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Mesenteric arterial occlusion is a vascular emergency that results from the sudden onset of decreased perfusion to the intestine due to an embolus or thrombus. Mesenteric arterial occlusion requires a high degree of clinical suspicion to allow for early diagnosis. It most commonly affects the superior mesenteric artery (SMA). Timely diagnosis with appropriate intervention to revascularize is critical in the management of mesenteric arterial occlusion to prevent the occurrence bowel necrosis, overwhelming sepsis and death. Mesenteric arterial occlusion can be due to arterial embolism or thrombosis. CT angiography remains the diagnostic test of choice. Treatment is highly dependent on etiology of the occlusion and patient stability.

Background— After aortic valve replacement, left ventricular afterload is often characterized by the residual valve obstruction. Our objective was to determine whether higher systemic arterial afterload—as reflected in blood pressure, pulsatile and resistive load—is associated with adverse clinical outcomes after transcatheter aortic valve replacement (TAVR). Methods and Results— Total, pulsatile, and resistive arterial load were measured in 2141 patients with severe aortic stenosis treated with TAVR in the PARTNER I trial (Placement of Aortic Transcatheter Valve) who had systolic blood pressure (SBP) and an echocardiogram obtained 30 days after TAVR. The primary end point was 30-day to 1-year all-cause mortality. Lower SBP at 30 days after TAVR was associated with higher mortality (20.0% for SBP 100–129 mm Hg versus 12.0% for SBP 130–170 mm Hg; P P Conclusions— Even after relief of valve obstruction in patients with aortic stenosis, there is an independent association between post-TAVR blood pressure, systemic arterial load, and mortality. Blood pressure goals in patients with a history of aortic stenosis may need to be redefined. Increased pulsatile arterial load, rather than blood pressure, may be a target for adjunctive medical therapy to improve outcomes after TAVR. Clinical Trial Registration— URL: http://www.clinicaltrials.gov . Unique identifier: NCT00530894

The main objective of the present investigation was to develop gastro retentive (floating) microsphere for Cefdinir. Cefdinir, Third-generation bactericidal cephalosporin antibiotic drugs has been chosen as a model drug in the formulation of floating drug delivery systems. It is a drug of choice in treatment of otitis media, soft tissue infections, and respiratory tract infections, including sinusitis, strep throat, community-acquired pneumonia and acute exacerbations of bronchitis. Three biocompatible polymers like HPMC, Ethyl cellulose and Eudragit were chosen in varying proportions with the drug. F5 formulation with drug: polymer (1:2) show excellent micromeritic properties, percent yield (87.22%), drug entrapment efficiency (92%), percent buoyancy (89%), and highest invitro drug release 98.9% within 12 h. In the stability studies no significant change in drug entrapment release characteristics of the microspheres.

Repair of the mitral valve should be the primary goal in the surgical management of acute mitral regurgitation following valvotomy. The earlier the repair is done, the better it is because the preoperative haemodynamics affect the overall outcome. The disadvantages and anticoagulation of prosthetic valves are avoided. Besides, it is economical to avoid the high cost of the prosthetic valves in a poor socio-economic group of patients. With good patient selection and additional effort by the surgeon to acquire the necessary expertise to reproduce the techniques of mitral valve repair, a superior quality of life can be offered to these patients. The present study is a retrospective analysis of 14 patients who required emergency open heart surgery following balloon or closed mitral valvotomy. The valve was successfully repaired in 8 patients. The medium term follow-up indicates that repair is reproducible, safe, reliable, and a stable procedure free of complications.

Osteomas are benign osteogenic lesions with very slow growth, which may arise from proliferation of either cancellous or compact bone. In the jaw, these are uncommon lesions. A 45-year-old female patient reported to our dental out patient department (OPD) with a complaint of painless swelling in the right lower back jaw region for the past 2 years. A single, well-defined radiopaque lesion intermixed with multiple radiolucent areas was evident in the right body of mandible region in orthopantomogram (OPG) and computed tomography (CT) with hyperdense area with intermixed hypodense areas. In this case report, we discuss about the subsequent diagnosis and the possible treatment modality of this entity.

Glutathione (GSH) is widely distributed among living cells and is involved in many biological functions. It provides the sulfhydryl groups for conjugation of toxic metabolites of several xenobiotica. Acetaminophen (Tylenol) toxicity is a classical example of this property. For this purpose, we studied the effects of delta-9-tetrahydrocannabinol (THC) on tissue levels of GSH in the mice. Groups of male Swiss Webster mice weighing 25±5 g were treated with 50 mg/kg, PO THC at 1300 h. Control mice were given equal volume of sesame oil (5 ml/kg, PO) which was the vehicle for THC. Ninety minutes following THC administration, mice were sacrificed, their plasma, brain, heart, liver, kidney and testis were collected. All tissues were homogenized in 5% TCA/EDTA solution and supernatant solutions of these homogenates were diluted. In these diluted samples, levels of GSH were determined by a modified spectrophotometric procedure and the GSH levels were expressed as micromoles of GSH/g tissue. In this study, THC caused no effects on GSH levels in brain, heart, testis and plasma. However, GSH levels in liver and kidney were decreased by 14% and 7% respectively. Although the decrease in kidney GSH levels were insignificant, these changes in liver and kidney could be indicative of a possible metabolic and/or dispositional interaction between THC and different commonly available drugs such as acetaminophen.

Report of a case, initially diagnosed as Anorexia Nervosa (AN) but later on revealing a fourth Ventricular Tumor is presented. Relevant literature is surveyed while drawing attention to the unusual location of the tumor, instead of hypothalamic area as customarily reported. Several years of duration between initial appearance of clinical signs and symptoms and discovery of the tumor require emphasizing the need to keep the diagnosis tentative and not to hesitate in following up any clues pointing to a probable organic base.

Patterns of prescription of medication to 50 consecutive male and 50 consecutive female patients admitted in 1976 and 1977 to a 15-bed child psychiatric facility in Canada were studied and analyzed. Data are presented with respect to the relationship of prescription of medication to age, sex, diagnosis, length of hospital stay and prescribing physician. The frequency of prescription of multiple medications is reported along with examination of the patterns in the light of Audit and Screening Criteria recommended by the American Psychiatric Association.