Objective:To collate and summarize phenotypic insecticide susceptibility data of Indian malaria vectors from 2017 to 2024,focusing on insecticides used in adult vector control,dichloro diphenyl trichloroethane,malathi...Objective:To collate and summarize phenotypic insecticide susceptibility data of Indian malaria vectors from 2017 to 2024,focusing on insecticides used in adult vector control,dichloro diphenyl trichloroethane,malathion,deltamethrin,alpha-cypermethrin,and permethrin to identify resistance patterns to different classes of insecticides.Methods:The data included information on vector species,location of the study(state/district),insecticide tested,mortality percentage,and susceptibility classification based on the World Health Organization interpretation criteria.Retrospective data were collected from peer-reviewed publications(2017-2024)and up to June 2025.The data were collated for five major malaria vector species,namely Anopheles(An.)culicifacies,An.fluviatilis,An.stephensi,An.baimaii,and An.minimus.Results:Insecticide susceptibility data were available from 86 districts across 16 Indian states for 40615 mosquitoes.The majority of the data was on An.culicifacies(n=28308),followed by An.stephensi(n=5611),An.fluviatilis(n=5967),An.baimaii(n=365),and An.minimus(n=364).Intensity bioassays revealed low to moderate resistance levels in An.culicifacies populations from selected districts in 3 states,Odisha,Madhya Pradesh,and Chhattisgarh against deltamethrin and alpha-cypermethrin.Conclusions:This review highlights spatial and species-level variations in insecticide susceptibility among Indian malaria vectors.The low to moderate intensity suggested that it may not yet be severe enough to cause operational failure with current vector control interventions.Continued monitoring of insecticide resistance,as well as the use of new-generation insecticides and interventions,is suggested to sustain vector control efficacy and manage insecticide resistance in malaria vectors to support India’s malaria elimination.展开更多
Breath tests are non-invasive tests and can detect H<sub>2</sub> and CH<sub>4</sub> gases which are produced by bacterial fermentation of unabsorbed intestinal carbohydrate and are excreted in ...Breath tests are non-invasive tests and can detect H<sub>2</sub> and CH<sub>4</sub> gases which are produced by bacterial fermentation of unabsorbed intestinal carbohydrate and are excreted in the breath. These tests are used in the diagnosis of carbohydrate malabsorption, small intestinal bacterial overgrowth, and for measuring the orocecal transit time. Malabsorption of carbohydrates is a key trigger of irritable bowel syndrome (IBS)-type symptoms such as diarrhea and/or constipation, bloating, excess flatulence, headaches and lack of energy. Abdominal bloating is a common nonspecific symptom which can negatively impact quality of life. It may reflect dietary imbalance, such as excess fiber intake, or may be a manifestation of IBS. However, bloating may also represent small intestinal bacterial overgrowth. Patients with persistent symptoms of abdominal bloating and distension despite dietary interventions should be referred for H<sub>2</sub> breath testing to determine the presence or absence of bacterial overgrowth. If bacterial overgrowth is identified, patients are typically treated with antibiotics. Evaluation of IBS generally includes testing of other disorders that cause similar symptoms. Carbohydrate malabsorption (lactose, fructose, sorbitol) can cause abdominal fullness, bloating, nausea, abdominal pain, flatulence, and diarrhea, which are similar to the symptoms of IBS. However, it is unclear if these digestive disorders contribute to or cause the symptoms of IBS. Research studies show that a proper diagnosis and effective dietary intervention significantly reduces the severity and frequency of gastrointestinal symptoms in IBS. Thus, diagnosis of malabsorption of these carbohydrates in IBS using a breath test is very important to guide the clinician in the proper treatment of IBS patients.展开更多
AIM:To study the role of needle knife assisted ampullary biopsy in the diagnosis of periampullary carcinoma.METHODS:In this study the authors retrospectively analyzed clinical records of patients with periampullary tu...AIM:To study the role of needle knife assisted ampullary biopsy in the diagnosis of periampullary carcinoma.METHODS:In this study the authors retrospectively analyzed clinical records of patients with periampullary tumors diagnosed by ampullary biopsy taken after needle knife papillotomy in whom surface ampullary biopsies were non contributory.RESULTS:Between January 2008 and December 2010,38 patients with periampullary tumors were seen by us and initial side viewing endoscopy with surface biopsy from the papilla was positive for malignancy in 25 patients.Thirteen patients with a negative surface biopsy for malignancy underwent a repeat ampullary biopsy following needle knife papillotomy.There were 8(61.5%)males and 5(38.5%)females.The most common presenting symptom was jaundice(100%),followed by fever(46.2%),melena(38.5%),abdominal pain(30.8%)and weight loss(30.8%).All the patients had hyperbilirubinemia with a mean ± SD serum bilirubin of(11.2 ± 1.9)mg/dL(normal value <1 mg%)and the mean ± SD serum alkaline phosphatase was(288.0 ± 94.3)IU/L(normal value < 129 IU/L).Serum CA 19.9 level estimation was done in 11 patients;it was elevated(cut off value > 70.5 IU/L)in all of them with a median of 1200 IU/L(inter quartile range 274-3500).Side viewing endoscopy showed a bulky papilla in all of them.Adequate tissue was obtained in all of the 13 patients for histological evaluation;12 of the 13 patients were reported to have adenocarcinoma while one patient had adenoma.There were no complications from the needle knife papillotomy in any of the patients.CONCLUSION:Needle knife assisted ampullary biopsy appears to be a safe and effective diagnostic modality for periampullary carcinoma.展开更多
