Macrocytosis in adults is defined as a red blood cell (RBC) mean corpuscular volume (MCV) >100 FL. Macrocytic anemia is generally classified into megaloblastic and non-megaloblastic anemia. The objective of this study was to assess haematological findings in patients of macrocytic anemia based on complete blood count and peripheral blood smear and to classify them based on clinical, serum vitamin B 12 and folic acid levels .The study was carried out over a period of one year at a tertiary care teaching hospital. 100 patients were selected on simple random sampling with MCV>99 FL and peripheral blood smear showing features of macrocytosis. Out of the 100 patients studied of macrocytic anemia, 55 percent had megaloblastic anemia and remaining 45 percent had non-megaloblastic anemia due to various causes. In our study, megaloblastic anemia was the most common cause of macrocytic anemia and among non- megaloblastic causes liver disorders like hepatitis was the most important cause.

Abstract: Sepsis is a clinical syndrome that complicates severe infection and is characterized by inflammation and widespread tissue injury. The clinical process usually begins with infection, which potentially leads to sepsis and organ dysfunction [1]. It is estimated that puerperal sepsis causes at least 75,000 maternal deaths every year, mostly in low-income countries [2]. To assess specific management of maternal sepsis in High Dependency unit (HDU) and its impact on maternal outcome. Prospective study carried out at HDU in Gauhati Medical College (GMCH) and Hospital from 1st June 2017- 30th July 2018.All patients with sepsis admitted to HDU during the period of study were studied for their response to management and outcome is evaluated. Out 74 patients with sepsis admitted to HDU, 42 expired due to severe sepsis, septic shock or MODS. The total number of maternal deaths during the study period was 148 due to various causes and the total number of live births was 15802. So maternal sepsis was responsible for 28 % of maternal deaths. The calculated MMR for the period of study was 936/ lakh live births and calculated MMR for maternal sepsis was 265 / lakh live births. From this study it can be concluded that sepsis is an important cause of maternal morbidity and mortality. A positive blood culture and the antibiotic susceptibility testing of the isolates are the best guide in choosing the appropriate antimicrobial therapy in treating sepsis. Blood and blood products, vasopressors also plays important role as adjunctive treatment of sepsis.

Acinetobacter has emerged as significant hospital pathogen involved in outbreaks of hospital infections, notoriously known to acquire antibiotic resistance to most of the commonly prescribed antimicrobials. Many risk factors are associated with Acinetobacter infections, especially in patients in intensive care unit (ICU). Acinetobacter species tend to be resistant to a variety of antibiotics and thus the infections are difficult to treat. This study aims to isolate Acinetobacter from various clinical samples and to determine its antimicrobial sensitivity pattern. The objectives of the present study were; 1) To isolate Acinetobacter species from various clinical samples. 2) To study their Antibiogram pattern of the Isolated Organisms. A total of 93 Acinetobacter species were isolated from various clinical samples. Identification of Acinetobacter was done on the basis of hemolysis on blood agar, growth at 42ºC, and oxidation fermentation test. Antibiotic susceptibility testing was done as per standard CLSI guidelines (2017). Maximum isolation of Acinetobacter species were from pus or wound swabs 57 (61.29%) followed by sputum and tracheal secretions 21 (22.58%) and urine 15 (16.12%) samples. Most of the strains were sensitive to imipenem (97%), piperacillin-tazobactam (91.39%), and getifloxacin (86%) whereas, maximum resistance was observed to co-trimoxazole (10.75%) and gentamicin (9.67%). Acinetobacter spp. has emerged as a major nosocomial pathogen. Broad-spectrum antibiotics should be used with caution and only after antibiotic susceptibility testing. Early identification and continued surveillance of prevalent organism will help prevent the spread of Acinetobacter in hospital environment. Empirical antibiotic policy should be determined for each hospital according to the resistance rates of that hospital setting.

