Oral pyridostigmine for treatment of postoperative ileus associated with elevated catecholamine levels: A case report
The etiology of post-operative ileus is usually multifactorial, but increased catecholamines have been implicated as an important cause. We present a case of catecholamine-induced prolonged post-operative ileus treated successfully with Pyridostigmine. A 70-year-old male underwent a low-anterior resection and diverting loop ileostomy for rectal cancer. Immediately post-operatively he developed refractory hypertensive urgency and a small bowel ileus. Biochemical testing revealed markedly elevated 24-hour urinary metanephrines and normetanephrines. However, radiologic studies failed to identify a pheochromocytoma. The ileus persisted despite employing a multimodal regimen consisting of avoidance of narcotic pain medications, gastric decompression via a nasogastric tube, maintenance of normal levels of electrolytes, parenteral nutritional support, and early mobilization. Two weeks after the surgery the patient was treated with oral Pyridostigmine with appropriate return of bowel function. Excessive circulating catecholamines play an important role in the etiology of refractory post-operative ileus, and cholinesterase inhibitors such as Pyridostigmine could be used as an effective treatment in such cases.
Pulmonary metastasis of a Dermatofibrosarcoma of Darier and Ferrand treated by IMATINIB: a case report
Dermatofibrosarcoma (DFS) described by Darier and Ferrand represents less than 5% of soft tissue sarcomas and metastases only very rarely. We report the case of a 51-year-old patient followed for six years for a DFS of the right thigh root recurrent several times after non-optimal surgical resections. The occurrence of thoracic pain associated with a cough with dyspnea, motivated the realization of a thoracic computed tomography (CT) showing a right basal pulmonary mass with pulmonary nodules. CT biopsy of one of the pulmonary nodules confirmed the metastatic nature of these lesions. The search for translocation t (17,22) could not be performed. A treatment based on imatinib has been started. The evolution was marked by the disappearance of the respiratory symptomatology and a good radiological response. The advent of targeted therapy with imatinib transformed the prognosis for this disease, which was considered incurable at the metastatic stage.
One of the culprits during this tough spring was a parasite called Cryptosporidium. It is an important zoonotic pathogen transmitted primarily through water.Cryptosporidiosis is a common cause of diarrhoea in young calves. It is caused by a protozoan parasite of the genus Cryptosporidium,family Crptosporididae,order Eucoccidiorida,class Coccidian and phylum Apicomplexa.The parasite infects epithelial cells in the microvillus border of the gastrointestinal tract of all class of vertebrates7.and causes severe chronic and even fatal diarrhea with malabsorption and dehydration 19 Currently,there are 16 recognized species and nearly triple this number of unnamedNeonatal calves becomes infected within the first few days after birth.Feces containing eggs are a major source of infection, but calves may also spread the parasite through direct contact. Since the egg survive well in the environment, calves can also pick up infections from water,feed and soil.In addition to calves, cryptosporidiosis affects other young animals including piglets,lamb,kid,oats,foals and fawn (farmed deer). Stressors such as inadequate milk consumption,cold weather and wind may also play an important role in determining how severe the infection will be and how long it will last.
Due to the increase of private vehicles in China cities, high-level pollution is often detected in urban street canyons. The study selected Jinlu building as the research object and used FLUCK985 particle counter to collect the particles concentration at different heights, at the same time, combined with meteorological to study the vertical variation characteristics. Finally, combined with the feature of human body, the exposure assessment method was used to analyze the effects of particulate matter on human health. The results are as follows. (1) As the diameter increased, particles number decreased. The CV (Coefficient variation) alongside viaduct was smaller than non-viaduct and the CV degree is weak or moderate. (2) The contamination degree in viaduct is greater than non-viaduct. The particulate concentration decreased with the increase of floor, but near viaduct, the coarse and fine particles showed different trends. (3) The early peaks concentration was more than evening peaks in sunny, windy and rainy days, among them, the sunny concentration was more than rainy days; the windy days concentration was changed during the different diameter. (4) the viaduct RDD was more than non-viaduct. The RDD was highest in Older; the second was Adult and Child RDD was the lowest. The RDD in early peak was higher than evening peak of which PM10 always stay on the nasal cavity. Thus the people should try to shorten linger under viaducts so as to prevent the coarse particles from causing discomfort to nasal cavity.
The use of remifentanil patient-controlled analgesia for labour analgesia remains controversial. The high potency of the drug, the fear of serious adverse drug reactions and drug administration errors are all legitimate concerns. We report the case of a woman in labour who inadvertently received a remifentanil solution via epidural route. In addition to the risk of respiratory depression, the epidural administration of remifentanil contains glycine in its solution and is therefore contraindicated due to potential neurological injury. The patient received a total of 2 mg of remifentanil and 15 mg of glycine in her epidural over a long period before the error was identified. Interestingly the patient was mostly comfortable during labour and fortunately no maternal or neonatal adverse events occurred.