India's healthcare system continues to place the highest priority on the fight against malaria[1].Malaria elimination program has received considerable attention from both the public and private sectors,resulting ...India's healthcare system continues to place the highest priority on the fight against malaria[1].Malaria elimination program has received considerable attention from both the public and private sectors,resulting in a significant drop in malaria cases[2].In 2022,a total of 176000 million cases of malaria were reported in India,in which Plasmodium(P.)falciparum has contributed 57.0%and 42.3%were P.vivax cases and limited cases of P.malariae and P.ovale.展开更多
The steady decline in malaria cases and deaths in recent years is a step ahead toward elimination;however,an increasing number of reports of antimalarial and insecticide resistance highlight the importance of having n...The steady decline in malaria cases and deaths in recent years is a step ahead toward elimination;however,an increasing number of reports of antimalarial and insecticide resistance highlight the importance of having newer approaches to achieve the goal in the stipulated time frame.Therefore,having an effective and durable malaria vaccine is extremely crucial,which can complement the tools currently in use.Although the malaria vaccine development efforts initiated in the 1910’s with the first attempts to develop a malaria vaccine involved inoculating humans with live,attenuated strains of the malaria parasite but the efforts have been intensified over the previous decade,resulting in several significant developments.展开更多
South Omo Administrative Zone in Ethiopia is home to 18 indigenous ethnic groups whose livelihood is vulnerable due to recurrent drought and degradation. Despite the preliminary observation showing the rich dry-forest...South Omo Administrative Zone in Ethiopia is home to 18 indigenous ethnic groups whose livelihood is vulnerable due to recurrent drought and degradation. Despite the preliminary observation showing the rich dry-forest resource base that, if sustainably managed could enhance livelihoods and biodiversity conservation, there is lack of empirical data on its current status. We conducted a study aiming at quantifying the population status of gum- and resin-bearing species in two randomly selected districts, Hamer and Bena-Tsemay. Seventy-five quadrats （35 at Hamer and 40 at Bena-Tsemay） each measuring 400 m2 were established along line transects to assess species diversity and equitability, density, frequency, dominance, importance value and population structure. We recorded a total of 27 woody species of 12 families and 14 genera. Fifteen species （9 at Hamer and 14 at Bena-Tsemay） of the genera Acacia, Boswellia, Commiphora and Sterculia, were identified as either major sources of commercial gums and resins or their adulterants. Gum- and resin-bearing species comprised 56% and 57% of species richness, 48% and 50% of total density per ha, 95% and 98% of basal area, and 64% and 56% of importance values at Hamer and Bena-Tsemay, respectively. Diversity of the entire woody species assemblage and of the gum- and resin-bearing species was slightly higher at Bena-Tsemay （H= 2.61, 1.4） than at Hamer （H＇= 2.48, 1.28）, respectively. The diversity and abundance of the resource base suggest potential for development of value-added commercialization of gum and resins to enhance livelihoods and encourage sustainable management of the forest at these study areas. We recorded, however, declining natural regeneration of most gum- and resin-bearing species, and this calls for integrated and participatory species management and landscape rehabilitation.展开更多
Objective:To identify the prevalence,determinants of reproductive tract infection,and healthcare seeking behavior among ever married women of reproductive age residing in an urban slum of Faridabad,Haryana,North India...Objective:To identify the prevalence,determinants of reproductive tract infection,and healthcare seeking behavior among ever married women of reproductive age residing in an urban slum of Faridabad,Haryana,North India.Methods:This community based cross-sectional study was conducted among ever married women aged between 15 and 49 years insured under employees state insurance scheme and residing in an urban slum of Faridabad.Simple random sampling technique was used to interview 149 eligible women using a predesigned structured questionnaire.Study variables included sociodemographic profile,family planning methods,menstrual absorbent usage,and symptoms of reproductive tract infection.Binary logistic regression was used to investigate the determinants of reproductive tract infection.Results:Of the women,46.3%had at least one reproductive tract infection or sexually transmitted infection symptom and 28.9%among them sought treatment for the symptom.Vaginal discharge,itching(14.1%)and lower abdominal pain(30.2%)were the major symptoms reported.Non-usage of condoms as contraceptive was significantly associated with a higher rate of symptoms(50.4%vs.20.0%).Abortion had a significantly high odds of having reproductive tract infection symptoms(aOR 3.71,95%CI 1.59-8.62;P<0.01).Less frequent change in absorbent during menstruation was also reported to have a higher rate of symptoms.The majority of those who took treatment sought it from government or employees state insurance dispensary.2%also went to faith healers.Conclusions:Nearly half of the study population have reproductive tract infection symptom.Abortions and non-usage of condom increase the risk of reproductive tract infection.Menstrual hygiene and condom usage are the significant interventions,which may reduce the prevalence of these symptoms.展开更多