In order to make full use of data of stroke and find the potential characters, we use computer algorithm to model the stroke so as to comply with the evolution of stroke disease. In order to visual express the complex reason of stroke, we use complex network to model the stroke so as to express the complex reason and describe the relation of stroke structure and function. Computer model and complex network model should be combined with stroke standard method and custom index, which are more direct for clinical index and practice. Hybrid methods for research of stroke are a test to model, prevention, control and serve for stroke and other clinical disease

Sclerosing rhabdomyosarcoma (SRMS) is a very rare subtype of rhabdomyosarcoma (RMS) and can lead to diagnostic difficulties especially if one is not advised of this variant. This entity was first described in 2000 by Mentzel and Katenkamp.Morphologically, it is characterized by an abundant hyalinized stroma that may erroneously lead to the diagnosis of extraskeletal chondrosarcoma, sometimes this stroma simulates a primary osteoid or vascular tumor. Thus, it can lead to confusion with osteosarcoma or angiosarcoma. We report here a case of SRMS mimicking a sclerosing epithelioid fibrosarcoma appearing in calves in a 55-year-old man. The tumor cells were arranged in nests, cords with sometimes a pseudovascular features. Immunostaining showed that the tumor was positive for Desmin, SMA and MyoD1, focally positive for myogenin and negative for CK, P63, EMA, S-100, H-caldesmon, CD34, CD31. Based on morphological discovery and immunostaining, he was diagnosed as an SRMS. This is the first case of SRMS to show a strong and diffuse α- SMA highlighting the risk of misdiagnosis as leiomyosarcoma.

Phenytoin is an Anticonvulsant mainly acts by promoting Na+ efflux or decreases Na+ influx from membranes in motor cortex neurons; stabilizes the neuronal membrane. Slows conduction velocity.Indicated in Seizures. A child of 12 years old of female patient came to pediatrics department with chief complaints of seizures not associated with fever. Generalised tonic clonic activity with loss of consciousness for 10 min and admitted in pediatrics department-II and his treatment chart was phenytoin 100mg PO OD and valproic acid 200mg – 200 mg – 200 mg Po 2tablets TID. During his second day of treatment child developed fever of 1020F and cough and to reduce the condition physician prescribed paracetamol 500mg Po BD and syrup chlorpheneramine maleate 5ml Po BD and increased the phenytoin dose 100 mg 2 tablets OD. On the 12th day of treatment child was irritable with hyperactive behaviour. Better vigilance is necessary for implementation of safe and effective treatment for each individual patient.in order to prevent serious adverse drug reactions of this drug, close monitoring drug treatment course, creating awareness, recognition of the problem and careful management of all the patients who receive medication are essential, because use of phenytoin causes Drowsiness, Fatigue, Ataxia, Irritability, Headache, Restlessness, Slurred speech, Nervousness, Nystagmus, Dizziness, Vertigo, Dysarthria, Paresthesia, Rash, Pruritus, Gingival hyperplasia (pediatric patients), Ataxia, Paradoxical seizure, Drug withdrawal seizure, Diplopia, Psychosis (high dose), Toxic amblyopia, Encephalopathy, AV conduction disorder, Ventricular fibrillation, Nausea, Vomiting, Constipation, Diarrhea, Megaloblastic (folate-deficiency) anemia, Hypocalcemia, Hepatotoxicity, Hypertrichosis, Lymphadenopathy, Purple glove syndrome, Rash, Allergic reactions in the form of rash or, rarely, more serious forms (drug reaction with eosinophilia and systemic symptoms, or DRESS) or anaphylaxis, Purpuric rash, Toxic epidermal necrolysis, Bullous dermatosis, Coarsening of facial features,Periarteritis nodosa,Immunoglobulin abnormalities, Altered taste sensation, including metallic taste, Peyronie disease

Hematological disorders are frequent in all age groups and most of them present with anemia. Bone marrow aspiration is useful and cost effective diagnostic procedure for diagnosis of both neoplastic and non-neoplastic hematological diseases. This study was done to emphasize the crucial role of Bone Marrow Aspiration in diagnosis of hematological disorders. This was a retrospective study carried out in a period of 1 year (July 2016-August 2017). Bone marrow examination of 65 cases of suspected hematological disorders on peripheral blood smear was carried out and clinical history was recorded. We studied total 65 patients among them most common red blood cell pathologies were megaloblastic anemia (56%) followed by mixed erythroid hyperplasia (11%), iron deficiency anemia (6%), normoblastic maturation (6%). All the 5 patients of platelet disorders were diagnosed as Idiopathic Thrombocytopenic purpura (ITP). Among WBC pathologies Acute Leukemia (6%) and other Miscellaneous like aleukemic leukemia, leucoerythroblastic reaction & haemophagocytic lymphohistocytosis. Megaloblastic anemia was found to be the most common finding in RBC pathology, in WBC pathology acute leukemia was the most common and among platelets ITP.

