Does Regular Surveillance Improve the Long-Term Survival of Arteriovenous Fistulas?

The rate of arteriovenous fistula (AVF) placement continues to rise and AVF failure is a major complication. The main cause of AVF failure is stenosis leading to thrombosis. Although the detection of early stenosis with preemptive correction prior to thrombosis seems to be a plausible option to prevent access failure, there is much debate, on the basis of studies of surveillance with arteriovenous grafts, as to whether early surveillance actually improves the longevity of AVFs. Evaluating the available information for surveillance, specifically the data for AVF stenosis and survival, is necessary to determine if surveillance is warranted. These trials have shown that vascular access flow (Qa) surveillance is beneficial in revealing subclinical stenosis. Preemptive angioplasty and surgical revision have shown to decrease thrombosis rates. However, at the present time, there is only limited data on whether preemptive treatment equates to improved long-term AVF survival

Postpartum depression: a prospective observational cross-sectional study

Background: To determine the prevalence of postpartum depression in the puerperium and offer referrals to counsellor/mental health practitioner for at risk patients Methods: Sample size was 214 patients and duration of study was 1 year, it included all deliveries at HN reliance foundation hospital. It excluded women with pre-existing mental health problems or neurological disease on medications and those who declined participation. On day 7 and day 42 post-delivery the women were phoned and asked questions from the Edinburg postnatal depression scale which is a validated questionnaire. Interpretation used was; EPDS ≥13 or saying yes to question no 10, with depression and EPDS <13 without depression. Those identified with depression were appropriately referred. Results: Patient identified to be depressed were more likely to have perceived complications during delivery (p=0.02), problems with lactation (p=0.035), hospital stay of more than four days (p=0.002). There was no statistical association with help available and place where the mother stayed post-discharge. Conclusions: Out of 213 study participants, 32 study participants (15.02 percent) had post-partum depression. This was prevalent among those that felt their delivery was complicated, those with lactation difficulties and those with hospital stay of more than 4 days. The prevalence of post-partum depression at our hospital was significantly high to institute routine use of EPDS for new mothers

Sensitivity of ultrasound scan and hysteroscopy with histopathological correlation in identifying endometrial pathology for a mixed group of symptomatic and asymptomatic patients

Background: We wished to correlate abnormal findings on hysteroscopy with abnormal findings on Ultrasound. To study the accuracy of ultrasound for detection of uterine polyps using hysteroscopy as gold standard. Analyse the cases detected with Carcinoma Endometrium and other endometrial pathology. Methods: In this retrospective study, we summarized data from 125 patients who underwent TVS examination followed by hysteroscopy under 2 consultants from 2017 to 2020. Specimens were obtained and sent for histopathological examination. Sensitivity, specificity, positive and negative predictive values for diagnosing uterine pathology were calculated for each method. Results: The sensitivity and specificity of ultrasonography for identifying polyps is 27.03% and 98.04% respectively The sensitivity of ultrasonography for identifying any abnormal pathology is 90.08%. A total of 74 hysteroscopy identified and histology confirmed polyps were identified with no incidence of cancer in all the polyps. A total of 8 patients were diagnosed to have Endometrial Cancer on endometrial biopsy. Of these 8, 7 were postmenopausal and 1 premenopausal. 2 patients of these were asymptomatic with incidental finding of thickened endometrium on ultrasonography. Conclusions: Transvaginal ultrasound is a practical approach for initial evaluation of abnormal uterine bleeding, however a hysteroscopy would be necessary in most of the suspicious cases due to better diagnostic accuracy. A unique feature of this study is the inclusion of a group of asymptomatic women incidentally detected to have uterine pathology including uterine carcinoma on routine health examination hence highlighting the importance of routine gynaecological check especially in the peri and post-menopausal age group

Low-cost, bottom-up fabrication of large-scale single-molecule nanoarrays by DNA origami placement