Dengue,an arboviral disease caused by infection with one of the four distinct serotypes is one of the 10 global health threats confirmed by the World Health Organization(WHO)in 2019[1].There has been an exponential in...Dengue,an arboviral disease caused by infection with one of the four distinct serotypes is one of the 10 global health threats confirmed by the World Health Organization(WHO)in 2019[1].There has been an exponential increase in dengue cases over last few years,attributed to unplanned urbanization,climate change,and migration,etc.Nearly 4 billion people worldwide in more than 100 countries are at risk of dengue,and 390 million infections occur every year,with 90 million symptomatic infections[2].The spectrum ranges from asymptomatic,mild,to severe dengue,leading to hospitalizations and even death[3].Due to unavailability of therapeutics for treating dengue,it is imperative to expand the arsenal by including vaccines in the efforts to combat dengue worldwide.展开更多
Understanding the genetic architecture of indi-vidual taxa of medical importance is the first step for designing disease preventive strategies. To understand the genetic details and evolu-tionary perspective of the mo...Understanding the genetic architecture of indi-vidual taxa of medical importance is the first step for designing disease preventive strategies. To understand the genetic details and evolu-tionary perspective of the model malaria vector, Anopheles gambiae and to use the information in other species of local importance, we scanned the published X-chromosome se-quence for detail characterization and obtain evolutionary status of different genes. The te-locentric X-chromosome contains 106 genes of known functions and 982 novel genes. Majori-ties of both the known and novel genes are with introns. The known genes are strictly biased towards less number of introns;about half of the total known genes have only one or two in-trons. The extreme sized (either long or short) genes were found to be most prevalent (58% short and 23% large). Statistically significant positive correlations between gene length and intron length as well as with intron number and intron length were obtained signifying the role of introns in contributing to the overall size of the known genes of X-chromosome in An. gam-biae. We compared each individual gene of An. gambiae with 33 other taxa having whole ge-nome sequence information. In general, the mosquito Aedes aegypti was found to be ge-netically closest and the yeast Saccharomyces cerevisiae as most distant taxa to An. gambiae. Further, only about a quarter of the known genes of X-chromosome were unique to An. gambiae and majorities have orthologs in dif-ferent taxa. A phylogenetic tree was constructed based on a single gene found to be highly orthologous across all the 34 taxa. Evolutionary relationships among 13 different taxa were in-ferred which corroborate the previous and pre-sent findings on genetic relationships across various taxa.展开更多
Neuro-endocrinological manifestations rarely are described in cases of SARS- CoV-2. We describe a case of a previously hypertensive patient who presented COVID-19 and developed refractory arterial hypotension. In the ...Neuro-endocrinological manifestations rarely are described in cases of SARS- CoV-2. We describe a case of a previously hypertensive patient who presented COVID-19 and developed refractory arterial hypotension. In the investigation, low levels of ACTH and cortisol were observed, suggesting secondary adrenal insufficiency as the cause of refractory hypotension.展开更多
Purpose:Lateral compression(LC)injuries account for more than two-thirds of all pelvic fractures.The goal of surgical treatment is to provide adequate stability and early mobilization.The consensus on posterior fixati...Purpose:Lateral compression(LC)injuries account for more than two-thirds of all pelvic fractures.The goal of surgical treatment is to provide adequate stability and early mobilization.The consensus on posterior fixation of such injuries is strong in the literature;however,the necessity of anterior ring fixation is not clear.Therefore,this study was formulated to determine the practicability of posterior-only fixation in LC injuries.Methods:Between March 2015 and May 2020,all patients with LC type pelvic ring fractures who were admitted and operated upon in a single level 1 trauma center were included in this cross-sectional observational study.Demographic data,co-morbidities,treatment,types of surgical fixation,concomitant injuries and surgeries,surgical complications,length of hospital stay,injury to weight bearing duration,and follow-up period were documented.Functional outcome and quality of life were assessed using Majeed score and SF-36 questionnaire.Non-normally distributed data were presented as median(Q1,Q3)and normally distributed data were presented as mean±standard deviation(SD).Spearman's rank correlation coefficient was used for correlation analysis.Results:A total of 25 patients were included,with a mean age of 29.8 years.All patients were managed operatively with posterior-only fixation.The median Majeed score was 90(76,95).The median physical component summary score was 69.37(38.75,85.62).The median mental component summary score was 63.95(39.25,87.87).There was no significant difference compared to population norms of both physical component summary and mental component summary.Injury to weight bearing time correlated significantly(p=0.002)with Majeed score as well as SF-36 score(p=0.044).No other variable had a significant association with outcomes.Conclusion:Posterior-only fixation is sufficient for fixing LC injuries with up to 80%of cases having good to excellent functional outcomes.However,comparative studies with larger sample sizes are needed for further validation.展开更多
