By O. Pedar. American Bible College and Seminary.
After intravenous administration of the aqueous extract of Shan-myin-khwar whole plants vermox 100 mg sale, Hmyit-khar vermox 100 mg for sale, Na-nwin-khar rhizome (Curcuma comosa Roxb order vermox 100 mg visa. Among the plants tested, the aqueous extract of Na-nwin-khar, Ye-yo-thee and Thagyar-ma-gike produced transient fall of mean systolic blood pressure about (31. The aqueous extract of Shan-myin-khwar produced fall of mean systolic blood pressure (15. The aqueous extract of Hmyint-khar and Ponna-yeik reduced the mean systolic blood pressure about (19. It was found that the aqueous extracts of Hmyit-khar and Ponna-yeik, Shan-myin-khwar reveal hypotensive activity for 30-40mins after drug administration whereas Na-nwin-khar, Ye-yo-thee and Thagyar-ma-gike had mild transient hypotensive activity for 2-10mins only. An aqueous extract of Brucea sumatrana (Ya-tan-sai), Butea frondosa (Pauk), Coptis teeta (Khan-tauk), Ixora coccinea (Pon-na-yeik) and Peperomia pellucida (Tein-ta-la) were tested against Escherichia coli, Klebsiella pneumoniae, Proteus mirabilis, P. Zone of inhibition of more than 2mm from the edge of the disc, were recorded ‘sensitive’. An extract of Butea frondosa had no antibacterial activity on the 12 tested organisms. Screening of some indigenous plants for anthelminthic action against Ascaris suum. Thirty three indigenous plants, traditionally claimed to be useful for purging human intestinal round worms and yet not been scientifically tested, were evaluated experimentally for their anthelminthic actions on an in vitro test Ascaris suum. Plant extracts were screened generally by a modification of the method of Sen and Hawkins (1960), and specific testing was done by the method of Goodwin (1958) as modified by Thawka-Kyin (1976). On the basis of producing muscle paralysis of the worm within predetermined experimental periods, twenty two of the plants tested were found to possess a moderate degree of anthelminthic activity and three of the plants, were highly potent ; the latters were Urginea indica, Ananas sativa and Hydnum sp. Screening of some medicinal plants reputed for anthelminthic activity on in vitro test models. Thirty three medicinal plants, traditionally claimed to be useful for purging human intestinal roundworms were evaluated experimentally for their anthelminthic action against Ascaris suum in vitro. On the basis of producing muscle paralysis of the worm within predetermined experimental periods, seventeen of the plants tested were found to possess anthelminthic activity. Urginea indica and Ananas sativa were most effective and a fungus, Hydnum repanda also showed good activity. Two indigenous medicinal plants, *rkef;wdrf-ym and ydef;&kdif; both of which have not yet been botanically identified were screened for their viper venom neutralization activity. Water- saline soluble extracts of both the plants showed no inhibitory activity on snake venom toxicity. Screening of the anti-peptic ulcer activity of some Myanmar traditional drugs experimentally. A further test model of gastric juice acidity in rats, employing pyloric ligation method, confirmed these three drugs reduced gastric acidity, particularly in diminishing the free acid amount to one-third and concomitantly attaining the pH of the gastric content to the value of 6-7. Standardization, pharmacological and toxicological evaluation of traditional drugs and herbal medicine: Project findings and recommendations. It describes the ingredients of each formulation with the retrospective weights, along with taste, dosage and indications. The ingredients of traditional drugs are mainly medicinal plants, while a few are materials of animal origin, mineral/inorganic salts or organic substances. The findings and recommendation consists of outputs, objectives achieved and conclusions. Structural and anti-hepatitis B viral activity study of some organic compounds present in the leaves of Urena lobata Linn. By percolation and silica gel column chromatographic separation methods, tiliroside, (3-O-β-D (6"-O- coumaryl) – glycopyranoside) (I) (0. However, the ethanolic extracts of Ywet-kya-pin-bauk leaves were more effective than those of Kat-si-ne leaves extracts. Structural elucidation of potent anti-bacterial constituents from Oroxylum indicum L. By silica gel column chromatographic separation, five compounds namely, oxoylin-A (A) (0. In vitro screening of antifungal activity using agar well diffusion method revealed all extracts (pet-ether, ethanol, methanol and ethyl acetate extracts) except aqueous extract were able to inhibit the growth of Candida albican. The investigation was conducted via diarrhoeal test, enteropolling test and gastrointestinal transit test. Results revealed that 6g/kg dose provided significant frequencies of diarrhoeal reducing effect, anti-secretory effect and anti-motility effect. However, ethyl acetate extract more rapidly discharged the purple background when compared to that of pet-ether extract showing much higher anti-oxidant potency. Chromatographic separation of active ethyl acetate extracts yielded three curcuminoids, namely curcumin (5. Isolated curcumin, thymoquinone, kaempferol, quercetin and the beter-diketone were found to show bactericidal activity. These plant extracts were tested for antibacterial activity on 18 bacterial organisms. The test organisms include five species of Shigella, three species of Vibrio and one species of each of Klebsiella, Plesiomonas, Proteus, Pseudomonas, Salmonella and Staphylococcus.