Large-scale nanoarrays of single biomolecules enable high-throughput assays while unmasking the underlying heterogeneity within ensemble populations. Until recently, creating such grids which combine the unique advantages of microarrays and single-molecule experiments (SMEs) has been particularly challenging due to the mismatch between the size of these molecules and the resolution of top-down fabrication techniques. DNA Origami Placement (DOP) combines two powerful techniques to address this issue: (i) DNA origami, which provides a 100-nm self-assembled template for single-molecule organization with 5 nm resolution, and (ii) top-down lithography, which patterns these DNA nanostructures, transforming them into functional nanodevices via large-scale integration with arbitrary substrates. Presently, this technique relies on state-of-the-art infrastructure and highly-trained personnel, making it prohibitively expensive for researchers. Here, we introduce a bench-top technique to create meso-to-macro-scale DNA origami nanoarrays using self-assembled colloidal nanoparticles, thereby circumventing the need for top-down fabrication. We report a maximum yield of 74%, two-fold higher than the statistical limit of 37% imposed on non-specific molecular loading alternatives. Furthermore, we provide a proof-of-principle for the ability of this nanoarray platform to transform traditionally low-throughput, stochastic, single-molecule assays into high-throughput, deterministic ones, without compromising data quality. Our approach has the potential to democratize single-molecule nanoarrays and demonstrates their utility as a tool for biophysical assays and diagnostics

Intramuscular hemangioma of masseter muscle: A report of unique case

BACKGROUND AND AIM: Even though hemangiomas are prevalent tumors in the region of head and neck, they are comparatively rare inside the mouth and less frequently detected by dental professionals. Therefore, the aim of this case report is to present such a rare variation of hemangioma manifested within the substance of the masseter muscle. CASE REPORT: We report a unique case of intramuscular hemangioma of masseter muscle in a 26-year-old woman complained of growth and swelling in the right cheek since 6-8 months before. The growth was surgical excised and diagnosed histopathologically as intramuscular mixed capillary with cavernous hemangioma. CONCLUSION: Hemangiomas are rarely seen intramuscularly. This case presents an intramuscular hemangioma occurring within the masseter muscle. Early detection and management is required in order to avoid the potential complications associated with it. KEYWORDS: Capillary; Cavernous; Hemangioma; Vascular Malformation; Benign Tumo

Essential amino acids in total knee and hip joint replacement: a narrative review

The increasing availability of total joint replacement especially for knee and hip joints has increased their rates substantially across the globe. It is associated with increased risk of sarcopenia with loss of muscle mass and strength in the postoperative period. The supplementation of proteins along with exercises have been mainframe strategy to improve the functional ability after total knee arthroplasty and total hip arthroplasty. However, supplementation of proteins necessitates effective proteolytic digestion and conversion to amino acids for exerting substantial effects. In overcoming this challenge, supplementation with essential amino acids can be an attractive approach In this article, we review the clinical evidence with use of essential amino acids in patients undergoing TKA and THA. In the nine studies included in the review, seven assessed EAAs in TKA and two in THA. In TKA studies, improvement in muscle mass, muscle strength and functional recovery has been significant over 6 weeks postoperatively in majority of the studies. Over long term (2 years), improved recovery of rectus femoris and quadriceps had been reported. In THA as well, significant improvement in hip function and stability has been reported. Thus, EAAs in addition to the existing rehabilitation program are helpful to improve sarcopenia and enhances the recovery to perform activities of daily living. We propose from current evidence that administration of EAAs 7 to 10 days prior to planned TKA or THA and continued for 14 to 20 days in the postoperative period along with rehabilitation program is optimal in enhancing the muscle strength and help in physical functional recovery. Current evidence indicates supplementation with EAAs should be a part of routine management protocol in patients undergoing TKA or THA

Low-cost, bottom-up fabrication of large-scale single-molecule nanoarrays by DNA origami placement