Nanotherapeutics has an increasing role in the treatment of diseases such as cancer. In photodynamic therapy （PDT） a therapeutically inactive photosensitizer compound is selectively activated by light to produce mol...Nanotherapeutics has an increasing role in the treatment of diseases such as cancer. In photodynamic therapy （PDT） a therapeutically inactive photosensitizer compound is selectively activated by light to produce molecules capable of killing diseased cells and pathogens. A phototheranostic agent can be defined as a single nanoentity with the capabilities for targeted delivery, optical imaging and photodynamic treatment of a disease. Malignant cells, tissue and microbial etiologic agents can be effectively targeted by PDT. Photodynamic therapy is noninvasive, or minimally invasive, and has few side effects as damage to healthy tissue is minimized and the killing effect is localized. Various forms of cancer, acne and other diseases may be treated. The in vivo efficacy of photosensitizers is further improved by attaching them to nanostructures capable of targeting the diseased site. Such photosensitizer-functionalized nanostructures, or nano- therapeutics, allow site-specific delivery of imaging and therapeutic agents for improved phototheranostic performance. This review explores the potential applications of phototheranostic nanostructures in diagnosis and therapy.展开更多
Intra-articular coronal fractures （Hoffas fractures） of distal femur are rare. Although bicondylar involvement in these fractures has been reported in the literature in association with high velocity traumata, the o...Intra-articular coronal fractures （Hoffas fractures） of distal femur are rare. Although bicondylar involvement in these fractures has been reported in the literature in association with high velocity traumata, the occurrence of these fractures involving extensor mechanism rupture and avulsion ofipsilateral tibial spine is extremely rare. To our acquaintance, such a fracture pattern has not yet been reported in the literature so far. In this article, we report one such case and discuss the importance of early diagnosis and prompt internal fixation in the management of such cases.We believe that these rare combinations of injuries should be treated aggressively by early open reduction and anatomic rigid internal fixation in order to achieve good recovery of function.展开更多
Objective： Management of Rockwood type 3 acromioclavicular disruptions is a matter of debate. Should we adopt conservative or operative measures at first presentation？ It is not clear but most of the evidences are i...Objective： Management of Rockwood type 3 acromioclavicular disruptions is a matter of debate. Should we adopt conservative or operative measures at first presentation？ It is not clear but most of the evidences are in favour of conservative management. We present our expe- rience in managing these patients surgically. Methods： We present a prospective series of eight cases of chronic Rockwood type 3 acromioclavicular joint disruptions treated surgically. Anatomical reconstruction of the coracoclavicular ligament was done by artificial braided polyester ligament prosthesis： Results： All the patients were able to perform daily activities from an average of the 14th postoperative day. All patients felt an improvement in pain, with decrease in ave- rage visual analogue scale from preoperative 6.5 points （range 3-9 points） to 2.0 points （range 0-5 points）, Constant score from 59% to 91% and American Shoulder and Elbow Surgeons shoulder score from 65 to 93 points postoperatively. These results improved or at least remained stationary on midterm follow-up, and no deterioration was recorded at an average follow-up of 46 months. Conclusion： This midterm outcome analysis of the artificial ligament prosthesis is the first such follow-up study with prosthesis. Our results are encouraging and justify the further use and evaluation of this relatively new and easily reproducible technique.展开更多
A titania slag product of Rosetta ilmenite assaying 72% TiO_(2) is treated by the sulfate process option of the pigmentary TiO_(2) manufacture.The relevant factors of acid concentration,particle size,slag/acid ratio b...A titania slag product of Rosetta ilmenite assaying 72% TiO_(2) is treated by the sulfate process option of the pigmentary TiO_(2) manufacture.The relevant factors of acid concentration,particle size,slag/acid ratio besides the reaction temperature,and time have been studied.After dissolving the cured mass in dilute acid and clarification,the obtained solution was subjected to hydrolysis of its titanium content.The final product was bleached under reducing conditions to redissolve the residual coloring impurities before being dewatered and calcinated.The obtained results indicated that a leaching efficiency of about 92% was realized due to the presence of some refractory components in the working slag material,namely,rutile and magnesium iron titanate.The obtained white pigment assay attained up to 99.85% TiO_(2),while the analyzed impurities involve 77ppm Mn and only 14 and 7ppm of total iron and V,respectively.展开更多
A case of a 50-year-old pedestrian who was hit by a bike and suffered fractures of both bones of his right leg was presented. Complete clinical and radiographic assessment showed double segmental fractures of the tibi...A case of a 50-year-old pedestrian who was hit by a bike and suffered fractures of both bones of his right leg was presented. Complete clinical and radiographic assessment showed double segmental fractures of the tibia and multisegmental fractures of the fibula. Review of the literature revealed that this fracture pattern was unique and only a single case was reported so far. Moreover, we discussed the possible mechanisms which can lead to such an injury. We also discussed the management of segmental tibial fracture and the difficulties encountered with them. This case was managed by modern osteosynthesis technique with a pleasing outcome.展开更多
