Nephrogenic Diabetes Insipidus with Intracranial Calcifications in a Child with Thalassemia Minor

Introduction: There are numerous causes for intracranial calcification in children. We describe an unusual cause of intracranial calcifications in a child, namely, nephrogenic diabetes insipidus (NDI).Case Report: A 12-year-old boy presented with seizures and developmental delay. MRI of the brain revealed intracranial calcifications. Evaluation showed findings suggestive of NDI. The lack of evidence of any other metabolic defect suggests that these calcifications were secondary to NDI. He also had anemia for which he was investigated and diagnosed as thalassemia minor. Detailed literature review failed to reveal any reported association between NDI and thalassemia minor.Conclusion: We report this case to emphasize the importance of early diagnosis and treatment of NDI to prevent organic brain damage.Keywords: Developmental Delay; Intracranial Calcifications; Nephrogenic Diabetes Insipidus; Seizures; Thalassemia Mino

Evaluation of efficacy and safety of cryotherapy in benign and premalignant cervical lesion

 Background: Cervical cancer ranks 3rd leading cause of cancer in the world. Cervical erosion is mostly asymptomatic in women but when symptoms like postcoital bleeding and vaginal discharge occur in the presence of cervical erosion, it becomes important to identify whether the erosion is a benign lesion or CIN or cancer by means of PAP smear and Biopsy. Treatment for benign and precancerous lesion can be provided by ablative or excisional methods. Cryotherapy was reliably used to treat cervical lesions.Methods: Women among 18 to 60 years of age attending outpatient department who had history of chronic discharge per vaginum, postcoital bleeding, dyspareunia, chronic pelvic pain. Patients were divided in two by PAP smear in erosion with inflammatory changes and presence of low grade squamous intraepithelial lesion. Cryotherapy was performed using double-freeze single session procedure. Each patient was followed up at 2, 6 and at 12 weeks. Complications and patients’ satisfaction were recorded and compared to calculate cure rate of symptoms, healing of lesion.Results: The healing efficacy of cryotherapy at 6th and 12th week was 87.8% and 91.1% respectively. Cryotherapy had high satisfaction rate. The cure rate was not affected by location of lesion and size of lesion in both inflammation and LSIL.Conclusions: Cryotherapy is an effective method for treatment of cervical erosion and effectively eliminates symptoms. Patients were highly satisfied. Cryotherapy is cheap, easy, and safe treatment. It is suitable for both hospital and office-based practice

Women in higher education: A brief report on stress during COVID-19

Higher education institutions have evolved into a more stressful environment. Women have been experiencing higher levels of stress than their male counterparts. With higher education adopting to the onset of the pandemic, this brief report studied women’s perceived stress in relation to perceived organizational and supervisory support, and age during times of crisis. In an era of social distancing, quarantines, and lockdowns, the findings suggest that women’s perceived stress is negatively related to age, perceived organizational support, and perceived supervisory support. Society as we once knew it pre-pandemic will never be the same. Higher education is inevitably going to have to manage the aftermath, a new normal that can only be as effective as the employees that help keep the organization running

A comparative study of effect on reducing pain, inflammation and side effect of combination of enzymes (bacterial proteases, papain, bromelain, vitamin C and rutin) versus conventional non-steroidal anti-inflammatory drugs (diclofenac) in patients of closed fracture lower end radius coming at orthopaedic department of a tertiary care hospital

Background: Diclofenac and oral systemic enzymes both are commonly used for control of pain and inflammation in fracture lower end radius as well as other such conditions. Some studies have shown that combination of enzymes like bacterial proteases, papain, bromelain, vitamin C and rutin can reduce pain and Inflammation which is comparable to diclofenac but it still not definite.Methods: Total 50 patients with closed fracture lower end radius were enrolled and randomly divided in to two groups. Group-1 with 25 patients received oral diclofenac and group-2 with 25 patients received oral preparation which contains combination of enzymes bacterial proteases, papain, bromelain, vittamin C and rutin. Effect of drug was assessed by improvement in wrist function which was evaluated by patient rated wrist evolution (PRWE) and reduction in oedema on day 1, day 3 and day 5. Both the groups were compared by unpaired Z test.Results: Mean reduction in PRWE score was 132.08±5.01 in Group 1 and 104.4±11.78 in group 2. Mean of percentage reduction of oedema for group 1 was 8.22 while for group 2 it was 17.8. Both were statistically significant (p<0.05). Total 5 patients out of 25 complained of gastritis in group 1 patients while there was no side effect reported in group 2 patients.Conclusions: Diclofenac was better in reducing pain, while combination of enzymes used in the study was better in reducing oedema. Combination of the enzymes used in this study is safer than diclofenac in cases of the closed fracture lower end radius

