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Introduction There is an increasing concern that the supply of essential medicines WHO in financially poor countries is contaminated with counterfeit and substandard medicines. This multi-country operation provided a common platform for coordination meetings and training.
Three national agencies, the customs, Drug Regulatory Agencies DRAs, and the police in each participating country conducted joint operations to investigate suspected pharmaceutical crime.
There has been confusion and controversy over the definitions of counterfeit and substandard medicines. We present the laboratory findings and discuss their regulatory and public health implications.
Materials and Methods Samples. Also consumed is a either pure goods or one lured by the.
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Her hematologic parameters started improving. She was extubated and was shifted to intermediate critical care on the 6 th day.
Two days later, she was shifted to the general ward and was discharged on the 10 th day of her admission. She underwent laparoscopic cholecystectomy 8 weeks later which revealed multiple calculi on her gallbladder Figure 2.
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Figure 2 Laparoscopic cholecystectomy revealed multiple small calculi inside the gallbladder. Discussion Acute cholecystitis usually occurs as a complication of gallstone disease especially in those who have a history of symptomatic gallstones.
Cystic duct obstruction, increase in the levels of inflammatory mediators, and infection of the bile have been implicated in the pathogenesis of acute cholecystitis.
Antibiotics, pain management, and gallbladder drainage are the recommended therapy for severe cholecystitis. The diagnosis of scrub typhus based on clinical symptoms is difficult; hence, the laboratory tests are needed to confirm the diagnosis.
Immunochromatographic test kits are rapid and reliable tools for point-of-care serological testing in resource-limited settings. Cholecystitis as a complication of scrub typhus is a rare entity.
In this case, acute cholecystitis could not be attributed to cholelithiasis alone as the patient continued to deteriorate despite treatment with antibiotics and gallbladder drainage, which is standard in the management of acute cholecystitis.
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