Bilateral shoulder dislocations are rare and almost always occur in the posterior direction. Simultaneous bilateral anterior shoulder dislocation is even rarer and only a few cases are stated in the literature. The mo...Bilateral shoulder dislocations are rare and almost always occur in the posterior direction. Simultaneous bilateral anterior shoulder dislocation is even rarer and only a few cases are stated in the literature. The most interesting part of a bilateral shoulder dislocation is about its injury mechanism as a synchronous and simultaneous force is needed to result in it. In cases of epilepsy or electrocution, the mechanism is different and the forceful contractions of the selective group of muscles result in the dislocation. This article reports two cases of bilateral simultaneous anterior shoulder joint dislocation that occurred after a road side accident and after an episode of convulsion in an epileptic patient. The dislocations were diagnosed early and reduced immediately with a proper postreduction rehabilitation. During their follow-up, both patients had satisfactory functional outcome. This article emphasizes on the importance of shoulder examination in road side accident victims and epileptic patients. All orthopedic surgeons and emergency physicians should be aware of such unusual possibilities to have an early diagnosis and treatment.An early reduction and appropriate rehabilitation can provide satisfactory functional outcome. This article also briefly discusses the injury mechanisms, diagnoses and treatments of bilateral shoulder dislocation as reported in the literature.展开更多
Angioleiomyoma of the hand is a rare differential diagnosis of painful soft tissue nodule in the extremity.It arises from smooth muscle of the blood vessels and the most common symptom is pain.Imaging with magnetic re...Angioleiomyoma of the hand is a rare differential diagnosis of painful soft tissue nodule in the extremity.It arises from smooth muscle of the blood vessels and the most common symptom is pain.Imaging with magnetic resonance imaging shows characteristic features like a hypodense peripheral capsule with linear or branching internal hyperdensities on T2-weighted images,and post-contrast diffuse homogenous enhancement with a vessel leading up to the lesion.Histopathological examination shows well circumscribed fascicles of mature smooth muscle cells surrounding vascular lumina,lined by normal appearing endothelium without elastic lamina present.These cells stain positive for smooth muscle actin,desmin,vimentin,type IV collagen and S100,but stain negative for HMB-45 and ER.Angioleiomyoma is amenable for surgical resection.We report a case of painful subcutaneous nodule of hand,with radiological and histopathological findings suggestive of angioleiomyoma.We outline the clinical,radiological and histopathological features of this rare diagnosis for painful nodule of extremity.展开更多
文摘Objective:To collate and summarize phenotypic insecticide susceptibility data of Indian malaria vectors from 2017 to 2024,focusing on insecticides used in adult vector control,dichloro diphenyl trichloroethane,malathion,deltamethrin,alpha-cypermethrin,and permethrin to identify resistance patterns to different classes of insecticides.Methods:The data included information on vector species,location of the study(state/district),insecticide tested,mortality percentage,and susceptibility classification based on the World Health Organization interpretation criteria.Retrospective data were collected from peer-reviewed publications(2017-2024)and up to June 2025.The data were collated for five major malaria vector species,namely Anopheles(An.)culicifacies,An.fluviatilis,An.stephensi,An.baimaii,and An.minimus.Results:Insecticide susceptibility data were available from 86 districts across 16 Indian states for 40615 mosquitoes.The majority of the data was on An.culicifacies(n=28308),followed by An.stephensi(n=5611),An.fluviatilis(n=5967),An.baimaii(n=365),and An.minimus(n=364).Intensity bioassays revealed low to moderate resistance levels in An.culicifacies populations from selected districts in 3 states,Odisha,Madhya Pradesh,and Chhattisgarh against deltamethrin and alpha-cypermethrin.Conclusions:This review highlights spatial and species-level variations in insecticide susceptibility among Indian malaria vectors.The low to moderate intensity suggested that it may not yet be severe enough to cause operational failure with current vector control interventions.Continued monitoring of insecticide resistance,as well as the use of new-generation insecticides and interventions,is suggested to sustain vector control efficacy and manage insecticide resistance in malaria vectors to support India’s malaria elimination.
文摘Breath tests are non-invasive tests and can detect H<sub>2</sub> and CH<sub>4</sub> gases which are produced by bacterial fermentation of unabsorbed intestinal carbohydrate and are excreted in the breath. These tests are used in the diagnosis of carbohydrate malabsorption, small intestinal bacterial overgrowth, and for measuring the orocecal transit time. Malabsorption of carbohydrates is a key trigger of irritable bowel syndrome (IBS)-type symptoms such as diarrhea and/or constipation, bloating, excess flatulence, headaches and lack of energy. Abdominal bloating is a common nonspecific symptom which can negatively impact quality of life. It may reflect dietary imbalance, such as excess fiber intake, or may be a manifestation of IBS. However, bloating may also represent small intestinal bacterial overgrowth. Patients with persistent symptoms of abdominal bloating and distension despite dietary interventions should be referred for H<sub>2</sub> breath testing to determine the presence or absence of bacterial overgrowth. If bacterial overgrowth is identified, patients are typically treated with antibiotics. Evaluation of IBS generally includes testing of other disorders that cause similar symptoms. Carbohydrate malabsorption (lactose, fructose, sorbitol) can cause abdominal fullness, bloating, nausea, abdominal pain, flatulence, and diarrhea, which are similar to the symptoms of IBS. However, it is unclear if these digestive disorders contribute to or cause the symptoms of IBS. Research studies show that a proper diagnosis and effective dietary intervention significantly reduces the severity and frequency of gastrointestinal symptoms in IBS. Thus, diagnosis of malabsorption of these carbohydrates in IBS using a breath test is very important to guide the clinician in the proper treatment of IBS patients.