Pharmacovigilance study of angiotensin-converting enzyme inhibitors in patients visiting Department of Medicine of a Tertiary Care Hospital, Surendranagar, Gujarat

Background: The objective of this study was to evaluate incidence, patterns, and severity of angiotensin-converting enzyme inhibitor (ACEI) induced adverse drug reactions (ADR).Methods: A total of 500 hypertensive patients taking ACEI was enrolled in the study by taking an informed consent. Reporting of all ACEI-induced ADRs was done by filling CDSCO ADR form. All ADR reports were evaluated according to WHO-UMC causality assessment scale.Results: A total of 53 ADRs (31 males and 22 females) was observed in 500 hypertensive patients taking ACEI. Of 53 ADRs, 22 (41.51%) were mild, 28 (52.83%) were moderate, and only 3 (5.66%) were classified as severe. 7 ADRs (13.21%) were classified as certain, 30 ADRs (56.60%) were in probable category, 8 (15.09%) were in possible category, 4 (7.55%) in unlikely category, 3 (5.66%) in conditional category (unclassified), and 1 ADR was in unassessable (unclassifiable) category. Among 53 ADRs, 24 (4.80%) patients developed dry cough, 8 (1.60%) hypotension, 2 (0.40%) headache, 2 (0.40%) dizziness, 3 (0.60%) nausea/bowel upset, 3 (0.60%) rashes, 2 (0.40%) developed angioedema, 3 (0.60%) dysgeusia, hyperkalemia, acute renal failure, proteinuria are rare.Conclusions: Incidence of ADRs by ACEIs is 10.60% with cough as the most common ADR followed by hypotension. As enalapril is most frequently used ACEI, ADRs due to enalapril are more common

Association of trans fatty acids with lipids and other cardiovascular risk factors in an Indian industrial population.

OBJECTIVE: Trans-fat, an invariable component of industrial fat is considered as one of the major dietary factors associated with CVD. Although the use of trans-fat is completely banned in some of the high-income countries where the CVD epidemic is declining, it is widely used in LMIC. We aimed to investigate the association of trans fatty acid in serum with risk markers of CVD in an industrial population in India. Participants were randomly selected from a study conducted in an industrial setting among employees and their family members. Information related to their demographic profile, anthropometric measurements, oil intake were recorded. Fasting samples were collected and stored at - 80 °C for analysis. Their lipid profile and hs CRP were measured and fatty acids analyzed using gas chromatography (GC) with flame ionization detector (FID). RESULTS: Complete data was available for 176 participants. Among trans fatty acids, mono trans fatty acid was significant predictor of serum triglycerides [Unadjusted β (95% CI) 22.9 (2.6, 43.2); Adjusted β (95% CI) 20.4 (3.5, 37.3)]. None of the other trans fatty acids either individually or in group correlated with any of the biochemical markers studied

Molekularni dokaz toksinskih tipova bakterije Clostridium perfringens, enteropatogenih sojeva Escherichia coli te rotavirusa i koronavirusa u uzorcima proljeva kod neonatalne jaradi