Causes of Gout • Increased purine intake • Increased production of purines (primary causes): Idiopathic (unknown causes) Due to specific enzyme defects • Increased production of purines (secondary to another factor) • Increased turnover of purines due to: Cancer Chronic hemolytic anemia Chemotherapy drugs Psoriasis • Increased synthesis of purines • Increased breakdown of purines due to: High fructose intake Exercise • Impaired kidney function: Decreased kidney clearance of uric acid (primary) Intrinsic kidney disease Decreased kidney clearance of uric acid (secondary) Functional impairment of kidney function – Drug-induced (e order generic vermox on line. The dietary contribution to the level of uric acid in the blood is usually only 10 to 20% of the total generic vermox 100 mg without a prescription, but purines and uric acid obtained through the diet can increase crystal formation in tissues nonetheless vermox 100 mg line. Although higher concentrations do not necessarily result in the deposit of uric acid crystals in tissues (some unknown factor in serum appears to inhibit crystal precipitation), the chance of an acute attack of gout is greater than 90% when the level is above 9 mg/100 ml. Lower body temperatures decrease the saturation point of uric acid, and this may explain why uric acid deposits tend to form in areas such as the top of the ear, where the temperature is lower than the average body temperature. Therapeutic Considerations The current standard medical treatment of acute gout is administration of colchicine, an anti- inﬂammatory drug originally isolated from the plant Colchicum autumnale (autumn crocus, meadow saffron). Colchicine has no effect on uric acid levels; rather, it stops the inﬂammatory process by inhibiting neutrophil migration into areas of inflammation. More than 75% of patients with gout show major improvement in symptoms within the ﬁrst 12 hours after receiving colchicine. However, up to 80% of patients are unable to tolerate an optimal dose because of gastrointestinal side effects. Colchicine may also cause bone marrow suppression, hair loss, liver damage, depression, seizures, respiratory depression, and even death. Once the acute episode has resolved, a number of measures are taken to reduce the likelihood of recurrence: • Drugs such as allopurinol or febuxostat to keep uric acid levels within a normal range • Controlled weight loss in obese individuals • Avoidance of known precipitating factors such as heavy alcohol consumption or a diet rich in purines or refined carbohydrates • Low doses of colchicine to prevent further acute attacks Several dietary factors are known to lead to the development of gout or trigger an attack: alcohol, especially beer and hard liquor; high-purine foods (e. Individuals with gout are typically obese; prone to hypertension, metabolic syndrome,3 and diabetes;4 and at a greater risk for cardiovascular disease. Thiazide and loop diuretics also are associated with a higher risk of incident gout and a higher rate of gout flares. The conventional medical treatment of gout often relies excessively on drugs that inhibit xanthine oxidase. The drug allopurinol, a structural isomer of hypoxanthine (a naturally occurring purine in the body), has been the mainstay treatment for decades. Lead Toxicity A secondary type of gout, sometimes called saturnine gout, can result from lead toxicity. Historically, saturnine gout was caused by the consumption of alcoholic beverages stored in containers with lead in them. An unexpected and fairly common source of lead appears to be leaded crystal; port wine, for example, takes on lead when stored in a crystal decanter. Even a few minutes in a crystal glass results in a measurable increase in the level of lead in wine. While lead levels in the general population have decreased substantially since it was banned from gasoline, those working with aviation fuel are still exposed. The mechanism of action is related to a decrease in excretion of uric acid by the kidneys. Dietary Considerations The dietary treatment of gout involves the following guidelines: • Decreasing purine intake • Eliminating alcohol • Achievement of ideal body weight • Liberal consumption of complex carbohydrates • Low fat intake • Low protein intake • Liberal fluid intake Low-Purine Alkaline-Ash Diet A low-purine diet has been the mainstay of the dietary therapy of gout for decades. Today, however, many physicians prefer to lower uric acid levels by prescribing potent drugs rather than subjecting the patient to the inconvenience and deprivation associated with a purine-free diet. However, dietary restriction of purines is still recommended to reduce metabolic stress. These include organ meats, yeast (brewer’s and baker’s), and smaller ﬁsh such as sardines, herring, and anchovies. These include dried legumes, spinach, asparagus, ﬁsh, meat, poultry, shellﬁsh, and mushrooms. An alkaline-ash diet is recommended in the dietary treatment of gout because a more alkaline pH increases uric acid solubility. An alkaline-ash diet was shown to increase uric acid excretion from 302 mg per day at pH 5. High-Purine Foods • Anchovies • Consommé • Meat extracts • Organ meats (brain, kidney, liver, sweetbreads) • Roe (fish eggs) • Sardines (and other small fish such as herring and mackerel) • Yeast Moderate-Purine Foods • Asparagus • Fish (larger species) • Legumes • Meat • Mushrooms • Peas (dried) • Poultry • Shellfish • Spinach Low-Purine Foods • Eggs • Fruit • Grains • Milk • Pasta • Nuts • Olives Alcohol Alcohol consumption increases uric acid production by accelerating purine nucleotide degradation and reduces uric acid excretion by increasing lactate production, which impairs kidney function. This explains why alcohol consumption is often a precipitating factor in acute attacks of gout. In many individuals, eliminating alcohol is all that is necessary to reduce uric acid levels and prevent gout. Weight reduction in obese individuals signiﬁcantly reduces serum uric acid levels. Carbohydrates, Fats, and Protein Reﬁned carbohydrates and saturated fats should be kept to a minimum, as the former increase uric acid production while the latter increase uric acid retention. In addition, one of the key dietary goals in the treatment of gout appears to be to enhance insulin sensitivity.