文摘AIM:To study the role of needle knife assisted ampullary biopsy in the diagnosis of periampullary carcinoma.METHODS:In this study the authors retrospectively analyzed clinical records of patients with periampullary tumors diagnosed by ampullary biopsy taken after needle knife papillotomy in whom surface ampullary biopsies were non contributory.RESULTS:Between January 2008 and December 2010,38 patients with periampullary tumors were seen by us and initial side viewing endoscopy with surface biopsy from the papilla was positive for malignancy in 25 patients.Thirteen patients with a negative surface biopsy for malignancy underwent a repeat ampullary biopsy following needle knife papillotomy.There were 8(61.5%)males and 5(38.5%)females.The most common presenting symptom was jaundice(100%),followed by fever(46.2%),melena(38.5%),abdominal pain(30.8%)and weight loss(30.8%).All the patients had hyperbilirubinemia with a mean ± SD serum bilirubin of(11.2 ± 1.9)mg/dL(normal value <1 mg%)and the mean ± SD serum alkaline phosphatase was(288.0 ± 94.3)IU/L(normal value < 129 IU/L).Serum CA 19.9 level estimation was done in 11 patients;it was elevated(cut off value > 70.5 IU/L)in all of them with a median of 1200 IU/L(inter quartile range 274-3500).Side viewing endoscopy showed a bulky papilla in all of them.Adequate tissue was obtained in all of the 13 patients for histological evaluation;12 of the 13 patients were reported to have adenocarcinoma while one patient had adenoma.There were no complications from the needle knife papillotomy in any of the patients.CONCLUSION:Needle knife assisted ampullary biopsy appears to be a safe and effective diagnostic modality for periampullary carcinoma.
文摘India's healthcare system continues to place the highest priority on the fight against malaria[1].Malaria elimination program has received considerable attention from both the public and private sectors,resulting in a significant drop in malaria cases[2].In 2022,a total of 176000 million cases of malaria were reported in India,in which Plasmodium(P.)falciparum has contributed 57.0%and 42.3%were P.vivax cases and limited cases of P.malariae and P.ovale.
文摘The steady decline in malaria cases and deaths in recent years is a step ahead toward elimination;however,an increasing number of reports of antimalarial and insecticide resistance highlight the importance of having newer approaches to achieve the goal in the stipulated time frame.Therefore,having an effective and durable malaria vaccine is extremely crucial,which can complement the tools currently in use.Although the malaria vaccine development efforts initiated in the 1910’s with the first attempts to develop a malaria vaccine involved inoculating humans with live,attenuated strains of the malaria parasite but the efforts have been intensified over the previous decade,resulting in several significant developments.
基金Forestry Research Center of Ethiopia for financial support of data collection
文摘South Omo Administrative Zone in Ethiopia is home to 18 indigenous ethnic groups whose livelihood is vulnerable due to recurrent drought and degradation. Despite the preliminary observation showing the rich dry-forest resource base that, if sustainably managed could enhance livelihoods and biodiversity conservation, there is lack of empirical data on its current status. We conducted a study aiming at quantifying the population status of gum- and resin-bearing species in two randomly selected districts, Hamer and Bena-Tsemay. Seventy-five quadrats （35 at Hamer and 40 at Bena-Tsemay） each measuring 400 m2 were established along line transects to assess species diversity and equitability, density, frequency, dominance, importance value and population structure. We recorded a total of 27 woody species of 12 families and 14 genera. Fifteen species （9 at Hamer and 14 at Bena-Tsemay） of the genera Acacia, Boswellia, Commiphora and Sterculia, were identified as either major sources of commercial gums and resins or their adulterants. Gum- and resin-bearing species comprised 56% and 57% of species richness, 48% and 50% of total density per ha, 95% and 98% of basal area, and 64% and 56% of importance values at Hamer and Bena-Tsemay, respectively. Diversity of the entire woody species assemblage and of the gum- and resin-bearing species was slightly higher at Bena-Tsemay （H= 2.61, 1.4） than at Hamer （H＇= 2.48, 1.28）, respectively. The diversity and abundance of the resource base suggest potential for development of value-added commercialization of gum and resins to enhance livelihoods and encourage sustainable management of the forest at these study areas. We recorded, however, declining natural regeneration of most gum- and resin-bearing species, and this calls for integrated and participatory species management and landscape rehabilitation.
文摘Objective:To identify the prevalence,determinants of reproductive tract infection,and healthcare seeking behavior among ever married women of reproductive age residing in an urban slum of Faridabad,Haryana,North India.Methods:This community based cross-sectional study was conducted among ever married women aged between 15 and 49 years insured under employees state insurance scheme and residing in an urban slum of Faridabad.Simple random sampling technique was used to interview 149 eligible women using a predesigned structured questionnaire.Study variables included sociodemographic profile,family planning methods,menstrual absorbent usage,and symptoms of reproductive tract infection.Binary logistic regression was used to investigate the determinants of reproductive tract infection.Results:Of the women,46.3%had at least one reproductive tract infection or sexually transmitted infection symptom and 28.9%among them sought treatment for the symptom.Vaginal discharge,itching(14.1%)and lower abdominal pain(30.2%)were the major symptoms reported.Non-usage of condoms as contraceptive was significantly associated with a higher rate of symptoms(50.4%vs.20.0%).Abortion had a significantly high odds of having reproductive tract infection symptoms(aOR 3.71,95%CI 1.59-8.62;P<0.01).Less frequent change in absorbent during menstruation was also reported to have a higher rate of symptoms.The majority of those who took treatment sought it from government or employees state insurance dispensary.2%also went to faith healers.Conclusions:Nearly half of the study population have reproductive tract infection symptom.Abortions and non-usage of condom increase the risk of reproductive tract infection.Menstrual hygiene and condom usage are the significant interventions,which may reduce the prevalence of these symptoms.