This study was designed to investigate the levels of blood glucose and hemoglobin among malaria infected students in Nnamdi Azikiwe University, Nnewi, Anambra State, Southeast Nigeria. A total of 100 participants (75 malaria infected and 25 control subjects) aged between 18 and 30 years were randomly recruited for the study. Thereafter, 5mls of blood sample each was collected from the subjects and dispensed in unit quantity into fluoride oxalate and EDTA bottles respectively for the determination of malaria parasites, hemoglobin (Hb) and fasting blood glucose levels respectively using standard laboratory methods. The results revealed no significant difference in the mean fasting blood glucose level (p>0.05), but there was a significant decrease in the mean hemoglobin level in malaria infected students than in control (p=0.000) respectively. Also, there was no significant difference in the mean values of fasting blood glucose level obtained between students with heavy malaria infection and those with moderate malaria parasitemia (p>0.05), while the mean hemoglobin level observed in the students with heavy malaria parasitemia was significantly lower compared with students with moderate malaria parasitemia (p=0.000). The implication of this finding is that malaria infection depletes the hemoglobin level in infected persons, thus predisposing them to the risk of anaemia

Gallbladder is affected by a wide spectrum of diseases ranging from nonneoplastic lesions like congenital anomalies, gallstones and its complications, noninflammatory, inflammatory, to the neoplastic lesions .The aim of the study spectrum of histopathological changes in cholecystitis. The objectives were to study the histomorphology and frequency of various gall bladder diseases among specimens received and to correlate the various types of mucosal responses to different gallstone characteristic (like type, number, size volume and weight). Gall bladder specimen after cholecystectomy of patients who was admitted in ward surgery of BPS GMC, Khanpur Kalan, Sonepat.Place of study:-Department of Pathology, BPS GMC Khanpur Kalan, Sonipat. Study design- Prospective study. Out of 339 cases, two hundred and ninety seven (87.61%) patients studied were females, whereas 42 (12.39%) cases were males. Male to female ratio was 1:7.07. Out of the 339 cases, 234 (69.7%) had mixed stones, followed by pigment 44(13%) cases and cholesterol31 (9.1%) and 27 (8.1%) had no stones. 126 (37%) had single stone, nine had (3%) double and the remaining 195 (58%) had multiple stones. Conclusion: The histopathological spectrum of gallbladder lesions includes chronic cholecystitis and associated mucosal alterations and lesions like metaplasia, dysplasia and carcinoma. Variants of chronic cholecystitis such as xanthogranulomatous, granulomatous and follicular cholecystitis were also noted. To conclude, it was seen that the average weight, volume and size of the gall bladder significantly correlated in increasing order with cholecystitis, hyperplasia, metaplasia and carcinoma.

This article describes the reconciliation between copyright law and library services. On the face of it, libraries and copyright protection seem to be located at cross-purposes. One seeks to freely disseminate literature, and the other seeks to preserve the exclusivity of the same. However, looking deeper, one can find a basis for reconciliation of the two in that copyright law is aimed at preventing the unfair use of and unlawful gain from another's literature or other creative work, while libraries aim at distributing knowledge from this literature and other creative works. The copyright act makes a sound balancing of the competing interest of the author on the one side and user on the other hand by recognizing library use as a privileged user right while upholding the moral and economic rights of the author. An attempt is made in this paper to examine the nature, extent and scope of this privileged use especially with a comparative analysis of the similar provisions in various national legislations. It’s really interesting that inspite of a series of technological developments and changed perceptions of public interest the legal provision stands as it is without any amendments for the last five decades. So it is right time to look into the efficacy of this legal provision in the context of changed public interest and technological challenges. Suggesting a viable mechanism keeping into account of the fragile social and economic needs of the country is the final aim of this analysis.

Mixed ovarian tumors are rare. The association of a granulosa tumor with a mucinous adenocarcinoma is exceptional and has never been reported to our knowledge in the literature. We report the case of a 44 year old patient, who consulted for an abdominal mass. The radiological explorations showed the presence of an enormous ovarian tumor, after hysterectomy the diagnosis of mixed ovarian tumor was made by histological and immunohistochemical study. The treatment is essentially surgical.

