Cholesterol and triglyceride fats are transported as part of lipoprotein particles in the bloodstream. The various lipoprotein classes Low Density Lipoprotein (LDL) that carry most part of the blood cholesterol, Very Low Density Lipoprotein (VLDL), which carry most of the blood triglycerides, High Density Lipoprotein (HDL) and Chylomicrons. LDL also found as serum cholesterol plays a significant role in coronary heart diseases. The role of these lipoproteins is quite independent of other risk factors and is quite predictive that could be easily assessed. The present article is focused on the estimation of plasma lipoprotein (a) [Lp(a)] level in AMI patients along with their cardiac Troponin-I levels to study the correlation between the two and to look into the possibility of dual marker approach to deal with complications associated with acute myocardial infarction. Lp(a) is a major risk factor of several cardiovascular diseases, namely atherosclerotic vascular diseases, aortic calcification, and perhaps also venous thromboembolic diseases and hence could be a prominent therapeutic target for primary and secondary prevention. This calls for the development of a safe and effective means of lowering Lp(a) that will provide an opportunity to conduct intervention trials to further decipher its contribution in the etiology of CHD

Neuroendocrine tumors are rare and can affect many organs, including the gastrointestinal tract and bronchi. The involvement of the larynx is exceptional, although neuroendocrine tumors are the second histological type of laryngeal malignancy after squamous cell carcinoma. They constitute a group of heterogeneous tumors, 4 in number, among the neuroendocrine tumors of the larynx, the carcinoma tumor neuroendocrine poorly differentiated is the most common. The diagnosis is purely histological, and the treatment is surgical. The prognosis is relatively good

Background: Fine-needle aspiration (FNAC) cytology is well established and widely used to evaluate palpable lesions and, with imaging studies as an adjunct, is equally applicable to deep-seated lesions. Although FNAC is considered quite a reliable procedure for diagnosing salivary gland lesions, one comes across frequent diagnostic challenges in diagnosing salivary gland lesion. Methods: 180 patients were enrolled in the study from January 2014 – august 2016 .Out of these 69 samples had histopathology samples. Special stains (PAS-D) and cell blocks were prepared wherever necessary. Results: Benign neoplastic lesions were (68.1%) found to be the most common with pleomorphic adenoma being predominant of all. Mucoepidermoid carcinoma was the most common malignant lesion followed by adenoid cystic carcinoma. Conclusion: Diagnostic dilemmas are commoner in certain lesions such as basaloid neoplasms, oncocyte lesions, mucus containing cysts and lesions with squamous cells or lymphocytes, spindle cells. These pitfalls can be reduced to minimum by adequate sampling by multiple passes from different areas along with thorough clinical and radiological examination.

Aim: The present research work was planned to prepare pluronic f 127 (poloxamer 407) based hydrogel formulations of ketorolac and to evaluate the parameters like swelling behaviour, drug PH stability, invite and in vivo drug release and in vitro cytotoxic activity. Methodology: Two different strengths of ketorolac hydrogel formulations were prepared using pluronic f127 and were analysed by validated HPLC method for drug content, PH stability and in vivo drug release. Further invitro anticancer activity was evaluated using sulphorhodamine B (SRB) assay in SCC29 cell lines. Result: Both the formulations F1 and F2 showed better PH stability at PH 3.5, 5.5 and 6.8. In vitro and in vivo drug release pattern showed half life at 3 hours, AUC0−t 669 and 667ng h/ml, Cmax 884 and 872 ng/ml for F1 and F2 respectively. Conclusion: Hydrogel formulation F1 showed better percentage control growth when compared to F2 hydrogel formulation and ketorolac alone.