While on-call best vermox 100mg, residents are supervised by a Faculty Member discount vermox online, who is available at all times purchase vermox with a visa, either via their office phone, pager, or home phone. No on call duties outside of regular laboratory working hours are assigned to the resident involving coverage at these sites. The resident who is assigned to Transfusion Medicine for the month, is responsible for Clinical Pathology Call from Monday to Friday 8 a. The remainder of the call time is divided between all residents who are on a Clinical pathology rotation, who have previously rotated through Transfusion Medicine. The Chief Residents will make out the clinical pathology call schedule and make sure no resident is on call for more than 6 days in a row. At all times, a supervising faculty member is on call for evening and weekend questions. In addition, the resident usually has an informal lunch meeting with the blood bank medical director at least once a week and often three times a week (case discussions, mentoring). Education in Blood Bank Management Blood supply inventory management is discussed both at regular Transfusion Committee meetings. Scholarly Activities/Research Because of this the resident evaluates and discusses research findings in the literature and receives feedback from faculty. The resident is urged to write up and publish interesting or unique transfusion problems Pathology Resident Manual Page 123 encountered during the rotation. Blood Bank faculty eagerly offers to mentor the resident through the process leading to a publication. If a resident is interested in a research project and has sufficient time, the blood bank faculty will arrange this in one of the Transfusion Medicine research labs. Resident Evaluation If problems with not meeting expected knowledge and skills are observed during the rotation, the lead faculty member meets with the resident to evaluate the problem and develop a corrective action plan. Residents will be evaluated on performance of daily activities (described previously), participation in required meetings and conferences, and presentations to the staff on assigned cases. The residents are provided with continuous feedback on their performance during the rotation. Residents are evaluated on their demonstrated ability to provide informative consultation to the clinical service teams, their medical knowledge, their application of this knowledge to efficient/quality patient care, and their diagnostic, technical and observational skills. Residents are also evaluated on their interpersonal skills, professional attitudes, reliability, and ethics with members of the teaching faculty, peers, laboratory staff, and clinicians. They are further evaluated on their initiative in fostering quality patient care and use of the medical literature, as it relates to their assigned cases. Their timely completion of assigned interpretive reports is another component of the evaluation. While designed for residents, clinical chemistry post-doctoral fellows and incoming chemical pathology fellows may also take this rotation either together with or separate from the residents. In either case the residents and fellows equally share the daily duties and are considered peers. Interaction with faculty located at these institutions is intended to provide a perspective on laboratory organization/design and the practice of clinical chemistry as seen in a variety of different settings. The clinical chemistry rotation is organized to both teach the fundamental principles of clinical chemistry and to provide extensive experience with the day-to-day clinical application of those fundamentals. The fundamental principles are taught through a structured list of teaching objectives that are arranged into three separate Units. Each Unit Coordinator is responsible for arranging the day-to-day scheduling of their Unit, how and when the laboratory exercises will be performed, and when the resident will meet with the faculty members. Depending on the faculty and the Unit, this interaction will includes the following: • Didactic sessions on specific topics with the faculty members. At least one week prior to the start date of each unit, the resident(s) should review the section of this manual that describes the requirements for the next scheduled Unit. They then should contact the Coordinator to receive information regarding appointments for the didactic sessions and to complete any necessary arrangements for laboratory demonstrations and exercises. Prior to each Unit, the resident should review the Specific Learning Objectives and review the Required Reading Assignment listed in each Unit. If they are familiar with the material, they need not read the reading assignment word-for-word. However, if the material is not familiar to them, they should make every attempt to master it before meeting with the faculty for the didactic sessions. This will allow for more efficient use of time during the didactic sessions and will minimize the possibility of not having a chance to discuss with the faculty any section that is confusing or needs extraction of the most clinically relevant points of the subject matter. The Additional/Optional Readings are for the resident particularly interested in that area or having a case or clinical question posed to them as part of their consultative responsibilities during the rotation. There is no expectation that a resident will read all of these Additional/Optional Readings during the clinical chemistry rotation. The clinical applications are taught primarily through performance of a variety of assigned clinical responsibilities which are intended to provide extensive contact with attending and house staff physicians from clinical services. Laboratory exercises are designed not only to illustrate technical aspects of clinical laboratory testing, but also interesting clinical results and potential clinically important interferences.