文摘Dengue,an arboviral disease caused by infection with one of the four distinct serotypes is one of the 10 global health threats confirmed by the World Health Organization(WHO)in 2019[1].There has been an exponential increase in dengue cases over last few years,attributed to unplanned urbanization,climate change,and migration,etc.Nearly 4 billion people worldwide in more than 100 countries are at risk of dengue,and 390 million infections occur every year,with 90 million symptomatic infections[2].The spectrum ranges from asymptomatic,mild,to severe dengue,leading to hospitalizations and even death[3].Due to unavailability of therapeutics for treating dengue,it is imperative to expand the arsenal by including vaccines in the efforts to combat dengue worldwide.
文摘Understanding the genetic architecture of indi-vidual taxa of medical importance is the first step for designing disease preventive strategies. To understand the genetic details and evolu-tionary perspective of the model malaria vector, Anopheles gambiae and to use the information in other species of local importance, we scanned the published X-chromosome se-quence for detail characterization and obtain evolutionary status of different genes. The te-locentric X-chromosome contains 106 genes of known functions and 982 novel genes. Majori-ties of both the known and novel genes are with introns. The known genes are strictly biased towards less number of introns;about half of the total known genes have only one or two in-trons. The extreme sized (either long or short) genes were found to be most prevalent (58% short and 23% large). Statistically significant positive correlations between gene length and intron length as well as with intron number and intron length were obtained signifying the role of introns in contributing to the overall size of the known genes of X-chromosome in An. gam-biae. We compared each individual gene of An. gambiae with 33 other taxa having whole ge-nome sequence information. In general, the mosquito Aedes aegypti was found to be ge-netically closest and the yeast Saccharomyces cerevisiae as most distant taxa to An. gambiae. Further, only about a quarter of the known genes of X-chromosome were unique to An. gambiae and majorities have orthologs in dif-ferent taxa. A phylogenetic tree was constructed based on a single gene found to be highly orthologous across all the 34 taxa. Evolutionary relationships among 13 different taxa were in-ferred which corroborate the previous and pre-sent findings on genetic relationships across various taxa.
文摘Neuro-endocrinological manifestations rarely are described in cases of SARS- CoV-2. We describe a case of a previously hypertensive patient who presented COVID-19 and developed refractory arterial hypotension. In the investigation, low levels of ACTH and cortisol were observed, suggesting secondary adrenal insufficiency as the cause of refractory hypotension.
文摘Purpose:Lateral compression(LC)injuries account for more than two-thirds of all pelvic fractures.The goal of surgical treatment is to provide adequate stability and early mobilization.The consensus on posterior fixation of such injuries is strong in the literature;however,the necessity of anterior ring fixation is not clear.Therefore,this study was formulated to determine the practicability of posterior-only fixation in LC injuries.Methods:Between March 2015 and May 2020,all patients with LC type pelvic ring fractures who were admitted and operated upon in a single level 1 trauma center were included in this cross-sectional observational study.Demographic data,co-morbidities,treatment,types of surgical fixation,concomitant injuries and surgeries,surgical complications,length of hospital stay,injury to weight bearing duration,and follow-up period were documented.Functional outcome and quality of life were assessed using Majeed score and SF-36 questionnaire.Non-normally distributed data were presented as median(Q1,Q3)and normally distributed data were presented as mean±standard deviation(SD).Spearman's rank correlation coefficient was used for correlation analysis.Results:A total of 25 patients were included,with a mean age of 29.8 years.All patients were managed operatively with posterior-only fixation.The median Majeed score was 90(76,95).The median physical component summary score was 69.37(38.75,85.62).The median mental component summary score was 63.95(39.25,87.87).There was no significant difference compared to population norms of both physical component summary and mental component summary.Injury to weight bearing time correlated significantly(p=0.002)with Majeed score as well as SF-36 score(p=0.044).No other variable had a significant association with outcomes.Conclusion:Posterior-only fixation is sufficient for fixing LC injuries with up to 80%of cases having good to excellent functional outcomes.However,comparative studies with larger sample sizes are needed for further validation.
文摘Nanotherapeutics has an increasing role in the treatment of diseases such as cancer. In photodynamic therapy （PDT） a therapeutically inactive photosensitizer compound is selectively activated by light to produce molecules capable of killing diseased cells and pathogens. A phototheranostic agent can be defined as a single nanoentity with the capabilities for targeted delivery, optical imaging and photodynamic treatment of a disease. Malignant cells, tissue and microbial etiologic agents can be effectively targeted by PDT. Photodynamic therapy is noninvasive, or minimally invasive, and has few side effects as damage to healthy tissue is minimized and the killing effect is localized. Various forms of cancer, acne and other diseases may be treated. The in vivo efficacy of photosensitizers is further improved by attaching them to nanostructures capable of targeting the diseased site. Such photosensitizer-functionalized nanostructures, or nano- therapeutics, allow site-specific delivery of imaging and therapeutic agents for improved phototheranostic performance. This review explores the potential applications of phototheranostic nanostructures in diagnosis and therapy.
