Physiology and Anatomy

Leptospirosis continues to be a challenge to health worldwide, among farmers, municipal workers etc. Despite widespread implementation of effective therapy, leptospirosis has not been eliminated or keeping under the control. The outbreaks occurring every year with increasing mortality during the flood and other water oriented natural calamities. Identification of patients with leptospirosis is challenging among the clinicians, due to misdiagnosing or under diagnosing, including non consideration of PUO cases to leptospirosis. Children who develop leptospirosis continue to be especially disadvantaged, with rates of late diagnosis and mortality remaining high. Leptospirosis is not a specified disease in the Millennium development goals, but severity and multiple organ dysfunctions to multiple organ failure induce the researchers and clinicians to concentrate for education and level of improvement of the patient care including immediate therapy. We review data and make recommendations for research on diagnosis, treatment and prevention such us further use of molecular analysis of Leptospira interrogans genome, formulation of newer vaccines and administration of doxycycline chemoprophylaxis to contacts. We also suggest developing the tools for early diagnosis and detection of infection and organ damage and formulation of strategies to manage the chronic complications of leptospirosis such as hepatospleenomegaly, renal failure, respiratory distress and neuropathy.

The present study provides the health application at affordable cost. This study such as ethnomedicine keenly represents one of the best avenues in searching new economic plants for medicine.The present investigation was carried out to examine the qualitative phytochemical analysis, antibacterial and anti-oxidant effect of polyherbal drugs namely Shirishadi and Bharangyadi. The hydroethanolic extracts of drugs showed the presence of alkaloid, tannins, flavanoids, phlobatannins, saponins, terpenoids, cardiac glycosides, anthraquinones, proteins, amino acids and carbohydrates particularly reducing sugars. The estimations of total phenolics content in the selected groups was also done spectrophotometrically following the Folin – ciocalteau method and was found to contained 112mg/g & 50.98+ 0.62 of phenolics respectively. Flavonoids were also estimated following the aluminium chloride method and 13.66 + 1.67mg/g of flavonoids was found to present in Bharangyadi compound whereas Shirishadi contains 23.89 + 4.62mg/g. ABTS+ assay shows maximum inhibition of 82.27 ± 2.69 with EC50 462.72 ± 4.56 for Shirishadi and Bharangyadi shows 64.2+ 0.86 percent inhibition with EC50 675.31 + 4.24. Assessment of antimicrobial activity shows that Bharangyadi has more potent antibacterial and anti-fungal effect than Shirishadi. Antibacterial activity was best revealed by Bharangyadi compound against Plesiomonas shigelloides followed by Pseudomonas aeruginosa it showed strong antifungal property with maximum affinity against Candida parapsilosis. Shirishadi compound also showed effective antibacterial and antifungal activities with maximum inhibition zone against Plesiomonas shigelloides and Candida tropicalis.Both the drugs were tested against seven bacterial strains and four fungal strains.

The authors report one case of anorectal malignant melanoma, seen and managed in EFD-HGE Unit, Ibn Sina Hopital . It’s a very uncommun affection of bad pronostic. At the present time, the surgical management is the only therapeutical attitude.

We report the case of a 69-year-old man with radiation-induced osteosarcoma of the mandi-ble diagnosed four years after radiation treatment for squamous cell carcinoma of the tongue. Although radiation therapy is a proven treatment modality for malignancies of the head and neck, it can have adverse effects. Late complications in bone following radiotherapy include osteoradionecrosis, radiation-induced osteitis, and osteosarcoma, which is an uncommun tumor, diagnosed by meeting certain diagnostic criteria. The mandible is a location very sensitive to radiation effects.

Retroperitoneal neuroblastoma is an embryonic tumor of the peripherical sympathetic nervous system. In this study, we report the case of an 18-years-old woman who underwent a subcostal laparotomy for a localized retroperitoneal tumor. The histological findings after resection showed it to be a neuroblastoma. Immunohistochemical staining showed no MYCN amplification. We managed this case using pediatrics staging systems and guidelines. She is now 20-years-old, and her CT scans and MIBG scintigraphys are showing neither recurrence nor progression.

Haemophilic pseudotumor is a rare complication of haemophilia consisting of chronic, encapsulated hematoma of muscle and or bone due to repeated bleeding. It is estimated to occur in approximately 1-2% of patients with severe disease. Imaging tests (radiography, sonography, CT, and MRI) are fundamental for diagnosis and monitoring the evolution of pseudotumors. In this paper, we report the radiography and computed tomography aspects of a rare case of a patient with large iliac hemophilic pseudotumor, occurring in severe hemophilia.

Bone solitary plasmocytoma is a rare entity characterized by monoclonal proliferation of malignant plasmocytic cells located at a bone segment, with no sign of systemic invasion. The vertebral location is the most common. The authors report a case of a woman who was 56-year-old with no medical history and addressed for a tumor of the proximal humerus. Anatomopathological examination of the segment of humerus noted an extensive diffuse plasmocytic infiltration. The absence of systemic biological signs of multiple myeloma led to the diagnosis of solitary plasmacytoma. After using the radiotherapy and chemotherapy, we obtained the complete remission without recurrence for 2 years. The interest of this study is the the rarity of this localization, and to release the particular diagnostic, therapeutic and evolutive of this affection in our context.

A quantitative study to assess level of stress, stressors and coping strategies used by newly admitted nursing students at selected college of Panipat, Haryana. Stress in nursing is inherent and inevitable. Stress inducing demands include long hours of study during examination, lack of free time, frequent change of practice areas, adjustment in hostel, separation from family and friends, financial problems etc. This was a descriptive, cross-sectional study conducted among consecutively sampled 95 newly admitted nursing students at Ved nursing college, Prem institute of medical sciences, Panipat, Haryana. Standardized as well as self-structured, pretested, validated questionnaires were used for data collection. Majority of students (81.1%) were experiencing moderate stress. Most frequently reported stressors were worry about poor grades, parent’s expectations, inferiority regarding low performance in studies. Most common healthy coping strategies used were talk to parents, listen to music, share feelings with friends and pray. By identifying the stressors and coping strategies used, effective coping strategies can be reinforced and co-curricular activities can be planned by the institute to minimize the stress of students and to channelize the energy of students in a positive manner.

The torsion of the greater omentum is a rotation of all or part of the omentum on itself, which creates vascularization disorders; however, this diagnosis remains an infrequent situation in current practice, and because of the non-specificity of the clinical symptomatology, which depends on the site of the torsion and is confused with many other etiology, we report In this article we report a case of this 90-year-old patient, type 2 diabetic under ADO, who presented during five days the installation of epigastric pain and the CT scan takes all its interest in finding an image of rotation "whirl sign" and the diagnosis of torsion of the greater omentum is confirmed intraoperatively.

The association between atrial fibrillation and left atrial thrombus had been widely described; on the contrary, the relation between atrial fibrillation and right atrial thrombus hasn’t been demonstrated. We always thought that right atrial thrombus originated from deep venous thrombosis and named as “emboli in transit”. We report the case of a 91 year-old male patient, presenting with a permanent atrial fibrillation, his echocardiography showed a huge floating right atrial thrombus complicated with a bilateral pulmonary embolism. Our aim is to demonstrate through this case the association between atrial fibrillation and right atrial thrombus, using our findings in the literature, and comparing between the prevalence of right and left atrial thrombi in association with atrial fibrillation, explaining the difference between the both, and discussing therapeutic options.