) has become an important cause of morbidity. As the awareness of PAH has increased, it is more likely that this condition will be diagnosed more frequently and earlier in the course of the disease and HIV infection. The etiopathogenesis is not clear; no evidence of direct infection of the pulmonary vascular tree has been found and the current evidence seems to favor a role of dysregulated cytokine response to HIV infection.

Epileptic seizure-induced hypertension and its prevention by calcium channel blockers: a real-time study in conscious telemetered rats.

Epileptic seizures are accompanied by changes in autonomic function that in turn influence the cardiovascular system (hypertension and bradyarrhythmia). We have studied possible cardioprotective activity (during the ictal state in conscious animals) of valproic acid, nifedipine, and verapamil, alone and in combination, during pentylenetetrazole (PTZ)-induced seizures. Telemetry system was used for recording EEG, blood pressure, and heart rate in conscious, freely moving rats during seizures.

Evaluation of estrogen receptor and circulating estradiol levels in pre- and postmenopausal women with periodontal disease.

Although the presence of estrogen receptors (ERs) in the gingival tissues has been confirmed, there is as yet insufficient literature regarding its expression in periodontal health and disease. Gingival samples were collected from 40 subjects who were divided into four groups. (Group A, premenopausal health; Group B, premenopausal periodontitis; Group C, postmenopausal health; Group D, postmenopausal periodontitis).

The efficacy of silicone gel for the treatment of hypertrophic scars and keloids.

Topical self drying silicone gel is a relatively recent treatment modality promoted as an alternative to topical silicone gel sheeting. Thirty patients with scars of different types including superficial scars, hypertrophic scars, and keloids were treated with silicon gel application. The results of the self-drying silicone gel have been satisfactory.

Vulval lymphoedema following pulmonary tuberculosis.

Acquired lymphoedema of the vulva is induced by impaired lymph flow. We present the case of a 35-year-old woman having lymphoedema of the vulva following pulmonary tuberculosis, which she had developed four years back for which she had taken a full course of antitubercular treatment for nine months from the Chest and Tuberculosis department. The biopsy taken from the perianal swellings showed hyperkeratosis and acanthosis with multiple dilated lymph specs.

Pulmonary manifestations of primary Sjögren's syndrome.

Sjögren's syndrome (SS) is a complex autoimmune exocrinopathy with multifactorial pathogenesis and multisystem manifestation. It is called primary Sjögren's syndrome (PSS) when the manifestations are seen without any other co-existent rheumatic diseases. The incidence of respiratory system involvement varies widely in the reported medical literature, partly due to lack of a universal agreement over the diagnostic criteria of the disease and the type of study methods employed.

Osteoblast response (initial adhesion and alkaline phosphatase activity) following exposure to a barrier membrane/enamel matrix derivative combination.

Background And Objective: The enamel matrix derivative (EMD) has been used in combination with barrier membranes to optimize regeneration in vertical osseous defects. However, the osteoblast response when exposed to the EMD/barrier membrane combination has not yet been evaluated. The osteoblast behavior when exposed to a combination of regenerative materials must be evaluated to fully understand their effect on bone regeneration.

A case of endobronchial leiomyoma and carcinoma in situ treated with electrocautery using flexible bronchoscopy.

An 82-year-old woman presented with dyspnea, fever, cough, and an endobronchial mass in the right main stem bronchus. Initial bronchoscopy revealed 80% obstruction of the distal right main bronchus by an exophytic tumor mass. Endobronchial biopsy of the mass revealed squamous cell carcinoma in situ.

A pilot study to examine the effects of smoking cessation on serum markers of inflammation in women at risk for cardiovascular disease.

Background: The links among smoking, inflammation, and cardiovascular disease (CVD) are well established. Several studies have demonstrated that quitting smoking reverses the risk of coronary heart disease within 5 to 10 years. However, the immediate effects of quitting smoking on inflammatory biomarkers associated with CVD risk have not been well described.

Repeated phlebotomies improve and stabilise renal function in cyanotic nephropathy.

Patients over 10 years of age with cyanotic congenital heart disease (CCHD) risk developing significant glomerular proteinuria, a condition called cyanotic nephropathy. Even though the pathogenesis of glomerulopathy associated with CCHD is still unclear, a potential mechanism is hyperviscosity-induced decrease in peritubular capillary blood flow leading to an increase in glomerular capillary pressure, in turn resulting in proteinuria. Although angiotensin-converting enzyme (ACE) inhibitors have been traditionally used in the treatment of these patients with cyanotic nephropathy, they may, however, not be well tolerated.

Root coverage in class I gingival recession defects, combining rotated papillary pedicle graft and coronally repositioned flap, using a micro surgical approach: A clinical evaluation.

Background: The purpose of this case study was to evaluate the success and predictability of a rotated papillary pedicle graft in combination with the coronally advanced flap using surgical loupe (2.5X magnification) for the treatment of Miller's class I gingival recession.

