Tetracycline and quinolones could be the antibiotics of choice in the eradication of H. pylori in this region, while recurrence of the infection with H. pylori could be expected among patients receiving either metronidazole or clarithromycin, for eradication therapy. DST should be done on a routine basis utilising both phenotypic and genotypic methods to prevent further emergence of resistance in this region.
Consumption of food crops contaminated with heavy metals is a major food chain route for human exposure. In the present study, vegetables grown in the sewage and tube well water irrigation are Raphanus sativus, Daucus carrota and Brassica rapa. Concentration of Cd, Pb and Ni was significantly higher in sewage irrigated soil at all the four depths (0-15, 15-30, 30-45 and 45-60 cm), respectively. Cadmium, Lead and Nickel concentration are higher at the surface horizons and it decreases sharply with depth in both tube well and sewage irrigated soils. Extent of heavy metal built up in sewage irrigated soils was significant in both 0-15 and 15-30 cm depth. Higher concentration of Pb, Cd and Ni, were observed in the roots of all crops grown in sewage irrigated soils compared to that of crops grown on tube well irrigated soils. Sewage water irrigation has a great potential to contaminate the soil which may lead to the accumulation of heavy metals in crop plants and may cause harmful effect on animals and plants. Results, indicate that, long term and indiscriminate application of sewage water, which contains heavy metals may cause accumulation of heavy metals in surface and sub-surface soils and the buildup of heavy metals on soil profile may prove harmful not only to plants, but also to consumers of the harvested crops.
Background:Corticosteroid insufficiency in acute illness can be difficult to discern clinically. Occult adrenal insufficiency (i.e., Δmax ≤9 μg/dL) after corticotropin may be associated with a high mortality rate.Objective:To assess the prevalence of occult adrenal insufficiency and the prognostic value of short corticotropin stimulation test in patients with septic shock.Materials and Methods:A total of 30 consecutive patients admitted in the adult intensive care unit of the Sheri Kashmir Institute of Medical Sciences who met the clinical criteria for septic shock were prospectively enrolled in the study. A low dose (1 μg) short corticotropin stimulation test was performed; blood samples were taken before the injection (T0) and 30 (T30) and 60 (T60) minutes afterward.Results:The prevalence of occult adrenal insufficiency was 57%. The 28-day mortality rate was 60% and the median time to death was 12 days. The following seven variables remained independently associated with death: organ system failure scores, simplified acute physiology score II score, mean arterial pressure, low platelet count, PaO2:FIO2, random baseline cortisol (T0) >34 μg/dL, and maximum variation after test (Δmax) of ≤9 μg/dL. Three different mortality patterns were observed: (I) low (T0 ≤34 μg/dL and Δmax >9 μg/dL; a 28-day mortality rate of 33%),(II) intermediate (T0 >34 μg/dL and Δmax >9 μg/dL or T0 ≤34 μg/dL and Δmax ≤9 μg/dL; a 28-day mortality rate of 71%), and (III) high (T0 >34 μg/dL and Δmax ≤9 μg/dL; a 28-day mortality rate of 82%).Conclusion:A short corticotropin test using low-dose corticotropin (1 μg) has a good prognostic value. High basal cortisol and a low increase in cortisol on corticotropin stimulation test are predictors of a poor outcome in patients with septic shock.
Rheumatic Heart Disease (RHD) is still a major public health problem in developing countries such as India. Present study was conducted in urban population of district Srinagar of J&K state (India). A study had been conducted in the same population in 1983 & the prevalence at that time was 5.9 / 1000. The aim of the present study was to know the present status of Acute Rheumatic Fever (ARF) & RHD in the same population since we have observed a significant decline in the attendance of these patients in OPD & wards of Sheri-Kashmir Institute of Medical Sciences (SKIMS) Srinagar. A survey of school children aged between 6-16 years studying in randomly selected private and government schools of Srinagar-city was done. A total of 5661 school children were examined. Eleven school children were found to have heart disease. Of these 4 had RHD, confirmed on Echocardiography while 7 had congenital heart disease (CHD) and were excluded from the study. No case of ARF could be identified. As per our study the prevalence of RHD is 0.7/1000 school children. The results observed were lower than that reported in earlier studies from developing countries, but are comparable to large studies conducted in Christian Medical College Vellore in 2003 & Gorakhpur in 2005-2006. Therefore it is concluded that there has been a dramatic decline in prevalence of RHD over last two decades.
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