Large-scale nanoarrays of single biomolecules enable high-throughput assays while unmasking the underlying heterogeneity within ensemble populations. Until recently, creating such grids which combine the unique advantages of microarrays and single-molecule experiments (SMEs) has been particularly challenging due to the mismatch between the size of these molecules and the resolution of top-down fabrication techniques. DNA Origami Placement (DOP) combines two powerful techniques to address this issue: (i) DNA origami, which provides a 100-nm self-assembled template for single-molecule organization with 5 nm resolution, and (ii) top-down lithography, which patterns these DNA nanostructures, transforming them into functional nanodevices via large-scale integration with arbitrary substrates. Presently, this technique relies on state-of-the-art infrastructure and highly-trained personnel, making it prohibitively expensive for researchers. Here, we introduce a bench-top technique to create meso-to-macro-scale DNA origami nanoarrays using self-assembled colloidal nanoparticles, thereby circumventing the need for top-down fabrication. We report a maximum yield of 74%, two-fold higher than the statistical limit of 37% imposed on non-specific molecular loading alternatives. Furthermore, we provide a proof-of-principle for the ability of this nanoarray platform to transform traditionally low-throughput, stochastic, single-molecule assays into high-throughput, deterministic ones, without compromising data quality. Our approach has the potential to democratize single-molecule nanoarrays and demonstrates their utility as a tool for biophysical assays and diagnostics

Chd8 Mutation Leads to Autistic-like Behaviors and Impaired Striatal Circuits

Autism spectrum disorder (ASD) is a heterogeneous disease, but genetically defined models can provide an entry point to studying the molecular underpinnings of this disorder. We generated germline mutant mice with loss-of-function mutations in Chd8, a de novo mutation strongly associated with ASD, and demonstrate that these mice display hallmark ASD behaviors, macrocephaly, and craniofacial abnormalities similar to patient phenotypes. Chd8[superscript +/–] mice display a broad, brain-region-specific dysregulation of major regulatory and cellular processes, most notably histone and chromatin modification, mRNA and protein processing, Wnt signaling, and cell-cycle regulation. We also find altered synaptic physiology in medium spiny neurons of the nucleus accumbens. Perturbation of Chd8 in adult mice recapitulates improved acquired motor learning behavior found in Chd8[superscript +/–] animals, suggesting a role for CHD8 in adult striatal circuits. These results support a mechanism linking chromatin modification to striatal dysfunction and the molecular pathology of ASD.National Science Foundation (U.S.) (1122374)National Science Foundation (U.S.) (2013169249)National Institute of Mental Health (U.S.) (F31-MH111157)Howard Hughes Medical Institute (NS046789)Simons Foundation Autism Research Initiative (306063)Simons Foundation Autism Research Initiative (6927482)National Institute of Mental Health (U.S.) (5DP1-MH100706)National Institute of Mental Health (U.S.) (1R01-MH110049)Nancy Lurie Marks Family Foundation (6928117)Howard Hughes Medical Institute (NS046789

Genetic dissection of the glutamatergic neuron system in cerebral cortex.

Diverse types of glutamatergic pyramidal neurons mediate the myriad processing streams and output channels of the cerebral cortex1,2, yet all derive from neural progenitors of the embryonic dorsal telencephalon3,4. Here we establish genetic strategies and tools for dissecting and fate-mapping subpopulations of pyramidal neurons on the basis of their developmental and molecular programs. We leverage key transcription factors and effector genes to systematically target temporal patterning programs in progenitors and differentiation programs in postmitotic neurons. We generated over a dozen temporally inducible mouse Cre and Flp knock-in driver lines to enable the combinatorial targeting of major progenitor types and projection classes. Combinatorial strategies confer viral access to subsets of pyramidal neurons defined by developmental origin, marker expression, anatomical location and projection targets. These strategies establish an experimental framework for understanding the hierarchical organization and developmental trajectory of subpopulations of pyramidal neurons that assemble cortical processing networks and output channels