Materials And Methods: Fifteen systemically healthy patients with isolated gingival recession underwent the procedure.

A contemporary review of chylothorax.

Objectives: This review will focus on anatomical and aetiologic factors as well as the conservative and operative therapy of chylothorax.

Data Source: A Pubmed search for studies pertaining to the aetiology and/or treatment published in the English language from 1960 to 2007.

Study Selection: Studies presenting case reports, series, observational and/or retrospective studies, and those with unique issues pertaining to chylothorax were reviewed independantly by both authors.

Sleep in the intensive care unit.

Sleep is commonly disrupted in intensive care unit patients. The causes of this sleep disruption include the underlying medical illness itself, intensive care unit (ICU) environment, psychological stress, and effects of many medications and other treatments used to help those who are critically ill. The purpose of this review is to discuss the relevant literature in this regard, in order to improve the knowledge and recognition of this problem by health care providers.

Lymphocyte subpopulation in healthy and diseased gingival tissue.

In this study, infiltrating lymphocytes subpopulation in gingival sections of healthy, inflamed, and periodontitis lesions was investigated. A set of cluster of differentiation (CD) antigen specific monoclonal/polyclonal antibodies to detect different cell types within the tissues was used. These included anti-CD3 (pan T-cell), anti-CD45RO (memory T-cell), anti-CD20 (B-cell), and kappa light chain (plasma cells).

Verrucous carcinoma of the groin misdiagnosed as granuloma hypertrophicus.

Verrucous carcinoma is a rare well-differentiated squamous cell carcinoma. We report a case of a 63-year-old male with a tumour-like growth in the right groin for three years. The tumour was slowly progressive without any considerable signs and symptoms.

Bis and tris indole alkaloids from marine organisms: new leads for drug discovery.

The marine organisms are a rich source of varied natural products with unique functionality. Marine natural products chemistry has undergone an explosive growth during the past three decades. A variety of natural products of new molecular structures with diverse biological activities have been reported from marine flora and fauna, thus ensuring motivation in the search of newer natural products.

Synthesis of marine alkaloid: 8,9-dihydrocoscinamide B and its analogues as Novel class of antileishmanial agents.

A series of marine alkaloid 8,9-dihydrocoscinamide B, its analogues and indolylglyoxylamide derivatives have been synthesized and screened for their in vitro antileishmanial activity profile in promastigote and amastigote models. Compounds 7 and 10 have shown 99-100% inhibition against promastigotes and 97-98% inhibition against amastigotes at a concentration of 10 microg/ml.

Community-acquired pneumonia: what is relevant and what is not?

Purpose Of Review: Community-acquired pneumonia is associated with significant morbidity and mortality and is the most common cause of death from infectious diseases in North America. The purpose of this review is to highlight recent advances in epidemiology, risk factors, severity criteria and antibiotic therapeutic regimens used for community-acquired pneumonia management.

Recent Findings: All guidelines recommend early and appropriate empiric therapy directed against common typical organisms, such as Streptococcus pneumoniae, and other atypical organisms, but clinicians should be aware of newer emerging pathogens such as community-acquired methicillin-resistant Staphylococcus aureus and Gram-negative pathogens.

Simultaneous recording of electroencephalogram and blood pressure in conscious telemetered rats during ictal state.

Introduction: Seizures are accompanied by autonomic dysfunction which in turn influences cardiovascular variables. A method for simultaneous acquisition of electroencephalogram (EEG) and arterial blood pressure (BP) during seizures in conscious animals has not previously been described.

Methods: The effect of pentylenetetrazole (PTZ) was first studied on isolated rat atria.

Waardenburg syndrome.

Waardenburg syndrome is a rare inherited and genetically heterogenous disorder of neural crest cell development. Four distinct subtypes showing marked interfamilial and intrafamilial variability have been described. We report a girl showing constellation of congenital hearing impairment with 110 dB and 105 dB loss in right and left ear respectively, hypoplastic blue iridis, white forelock, dystopia canthorum and broad nasal root.

Tobacco and HIV.

The risks to an HIV-infected person who smokes are dramatically amplified compared with the general population. Smoking has been shown to be an independent risk factor for non-AIDS-related mortality in patients who have HIV, even in patients who receive highly active antiretroviral therapy. It has been independently associated with lower scores for quality-of-life indices, such as general health perception, physical functioning, bodily pain, energy, and cognitive functioning.

Tobacco and the health care industry.

The 1964 US Surgeon General's report was the first from the medical profession to document tobacco as a cause of cancers and other serious illnesses. Over the next 40 years, numerous health care groups have worked to decrease tobacco use and lower the associated morbidity and mortality. Registered nurses are the largest group of health care providers and have one of the highest rates of smoking among health care professionals.