BackgroundThe prevalence of self -medication with antibiotics is quite high in developing countries as opposed to developed countries. Antibiotics are often taken erroneously for certain ailments, without having the appropriate knowledge of their use. This carries potential risks for the individual as well as the community, in form of several side effects such as antibiotic resistance. Therefore the prevalence of self-medicated antibiotics in developing countries needs to be studied.MethodsA descriptive cross-sectional study was carried out at six different non-medical universities of Karachi. 431 students were included in the study. Data was collected using self-administered questionnaires and analyzed using SPSS version 19.Results50.1% students reported having self-medicated themselves in the past 6 months and 205 (47.6%) reported self-medication with antibiotics. Amoxicillin was the most self-prescribed antibiotic (41.4%). Awareness of the adverse effects of antibiotics was demonstrated by 77.3% of the students and sleep disturbance was the most commonly known (46.5%) side effect. 63.1% denied having any knowledge about antibiotic resistance and only 19.9% correctly knew that indiscriminate use of antibiotics can lead to increased antibiotic resistance.ConclusionThe prevalence of self-medication with antibiotics among the non-medical university students was high despite the awareness of adverse effects. Antibiotic resistance was a relatively unknown terminology.Electronic supplementary materialThe online version of this article (doi:10.1186/2050-6511-15-74) contains supplementary material, which is available to authorized users.
Two patients are presented with primary low grade pleural B cell lymphomas with no history of a pyothorax.P leural disease in non-Hodgkin's lymphoma is well documented and commonly presents with pleural effusions in 20% of patients. 1 However, solid pleural involvement is less common and is usually a secondary event. Primary pleural lymphomas are extremely rare and, in a series reported by Burgener and Hamlin, pleural plaques were seen in less then 4% of cases. 2 Two types of primary pleural lymphomas have been described-the body cavity based lymphoma in patients with HIV and the pyothorax associated pleural lymphoma in those with tuberculosis. Primary pleural non-Hodgkin's lymphoma in an immunocompetent patient without a history of chronic pyothorax is extremely rare. CASE HISTORY 1A 59 year old man presented with a 4 month history of gradually increasing shortness of breath and left sided chest pain. He was a non-smoker with a history of occupational exposure to asbestos (he had worked in power stations for over 30 years). On examination, air entry over the left side of his chest was diminished.Investigations showed a normal full blood count, urea and electrolytes. His chest radiograph revealed a left sided pleural effusion. A chest drain was therefore inserted and approximately 7 litres of serous fluid were drained. A computed tomographic (CT) scan of the thorax showed a left pleural effusion with irregular thickening of the adjacent parietal pleura, extending medially to displace the aorta. Bilateral pleural calcification suggestive of asbestos exposure was also seen. No significant lymphadenopathy was noted. A bone marrow biopsy performed during this admission did not show any evidence of lymphoma. Video assisted thoracoscopy showed diffuse involvement of the parietal pleura from which biopsy samples were taken. Light microscopy showed lymphoid infiltration with a hint of nodularity. Isolated reactive germinal centres were buried within the infiltrate of medium sized lymphoid cells and mononuclear blasts (fig 1). Mitotic figures were easily visible. Immunohistochemical staining confirmed the dominant B cell nature of the infiltrate. The phenotype of the B cells was confirmed as CD43, CD23 and BCl-2 positive, and CD5 and CD10 negative. Follicular dendritic cells in lymphoid nodules were highlighted with CD23 and CD21, confirming follicular colonisation. Ki67 labelling was observed in 30% of the tumour population. These findings supported a diagnosis of low grade marginal zone lymphoma of the pleura. Also present in the sample were hyalinised plaques infiltrated by lymphoma on one surface.DNA was extracted from paraffin embedded material and PCR was performed by standard methods using primers for the FR2 and FR3 regions of immunoglobulin heavy chain.This showed a band, in keeping with the monoclonal nature of the disease. Pleurodesis with 5-fluorouracil was performed and the chest drain was eventually removed. The patient was treated with chlorambucil. Follow up at 18 months showed no evidence of lymphadenopa...
The existing bioinformatics tools, ligand binding attribute prediction, and model building offer a specific method to establish homology of proteins, discover drug targets, and facilitate the investigation of the evolution of several types of cardinal ion channels from unicellular eukaryotes to multicellular species as humans.
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Profound lactic acidosis is rare in patients with decompensated heart failure (HF). CASE PRESENTATION: Mr. A is a 49-year-old man with a past medical history of coronary artery disease with bypass grafts, chronic systolic HF (with previous ejection fraction 30%), who presented with worsening dyspnea of one-week, in the setting of non-adherence with medications. His labs showed significant metabolic acidosis with pH 7.17, bicarbonate 8 mEq/L, lactic acid 15.5 mmol/L, and creatinine 1.3 mg/dl (at baseline). The echocardiogram showed an ejection fraction of <20% with biventricular failure. After treatment with intravenous nitroprusside and furosemide drips, he had normalization of lactic acid (see Figure 1). Mr. B is a 65-year old man with a history of diabetes mellitus, hypertension, but no known heart disease (a normal echocardiogram one week prior to the admission), who came with recurrent angina and worsening dyspnea for one-month. His labs showed severe metabolic acidosis with pH 7.1, bicarbonate 14 mEq/L, lactic acid 12 mmol/L, creatinine 1.7 mg/dl (at baseline). The echocardiogram showed an ejection fraction of <20% with global left ventricular hypokinesis. The coronary angiogram revealed three-vessel disease, and complex interventions with stents were done. He had significant improvement in lactic acid after treatment with dobutamine and furosemide drips, along with an intra-aortic balloon pump (see Figure 1). Th right heart catheterization showed cold and wet type HF in both patients (see Table 1). We found no other cause to explain the lactic acidosis such as sepsis, hypovolemia, alcohol, metformin use, or worsening renal failure in either patient.
The objectives of Master of Philosophy (MPhil) in Physiological Sciences are: 1) to describe the new ways in which anatomy, biochemistry and physiology on one hand, and microbiology, pathology and pharmacology on other hand meet their functional requirements through multidisciplinary integrated concepts; 2) to elucidate relationships between cell biology, molecular biology and molecular genetics by connecting dots of how cell functions are driven by molecules and being controlled by genes. This forms the basis of cell, molecular and genetics [CMG] module upon which 7 multidisciplinary modules of Physiological Sciences follow; 3) these 24 credit hours provide the physiological basis for PhD studies as well as faculty development to enhance learning abilities of medical student; 4) the modules constitute Cardio- Respiratory Physiological Sciences, GI and Renal Physiological Sciences, Neurosciences, Endo-Reproductive Physiological Sciences.; 5) it has integrated microbiology, pathology and pharmacology in a unique way through CMG of microbes leading to associated pathology and mechanisms of prescribed drugs; 6) it has additional synopsis and thesis friendly course work leading to comprehensive examinations; 7) the year two deals with research work of 6 credit hours leading to defense of thesis; 8) The MPhil in Physiological Sciences is fundamentally different from what is being offered elsewhere. It prepares and offers a good spring board to dovetail PhD studies as well as faculty and institutional development.This is the first study that deals with innovative programmes in research, learning and education in the field of physiological sciences. This broad-based MPhil would make its recipients competent, critical, confident and productive learner. This is a completely unique design of a curriculum that has no comparable examples elsewhere. Our mission is to educate graduate students in the field of Physiological Sciences such that they have a complete grasp over the broad-based integrated concepts of basic health sciences. Upon completion of their education, the students will be able to use the duality of imagination and skepticism. Hence, the students will contribute to their fields by unfolding their creative energy.
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