Other techniques to assess renal function and renal perfusion have mostly remained research tools although their use may help in providing interesting insight into the pathophysiological mechanisms involved in renal injury cheap vermox online master card. The distinction between acute renal transplant rejection and cyclosporine nephrotoxicity: value of duplex sonography discount vermox 100mg with amex. Hemolytic-uremic syndrome: intrarenal arterial Doppler patterns as a useful guide to therapy vermox 100mg generic. Duplex Doppler evaluation of native kidney dysfunction: obstructive and nonobstruc- tive disease. Renal arterial resistance in septic shock: effects of increasing mean arterial pressure with norepinephrine on the renal resistive index assessed with Doppler ultrasonography. Renal failure in septic shock: predictive value of Doppler-based renal arterial resistive index. Diagnostic accuracy of Doppler renal resistive index for reversibility of acute kidney injury in critically ill patients. Renal Doppler ultrasonography in the diagnosis of acute obstructions of the upper urinary tract. Resistive Index or Color-Doppler semi-quantitative evaluation of renal perfusion by inexperienced physicians: results of a pilot study. Reproducibility of Doppler ultrasound measurement of resistance index in renal allografts. Correlation between renal vascular resistance, pulse pressure, and the resistive index in isolated perfused rabbit kidneys. Effects of central arterial aging on the structure and function of the peripheral vasculature: implications for end-organ damage. Increased renal resistive index in atherosclerosis and diabetic nephropathy assessed by Doppler sonography. Effect of heart rate on Doppler measurements of resistive index in renal arteries. Acute effects of hypoxaemia, hyperoxaemia and hypercapnia on renal blood ﬂow in normal and renal transplant subjects. Impact of mild hypoxemia on renal function and renal resistive index during mechanical ventilation. Renal arterial resistive index response to intraabdominal hypertension in a porcine model. Renal resistive index and renal function before and after paracentesis in patients with hepatorenal syndrome and tense ascites. Hemorrhagic shock in polytrauma patients: early detection with renal Doppler resistive index measure- ments. Differential diagnosis of prerenal azotemia from acute tubular necrosis and prediction of recovery by Doppler ultrasound. Early detection of postoperative acute kidney injury by Doppler renal resistive index in cardiac surgery with cardiopulmonary bypass. Renal resistive index better predicts the occurrence of acute kidney injury than cystatin C. Doppler resistive index to reﬂect regulation of renal vascular tone during sepsis and acute kidney injury. Microbubble contrast agents for echocardiography: rationale, composition, ultrasound interactions, and safety. The quantiﬁcation of absolute myocardial perfusion in humans by contrast echocardiography: algorithm and validation. Safety and efﬁcacy of commercially available ultrasound contrast agents for rest and stress echocardiography a multicenter experience. Contrast- enhanced ultrasound to evaluate changes in renal cortical perfusion around cardiac surgery: a pilot study. Contrast- enhanced ultrasonography to evaluate changes in renal cortical microcirculation induced by noradrenaline: a pilot study. Association of gadolinium based magnetic resonance imaging contrast agents and nephrogenic systemic ﬁbrosis. High-resolution, whole-body vascular imaging with ferumoxytol as an alternative to gado- linium agents in a pediatric chronic kidney disease cohort. Assessment of renal func- tion; clearance, the renal microcirculation, renal blood ﬂow, and metabolic balance. Inoue T, Kozawa E, Okada H, Inukai K, Watanabe S, Kikuta T, Watanabe Y, Takenaka T, Katayama S, Tanaka J, Suzuki H. Noninvasive evaluation of kidney hypoxia and ﬁbrosis using magnetic resonance imaging. The use of magnetic resonance to evaluate tissue oxygenation in renal artery stenosis. However, the practicalities of how to provide optimal renal perfusion are far from straightforward but are best achieved by a systematic approach with the main targets being: (a) Optimizing systemic haemodynamics (b) Reducing factors compromising renal perfusion and ﬁltration (c) Selective vasodilation of the renal vascular bed 11. Usual targets include adequate oxygen delivery achieved by normalizing the stroke index and arterial oxygen saturation.