Pituitary abscess is a rare, but potentially life-threatening condition unless promptly diagnosed and treated, and it accounts for less than 1% of all pituitary diseases, few cases have then been published in the literature, the majority of this cases are diagnosed either post mortem or post operatively. Pituitary abscesses may occur in a normal pituitary gland in 70% of cases (primary types), or secondary to a preexisting lesion. We report a successfully managed case of a 66-year-old woman. We discuss the pathogenicity, the morphologic and radiologic criteria suggestive of this unusual infection of pituitary region and also treatment options

Plants of the genus Ceiba (Bombacaceae) are widely implemented in folklore treatment of diabetes, bronchitis, chronic fever, diarrhea, dysentery, gastritis, peptic ulcers and parasitic infections in many countries. Over the years, at least eighty-three compounds have been isolated from different parts of plant species of Ceiba. These compounds belong to the plant steroids, triterpenes, sesquiterpenes, sesquiterpene lactones, coumarins, flavonoids, anthocyanins, oxidized naphthalenes, phenolic acids, alcohols, fatty acids and esters. Extracts and isolated compounds of Ceiba plants have been extensively examined for their possible analgesic, antipyretic, anti-inflammatory, anti-microbial, cytotoxicity, antitumor, antidiabetic, hypolipidemic, antioxidant, and hepatoprotective, activities. This review compiles the different isolated phytochemicals as well as the biological studies carried out on extracts and isolated compounds of the genus Ceiba plants. It will also provide important knowledge for the researchers in the field of natural therapeutics to explore further alternative medicine from Ceiba plants.

Introduction: Dysphagia is a common reason for gastroenterology consultation. Esophageal manometry is recommended for the exploration of dysphagia, when gastroscopy is normal and esophageal biopsies are negative. The advent of high-resolution manometry (HRM) has led to the development of a new classification of esophageal motor disorders. The goal of this study is to evaluate the frequency and identify the type of esophageal motor disorders in dysphagic patients with normal upper digestive endoscopy. Materials and Methods: 141 patients with dysphagia with normal upper gastrointestinal endoscopy, negative esophageal biopsies and HRM were included. Esophageal motor disorders have been identified according to the Chicago classification. Results: HRM was pathological in 87 cases (61.7%). It revealed achalasia in 74 patients (52.5%). It was a type I achalasia in 23 patients (16.3%), type II in 44 patients (31.2%) type III in 7 cases (5%). It showed motor disorders that could correspond to scleroderma in 6 patients (4.2%), obstruction of the oesogastric junction in 4 cases (2.8%), and a jackhammer oesophagus in 3 cases (2.1%). HRM was normal in 54 patients (38.3%). Conclusion: The HRM of the esophagus represents an undeniable progress in the exploration of the motor system of the esophagus, mainly dysphagia with normal endoscopy. Achalasia, which can now be classified into 3 types according to HRM results, remains the most frequently found primary motor disorder.

Objective: To evaluate the characteristics of central corneal thickness (CCT) in glaucoma patients followed a military hospital in Rabat. Patients and methods: This is a retrospective study of glaucoma patients followed in the military hospital ophthalmology flap service between January and December 2018. All subjects underwent a complete ophthalmic examination that included measures of CCT with an ultrasonic pachymeter. Results: A total of 205 patients (123 men and 82 women) were included in this study corresponding to 410 eyes. The age of patients ranged between 19 and 79 years. The average central corneal thickness was 519.54 ± 27.52µm in the right eye and 520.71 ± 27.99 µm in the left eye. Comparing the CCT between men and women and between the right eye and the left eye the other hand finds no statistically significant difference. Thus, the average age of the patients was 50.74 ± 12.7 years, with a mean central corneal thickness of 520.12 ± 27.75 microns. Discussion and conclusion: Compared to the Caucasian patient, our glaucoma patients differ in the early glaucoma and the thinness of the cornea, and are close to black African patients. This may induce a potential error in the measurement of intraocular pressure in glaucoma patients where our interests of Forever correlate intraocular pressure with pachymetry.