Warfarin is an oral vitamin k antagonist prescribed to those patients for the treatment and prevention of venous thromboembolism. The major challenges to be faced during the therapy were a greater risk for both major well as minor bleeding, which makes the regular monitoring of INR (international normalized ratio) mandatory. Here we report a case study of 76 year old male who presented to institution with the complaints of bleeding from oral cavity due to consumption of conventional anticoagulant therapy. Patient was on anticoagulation therapy for paroxysmal atrial fibrillation since 2011. The blood investigation revealed anemia (Hemoglobin: 6.1g/dl). He was immediately transfused with packed RBC and fresh frozen plasma to replenish the body reserves. Prothrombin time (PT)/INR was reported undetectable and warfarin was withheld from the past medications and was restarted at INR therapeutic range. Furthermore this case highlights the need for a better communication by providing counselling regarding all aspects of medications as well as lifestyle modifications and also by giving patient information leaflets.
The use of central neuraxial anaesthesia for lumbar laminectomy is evolving in our centre with its attendant advantages like decrease in intraoperative blood loss, peri-operative cardiac ischemic incidents, postoperative hypoxic episodes, arterial and venous thrombosis, and it provides longer/ adequate postoperative pain control. Nonetheless, blindness a possible complication under general anaesthesia is preventable with regional anaesthesia, this is because patient is awake and there is no restriction in neck movement. This case series helps to provide feasibility of lumbar laminectomy under central neuraxial anaesthesia (spinal, epidural and combined spinal epidural anaesthesia).
The Implementation of OECD Corporate Governance Principles in Nigeria: Evidence from Stakeholders’ Perspectives
This study investigates the stakeholders’ perspectives on the implementation of Organization for Economic Cooperation and Development (OECD) corporate governance principles in Nigeria. The study adopted an ex-post research design with a structured questionnaire to elicit information from the respondents. The descriptive statistical method was also considered as analytical techniques. Findings revealed that shareholders in Nigerian firms have the right to participate in profits of the firm; they have the right to vote in general meetings and also have the right to obtain information about voting rights before purchase of shares. However, the study found that the details about the capital structure, financial and operating reports of firms were not fully disclosed. It was also discovered from the study that ownership transfer among shareholders was poorly facilitated, with minority shareholders not fairly treated. The study concludes that board of directors usually takes the interest of shareholders’ more important than the stakeholders interest in the firms. It was however suggested that corporate governance framework in Nigeria should recognize the rights of stakeholders established by law or through mutual agreements; and encourage wealth creation and employment opportunities for sound financial sustainability of corporate firms.
The performance of an animal for a particular trait is the result of its genetic merit and the effects of the environment where it exists. To set up genetic improvement in sheep, the genetic component attributed to the trait of interest need to be defined. The aim of this review was to describe major candidate genes influencing growth traits and prolificacy in sheep. Although growth and prolificacy are quantitative traits and are expected to be influenced by many genes with individual genes contributing small effects, there are major genes that have been identified with significant influence on growth and prolificacy. The CLPG, GDF8 and CAST genes are some of the major genes that have strong influence on sheep growth and carcass quality. The CLPG mutation can cause pronounced effect in the muscle found in the hindquarter and is responsible for the muscular hypertrophy phenotype in sheep. The GDF8 gene also play important role in increasing muscle depth due to mutation in the regulatory region and coding sequences. The CAST gene is an endogenous and specific inhibitor of calpain enzyme and thereby regulates the rate and extent of muscle tenderization following slaughtering. For prolificacy, BMP15, GDF9 and BMPR1B have been shown to exert significant influence on ovulation rate and litter size in various sheep breeds in the world. Both of the three genes are member of the TGF-beta family protein that encode protein product responsible for growth, differentiation and proliferation of ovarian follicles. The mechanism of action for such major genes are associated with the existence of mutation in the coding sequence resulting amino acid change as well as in the regulatory region that vary the expression level and inheritance of the genes. Up to now, better attempts have been made to describe the genetic basis of growth and prolificacy in…
This experimental study was performed to investigate the effect of coccidia infestation on biochemical parameters in broiler chicken. The experimental animals (n=100) were randomly allocated into four equal groups, group one (G-I), group two (G-II), group three (G-III) and group four (G-IV) with 25 chickens in each group. The G-I, G-II, and G-III were treatments groups challenged by different Eimeria sporulated oocysts, while G-IV served as the control group. In this study, the infective dose of E. tenella (G-I), E. acervulina(G-II) and mixed Eimeria spp (G-III)was 2×104 sporulated Eimeria oocyst inoculated orally at three weeks of age in broiler chicken and subsequent alterations in different plasma biochemical constituents were evaluated at interval of 5 , 7 and 9 day of post inoculation. Serum total protein values after challenge showed statistically significant decrease in group one, group two and group three in comparison with group four. Further, significant decrease total protien value was noticed on 7 day of post infection in group one and group two.The mean values of serum glucose between the infected and control group at 5, 7 and 9 day of post infection which revealed non-statistically significant difference. Coccidiosis due to E. tenella, E. acervulina and mixed identified Eimeria spp. infectionin chicken showed highly statistically significant increase in serum ALT and AST level as compared with control group. This was also significant increase in infected group on 7 day of post infection. But, no significant variation among the infected groups were on 5 and 9 day of post infection.