文摘Intra-articular coronal fractures （Hoffas fractures） of distal femur are rare. Although bicondylar involvement in these fractures has been reported in the literature in association with high velocity traumata, the occurrence of these fractures involving extensor mechanism rupture and avulsion ofipsilateral tibial spine is extremely rare. To our acquaintance, such a fracture pattern has not yet been reported in the literature so far. In this article, we report one such case and discuss the importance of early diagnosis and prompt internal fixation in the management of such cases.We believe that these rare combinations of injuries should be treated aggressively by early open reduction and anatomic rigid internal fixation in order to achieve good recovery of function.
文摘Objective： Management of Rockwood type 3 acromioclavicular disruptions is a matter of debate. Should we adopt conservative or operative measures at first presentation？ It is not clear but most of the evidences are in favour of conservative management. We present our expe- rience in managing these patients surgically. Methods： We present a prospective series of eight cases of chronic Rockwood type 3 acromioclavicular joint disruptions treated surgically. Anatomical reconstruction of the coracoclavicular ligament was done by artificial braided polyester ligament prosthesis： Results： All the patients were able to perform daily activities from an average of the 14th postoperative day. All patients felt an improvement in pain, with decrease in ave- rage visual analogue scale from preoperative 6.5 points （range 3-9 points） to 2.0 points （range 0-5 points）, Constant score from 59% to 91% and American Shoulder and Elbow Surgeons shoulder score from 65 to 93 points postoperatively. These results improved or at least remained stationary on midterm follow-up, and no deterioration was recorded at an average follow-up of 46 months. Conclusion： This midterm outcome analysis of the artificial ligament prosthesis is the first such follow-up study with prosthesis. Our results are encouraging and justify the further use and evaluation of this relatively new and easily reproducible technique.
文摘A titania slag product of Rosetta ilmenite assaying 72% TiO_(2) is treated by the sulfate process option of the pigmentary TiO_(2) manufacture.The relevant factors of acid concentration,particle size,slag/acid ratio besides the reaction temperature,and time have been studied.After dissolving the cured mass in dilute acid and clarification,the obtained solution was subjected to hydrolysis of its titanium content.The final product was bleached under reducing conditions to redissolve the residual coloring impurities before being dewatered and calcinated.The obtained results indicated that a leaching efficiency of about 92% was realized due to the presence of some refractory components in the working slag material,namely,rutile and magnesium iron titanate.The obtained white pigment assay attained up to 99.85% TiO_(2),while the analyzed impurities involve 77ppm Mn and only 14 and 7ppm of total iron and V,respectively.
文摘A case of a 50-year-old pedestrian who was hit by a bike and suffered fractures of both bones of his right leg was presented. Complete clinical and radiographic assessment showed double segmental fractures of the tibia and multisegmental fractures of the fibula. Review of the literature revealed that this fracture pattern was unique and only a single case was reported so far. Moreover, we discussed the possible mechanisms which can lead to such an injury. We also discussed the management of segmental tibial fracture and the difficulties encountered with them. This case was managed by modern osteosynthesis technique with a pleasing outcome.
文摘Bilateral shoulder dislocations are rare and almost always occur in the posterior direction. Simultaneous bilateral anterior shoulder dislocation is even rarer and only a few cases are stated in the literature. The most interesting part of a bilateral shoulder dislocation is about its injury mechanism as a synchronous and simultaneous force is needed to result in it. In cases of epilepsy or electrocution, the mechanism is different and the forceful contractions of the selective group of muscles result in the dislocation. This article reports two cases of bilateral simultaneous anterior shoulder joint dislocation that occurred after a road side accident and after an episode of convulsion in an epileptic patient. The dislocations were diagnosed early and reduced immediately with a proper postreduction rehabilitation. During their follow-up, both patients had satisfactory functional outcome. This article emphasizes on the importance of shoulder examination in road side accident victims and epileptic patients. All orthopedic surgeons and emergency physicians should be aware of such unusual possibilities to have an early diagnosis and treatment.An early reduction and appropriate rehabilitation can provide satisfactory functional outcome. This article also briefly discusses the injury mechanisms, diagnoses and treatments of bilateral shoulder dislocation as reported in the literature.
文摘Angioleiomyoma of the hand is a rare differential diagnosis of painful soft tissue nodule in the extremity.It arises from smooth muscle of the blood vessels and the most common symptom is pain.Imaging with magnetic resonance imaging shows characteristic features like a hypodense peripheral capsule with linear or branching internal hyperdensities on T2-weighted images,and post-contrast diffuse homogenous enhancement with a vessel leading up to the lesion.Histopathological examination shows well circumscribed fascicles of mature smooth muscle cells surrounding vascular lumina,lined by normal appearing endothelium without elastic lamina present.These cells stain positive for smooth muscle actin,desmin,vimentin,type IV collagen and S100,but stain negative for HMB-45 and ER.Angioleiomyoma is amenable for surgical resection.We report a case of painful subcutaneous nodule of hand,with radiological and histopathological findings suggestive of angioleiomyoma.We outline the clinical,radiological and histopathological features of this rare diagnosis for painful nodule of extremity.