Introduction: Plummer-Vinson syndrome (PVS), also known as sideropenic dysphagia, is a very rare entity that combines a classic triad: iron deficiency anemia, dysphagia and upper esophageal diaphragm. Its association with celiac disease has been rarely reported. The goal of this work is to determine the clinical characteristics of patients with PVS, in celiac disease, thus the evolutionary profile. Materials and Methods: This is a descriptive retrospective study covering a period of 26 years, from January 1993 to January 2019, collecting all patients followed in the service of Medecine C at the University Hospital Ibn Sina of Rabat-Morocco for PVS who have systematically benefited from jealousy biopsies in search of celiac disease. Results: Out of a total of 149 patients followed in the PVS unit, the prevalence of celiac disease was 6.1% (10 cases). 8 cases diagnosed as part of the etiological assessment of PVS, the diagnosis of celiac disease was concomitant with PVS in 2 cases. These were 8 women and 2 men with a sex ratio of 0.25. The average age was 28 years [19- 56 years]. All patients had organic dysphagia, five cases (62.5%) had clinical anemic syndrome associated with malabsorption diarrhea. Upper GI fibroscopy showed a ring at the killian's mouth in all cases. After oesophageal dilation by candles of different diameters, fibroscopy showed a rarefaction of duodenal folds in 9 cases (90%) and a duodenum of normal appearance in one case (10%). The anatomopathological study of duodenal biopsies showed intraepithelial lymphocytosis (IEL) > 30% in all cases, moderate atrophy of the villus in 6 cases and severe atrophy in 4 patients. All our patients have received martial treatment in combination with a gluten-free diet (GFD). The progression was favourable in 8 patients after a single dilation session and a well-followed GFD; 2 patients with poor GFD compliance also had a recurrence of dysphagia. Conclusion: PVS on celiac disease remains rare, found only in 3.5% in our series; good compliance with the GFD has improved signs of malabsorption and the disappearance of dysphagia in 80%.

A major trend in ulcer management currently is the role of nitric oxide (NO) and its agonists such as L-Arginine in ameliorating gastric ulcers. The current study focuses on the possible effects of L-Arginine supplementation on indomethacin-induced gastric ulcerations in rats. Male Wistar albino rats weighing between 150-180g were used and divided thus: Group I (Control) – saline, 8ml/kg, Group II- L-Arginine 1g/kg B.W for 3 days, Group III- L-Arginine 1g/kg B.W for 7 days. The effect of L-arginine supplementation was on indomethacin-induced gastric ulcerations, ulcer dimensions and histological profile of the gastric mucosa was examined. The result showed that arginine supplementation possesses capabilities of reducing ulcer formation as evident by the lower ulcer scores of the supplemented groups when compared with the Control. The 3-day supplemented group had a significantly lower ulcer score (p<0.05). Ulcer area and width were significantly reduced in the 3-day supplemented group (p<0.05) while the ulcer depth was significantly reduced in both supplemented groups (p<0.01). Histological examination of the gastric tissues showed that the 3-day supplemented group had greater reduction in the level of gastric disturbance than both Control group and the 7-day supplemented group. We proposed that a rapid angiogenetic activity in response to arginine supplementation which then wanes over time may be responsible for this pattern. This study provides evidence that arginine supplementation is beneficial in reducing the risk of gastric ulcer induced by NSAIDS and this is possibly mediated by direct enhancement of angiogenetic activity around the disturbed gastrum.

A simple, rapid, precise, stability indicating, isocratic reverse phase-high performance liquid chromatography method has been developed and validated for the determination of Zonisamide in bulk and pharmaceutical dosage form. The Chromatographic Separation was achieved by using Enable ODS reverse phase (250 x 4.6 mm, 5 μm particle size) C18G column. Mobile phase consists of mixture of 0.1% (v/v) ortho phosphoric acid and Methanol in the ratio of 30:70 (v/v) and was delivered at a flow rate of 1 ml/min, while the detection was monitored at a wave length of 285 nm. The developed method showed excellent linear response (r2>0.9999) in the range of 10-70 μg/ml. The retention time for Zonisamide was found to be 3.5 mins. The proposed method was validated as per ICH guideline and can be applied for estimation of Zonisamide in pharmaceutical dosage forms in routine analysis.

