We investigated the role of IL-4, IL-12 and TNF-alpha in clinically well-defined groups of Plasmodium falciparum and vivax (Pf & Pv) infected patients belonging to Group I (??), Group II (???) and Group III (????). On the basis of hematological parameters, hyperparasitaemia, and evidence of neurological involvement, three different levels of severity were selected attributing a score from Group I (??) to Group III (????). In each group 16 patients each of P. falciparum and P. vivax malaria were studied. As a control group for cytokine determination 30 healthy volunteers were included in the study. Serum samples were analyzed for IL-12, IL-4 and TNF-alpha using (ELISA) obtained commercially (Ray Biotech). Hb levels of Pf and Pv patients were 8 ± 1.94, 7.6 ± 1.64 g/dl and 3.6 ± 1.23 and 10.1 ± 1.21, 9.4 ± 1.43 and 7.1 ± 0.98 g/dl. Serum iron levels of Pf and Pv patients were 85.86 ± 0.86, 81.10 ± 0.70 and 70.1 ± 0.73 and 99.47 ± 0.85, 96.67 ± 1.13 and 91.7 ± 2.65 mg/dl. TNF-alpha levels of Pf and Pv patients were 155 ± 23.66, 307.5 ± 111.87 and 955 ± 261.32 and 72 ± 9.93, 140.88 ± 23.11 and 469.37 ± 416.99 pg/ml. IL-12 levels of Pf and Pv patients were 117.5 ± 8.16, 160.63 ± 20.81 and 293.13 ± 94.64 and 75.7 ± 9.25, 112.9 ± 12.05 and 200 ± 53.78 pg/ml. IL-4 levels of Pf and Pv patients were 3.7 ± 0.11, 3.2 ± 0.13 and 2.3 ± 0.63 and 5.33 ± 1.08, 4.8 ± 0.16 and 3.9 ± 0.48 pg/ml. In the control group the values of TNF-alpha, IL-12 and IL-4 were 42.9 ± 13.5, 49.8 ± 11.59 and 6.06 ± 1.32 pg/ml respectively. Cytokines and poor oxygen delivery should not be viewed as alternative theories of malarial disease pathophysiology instead poor oxygen delivery is one of the consequences of excessive release of inflammatory cytokines which is further augmented by the present work.
We investigated the prognostic role of TNFalpha, IL-4 and IL-12 in a clinically well defined group of Plasmodium falciparum infected patients (n = 32) sequentially from Day 0 to Day 10 with a 2 day interval along with a control group of 16 healthy volunteers of same range of age and sex. Infection with malaria is often fatal because mitochondria are unable to generate enough ATP to maintain normal cellular function. ATP deficiency arises in malaria due to an inability of mitochondria through the effects of inflammatory cytokines on their function, to utilize available oxygen. In our study TNF-alpha and IL-12 levels were significantly elevated but IL-4 level showed persistent decline in Day 0, but subsequent measurement in Day 2, 4, 6, 8 and 10 showed persistent decline in levels of TNF-alpha and IL-12, an elevation in IL-4 levels which were associated with disease prognosis of the infected patients. These results again provide evidence that cytokines are very much a dominant partner in malaria pathogenesis with a specific prognostic role.
Background: India, has an estimated annual incidence of 6-7 million burn cases. In the state of Odisha, there are very few epidemiological studies of Burn injuries. Therefore a hospital based descriptive study among the admitted burn cases was conducted. Methods: The study was conducted among the burn cases admitted to the burn unit of Surgery Department of SCB Medical College and Hospital, Cuttack during the time period from 1st January 2014 to 31st May 2015.A total of 145 patients were included for the study. Results: Socio-demographic profile of burn cases showed 83 (57.2%) were females and rest 62 (42.8%) were males. Regarding residence, 109 (75.1%) of the burn victims were from rural area and the rest 36 (24.9%) were from urban area. Also 140 cases (96.5%) belonged to low socio-economic status and were having BPL card. Regarding the nature of burn, 108 (74.5%) cases had it accidentally while 33 (22.7%) had burn due to suicidal attempt and the rest 4 (2.8%) had homicidal burn and all these 4 cases were married females. 104 (71.7%) cases were affected by flame, 12 (8.2%) cases were due to scald while 29 (20%) were due to electric burn. Among the burn cases due to flame, kerosene was the most common cause. Conclusions: The study revealed that thermal burn was the most common type of burn and the victims were in their active productive period of life (21-40 years), married, illiterate and were from rural areas. Among the thermal burn victims, use of kerosene was the most common cause of burns in both the sexes.
Background: Acute pancreatitis is sudden swelling and inflammation of the pancreas. It can be diagnosed on the basis of clinical and laboratory data. At times, it may be difficult to differentiate it from other acute abdominal conditions. In these patients, serum enzymes (amylase and lipase) study, imaging by ultrasonography (USG) and/or computed tomography (CT) is of immense value in arriving at a diagnosis. In this study, we have compared the role of serum enzymes (amylase and lipase) levels, with the imaging studies (US/CECT scan) in relation to early diagnosis of acute pancreatitis and to find out the most specific and sensitive diagnostic modality.Methods: 300 patients (220 males, 80 females) in age group of 21 to 62 years with a clinical diagnosis of acute pancreatitis, which were admitted to surgical ward of S.C.B. Medical College Hospital, Cuttack during a period from November 2013 to October 2015, were included in the study. All selected cases (clinically diagnosed as acute pancreatitis) were serially subjected to tests of serum amylase and lipase estimation, USG and CECT scan of abdomen.Results: In our study the most common cause found was gall stone disease followed by chronic alcoholism. Serum amylase test showed diagnostic accuracy of 46.66% whereas serum lipase it was 70 %. Further USG of abdomen diagnostic accuracy was 83.33%, finally CECT scan had a diagnostic accuracy of 93.33%.Conclusions: Comparing all the diagnostic modalities described above it was found that contrast enhanced CT scan has highest accuracy rate (i.e. about 93% in our study) in detecting acute pancreatitis. This study proved that CECT scan was very important in the following up of the patients in order to detecting regression of disease appearance and complication in relation to acute pancreatitis.
Giant cell tumor (GCT) at distal end of tibia is relatively a rare site of occurrence. We presented our experience with extensive excision and reconstruction for GCT of distal tibia using a free vascular double strut/single strut fibula graft. The present case series was conducted on six patients of GCT at lower end of tibia who were treated with extensive excision and reconstruction either in index (n=4) or recurrence (n=2) settings. Four patients were male and 2 were female. The mean age was 26.5 years. The average length of bone defect after tumor excision was 7.4 cm. The range of movement at ankle joint up to 70% of normal opposite side achieved in 2 cases and arthrodesis of ankle joint done in rest 4 cases (2 recurrent and 2 index cases). In GCT treatment, in spite of reconstruction difficulty for bony defect of lower end tibia due to its weight bearing property, vascularized free fibula graft has advantages like allows wide excision of tumor, single stage procedure, early weight bearing capacity in young patients and no bone resorption but bone thickening.
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