This paper aimed at investigating the relationship between oil price and some macroeconomic indicators of Saudi Arabia. The co-integration test and VECM were applied to achieve the paper objective. The time series data from (1970-2016) were used. The data was tested for stationarity, and then the co-integration test and VECM were estimated. The results reveal that there is a long run relationship between oil prices and real GDP with weak short run interactions. The result showed that rising of oil prices are negatively correlated with real GDP in the long run. Rising of oil prices may lead to a lower demand for oil in the long run, which will negatively affect government revenue and real GDP growth. The short run results suggest a positive relation between oil prices and real GDP. Rising demand in the short run will increase returns from oil export for the exporting countries. The oil price shocks have significant impact on real GDP in Saudi Arabia. This means the economy of Saudi Arabia will become highly volatile if depends on oil revenue as a major source of income. Diversifying sources of income is highly required in this case.

The Large Intestine neoplasms are one of the most common neoplasms encountered now a days. It consists of both colon and rectum malignancies. At present it ranks second to bronchogenic carcinoma in most prevalent cancers. Globally 8,00,000 Colo-Rectal Cancer cases are believed to occur and mortality of this is expected to be near 4,50,000. Overall incidence is 10% of all cancers. The present study was undertaken to study neoplastic lesions in the large intestine for the period of twenty-two months. The study consisted of total 65 cases out of which, 46 were surgically resected specimen and 19 were biopsies. Majority of the cases were Adenocarcinomas (61.5%), followed by Mucinous adenocarcinoma (24.6%). Most common location of Colo-Rectal Cancer was rectum (47.7%) followed by sigmoid colon (15.4%). Rare cases like Signet ring cell carcinoma, squamous cell carcinoma, Gastrointestinal stromal tumor and lymphoma were also found in the study. Histopathological evaluation is the only confirmatory investigation for diagnosis of such tumors. Present study emphasizes the need for early histopathological diagnosis for appropriate treatment.

A cross-sectional study of gastrointestinal helminthes parasites of equine was conducted for 6 months from November 2013 to April 2014 in and around Gondar, to determine the prevalence and associated risk factors of helminthes parasites of equines. A total of 384 faecal samples (donkeys (n=238), horses and (n=146) were collected from randomly selected equine for coproscopical examination and 40 pooled samples for recovery of parasitic larvae were collected and processed in Gonder University Veterinary Parasitological Laboratory. The overall prevalence of gastrointestinal helminthes parasite was 97.4% (374/384) out of which, 28.12% were mixed infections, with the prevalence rate of 97.9% and 96.6% in donkey, and horse, respectively. Coprological examination revealed the existence of five species and four genera of helminthes parasite namely, Strongylus species 47.13 %, Cyathostomes 22.65% Trichostrongylus axei 8.07 %, Triodonthophorus species 6.77%, Parascaris equorum5.2 %, Oxyuris equi 3.12 %, Strongyloides westeri 1.56 %, Anoplocephala species 1.04 % and Gastrodiscus species 1.82 %. No significant variations(P>0.05) in prevalence of helminth parasites were noticed in relation to species, age, body condition score and sex groups of equine, except in case of Parascaris equorum in which prevalence was observed to significantly decrease and increase with age, respectively (P<0.05). The average egg per gram of faeces in this study was 114.7 with a range of 100 to 5,500. The copro-culture study revealed that Strongylus vulgaris, Strongylus edentates and Cyathostomes were the major helminths larvae identified in the area during the study period. Generally parasitism and poly parasitism were the common finding of this work. Equine diseases in general, parasitism in particular, should be given attention in the region where equines are practically participating in all agricultural activities, from tillage to harvest.

Elicitors are the synthetic or naturally occurring molecules, which capable of trigger the plant defense mechanism against the plant pathogens and environmental hazards. Plants deploy a number of defense mechanism against the phytopathogens and elicitors can able to induce the production of secondary metabolites to facilitate the biochemical defense mechanism, which eventually leads to plant resistance. Biotic elicitors are the type of elicitors that have the biological origin and derived from the pathogen or from the plant itself. To induce the plant resistant, initially biotic elicitors need to go through with microbial-associated molecular patterns (MAMPs, also called PAMPs). As well, the plants have evolved other receptors to detect the elicitors and leads to gene mediate resistance mechanism against the pathogens. This review discusses such biotic elicitors and their way to induce the disease resistance.