The aim of the present study was to study the efficacy and safety of Nebivolol and Metoprolol in post-myocardial infarction patient and to compare the efficacy and safety of Nebivolol and Metoprolol in post-myocardial infarction patients. This randomized, open-label and comparative study was done in the Department of General Medicine, Kakatiya Medical College, and MGM Hospital Warangal. A total of n=110 patients were selected based on inclusion and exclusion criteria. Patients were randomized to two groups N-groups of n=55, M-group to receive once-daily Nebivolol 5 mg and Metoprolol 50mg twice-daily respectively for 2 months. Clinical laboratory parameters were measured at day (0), and at day 56. Results The standing baseline mean systolic blood pressure 166±9 mmHg was reduced to 139±10 mmHg after 2 months treatment with Nebivolol, whereas in case of Metoprolol standing baseline systolic blood pressure 161±11 mmHg reduced to 143±14 mmHg after 2 months treatment. In case of standing, baseline mean diastolic blood pressure 103±7 mm Hg reduced to 84±4 mmHg after 2 months of treatment with Nebivolol, whereas with Metoprolol standing baseline diastolic blood pressure 100±6 mmHg reduced to 87±7 mmHg after 2 months treatment. Heart rate in case of N-group baseline 87±9 beats/min reduced to 74±6 beats/min after 2 months treatment, whereas in M-group baseline heart rate 82±7 beats/min reduced to 76±5 beats/min after 2 months treatment. Conclusion: it can be concluded that Nebivolol is superior to Metoprolol in control of blood pressure in post-myocardial infarction patients with hypertension. The distinct advantages of Nebivolol include lower incidences of adverse effects and since the dose is single there is better compliance as compared to Metoprolol

With the development of feminism, the works of American ethnic female writers’ works has received a lot of attention. Discovering and interpreting the subjectivity in these works are of great importance to female readers. Here, the author made an effort in exploring the subjectivity contained in female writers’ works. The exploration is based on the women’ voice in The Bluest Eye and The Joy Luck Club. The author explained how the works represented the rising of female consciousness and how the figures are portrayed in this paper, trying to get a better understanding of subjectivity, the author relates her findings with gender issues.

This paper aims to highlight several points on the topic of relative clause of Indonesian and Java Language. The method used on this study is descriptive analysis. The focuses are on finding on several outcomes from previous papers on how these two languages share the similarity and differences as well as how the two languages differ from English. This found Indonesian relative clause of Bahasa Indonesia known as yang is typical and different from the structured English counterparts. In the meantime, there is a tendency that Javanese always uses construction passive to relativize noun phrases or nouns in complex sentences.

Malnutrition has been implicated as a possible indicator of development of atherosclerotic cardiovascular disease in hemodialysis patients. Recently a new quantitative scoring system, called MQSGA (Modified Quantitative Subjective Global Assessment) has been developed to assess dialysis malnutrition. Study was conducted with following objectives 1) To assess the nutritional status in hemodialysis patients by the MQSGA scoring. 2) To correlate the MQSGA score with biochemical marker of malnutrition- Albumin and inflammatory marker hs CRP (High Sensitive CRP). 50 patients in the age group of 20-70 years diagnosed as having chronic kidney disease undergoing hemodialysis were studied. MQSGA score was calculated using 7 features- weight change, dietary intake, GI symptoms, functional capacity, co-morbidity, subcutaneous fat and signs of muscle wasting. Serum albumin levels were estimated using end point colorimetric method and hsCRP using Immunoturbidimetric method. MQSGA scores in the present study was found to be 17.32+4.37 in males and 16.2+4.81 in females with a total 17.19+4.4. hsCRP levels was found to be significantly raised (16.59+21.4mg/L). Serum Albumin levels were low (3.27+0.67 g/dl), in both males (3.28+0.69) and females (3.22+0.153). There was a significant positive correlation between serum hsCRP levels and MQSGA scores of the subjects (p=0.0418, r=0.3156). To conclude Nutritional status of the patients undergoing dialysis is frequently ignored. Present study shows moderate degree of malnutrition in CKD patients. Simple methods of nutritional assessment and diet modification could have a favorable impact on the patient management.