In the present study, out of 1156 neonatal goat kids, 238 showing clinical diarrhea were used for detection of toxinotypes of Clostridium perfringens, Enteropathogenic E. coli (EPEC), Group A rotavirus (GARV) and Bovine coronavirus (BCV). Isolation and toxinotyping of isolates were done by multiplex Polymerase chain reaction (PCR) using primers for cpa, cpb, cpb2, etx and iap genes. For EPEC, isolation and identification were done using bfpA gene and SYBR green based real time PCR (qPCR). GARV and BCV were detected, by one-step RT-PCR (osRT-PCR). The incidence of C. perfringens was 15.13% with 75% isolates toxinotype A, 25% type D and 61.11% of isolates carrying the β2-toxin gene. The incidence of EPEC was 68.07% based on qPCR, whereas 21.85% were positive for GARV and 15.97% for BCV by osRT-PCR. There was mixed infection of C. perfringens and EPEC in 11.76% and 3.78% for C. perfringens and GARV and 2.1% of C. perfringens and BCV. EPEC and GARV was 19.74% and EPEC plus BCV positivity was 11.34%. GARV and BCV was 5.88%, and 4.20% had mixed infection of EPEC, GARV and BCV. Of the total diarrheic kids sampled, 0.84% had mixed infection of C. perfringens, GARV, BCV and EPEC. On the basis of the above findings, it may be concluded that isolation, multiplex PCR and real time PCR facilitated the characterization of circulating C. perfringens toxinotypes and EPEC in goats reared under semi-arid conditions. The importance of enteritis caused by GARV and BCV and their role in mixed infection in goats requires extensive screening and pathogenicity studies to associate the symptoms with disease.U populaciji od 1156 neonatalnih jarića 238 je pokazivalo kliničke znakove proljeva. Od njih su uzeti uzorci izmeta za dokazivanje toksinskih tipova bakterije Clostridium perfringens, enteropatogenih sojeva bakterije E. coli (engl. enteropathogenic E. coli, EPEC), rotavirusa skupine A (engl. group A rotavirus, GARV) i goveđeg koronavirusa (engl. bovine coronavirus, BCV). Izdvajanje i toksinska tipizacija izolata provedeni su višestrukom lančanom reakcijom polimerazom (PCR) upotrebom početnica za gene cpa, cpb, cpb2, etx i iap. Izdvajanje i identifikacija EPEC-a provedeni su pretragom na gen bfpA i PCR-om u stvarnom vremenu, uz upotrebu SYBR zelenila (qPCR). Za dokaz rotavirusa skupine A i goveđeg koronavirusa upotrijebljena je RT-PCR (osRT-PCR). Incidencija bakterije C. perfringens iznosila je 15,13 %. Od toga je 75 % izolata pripadalo toksinskom tipu A, 25 % tipu D, dok je 61,11 % izolata imalo gen za toksin β2. Incidencija EPEC-a iznosila je 68,07 %, a 21,85 % pretraženih uzoraka bilo je pozitivno na GARV te 15,97 % na BCV. Mješovita infekcija bakterijom C. perfringens i EPEC-om utvrđena je u 11,76 % uzoraka, C. perfringens i GARV u 3,78 % te C. perfringens i BCV u 2,1 % pretraženih uzoraka. Mješovita infekcija EPEC-om i GARV-om utvrđena je u 19,74 %, a EPEC-om i BCV-om u 11,34 %. Mješovita infekcija rotavirusom i koronavirusom bila je ustanovljena u 5,88 %, a mješovita infekcija EPEC-om, GARV-om i BCV-om u 4,20 % uzoraka. Od ukupnog broja pretražene jaradi s proljevom u njih 0,84 % dokazana je mješovita infekcija bakterijom C. perfringens, rotavirusom skupine A, goveđim koronavirusom i EPEC-om. Na osnovi prikazanih rezultata može se zaključiti da izdvajanje, višestruki PCR te PCR u stvarnom vremenu omogućuju karakterizaciju i praćenje kolanja toksinskih tipova bakterija C. perfringens i EPEC-a u koza uzgajanih u sušnim uvjetima. Važnost enteritisa uzrokovanog rotavirusom skupine A i goveđim koronavirusom te njihova uloga kod mješovitih infekcija u koza zahtijevaju pojačan nadzor i istraživanje patogenosti radi povezivanja kliničkih znakova s ustanovljenom bolešću

Leveraging Existing Cohorts to Study Health Effects of Air Pollution on Cardiometabolic Disorders:India Global Environmental and Occupational Health Hub

Air pollution is a growing public health concern in developing countries and poses a huge epidemiological burden. Despite the growing awareness of ill effects of air pollution, the evidence linking air pollution and health effects is sparse. This requires environmental exposure scientist and public health researchers to work more cohesively to generate evidence on health impacts of air pollution in developing countries for policy advocacy. In the Global Environmental and Occupational Health (GEOHealth) Program, we aim to build exposure assessment model to estimate ambient air pollution exposure at a very fine resolution which can be linked with health outcomes leveraging well-phenotyped cohorts which have information on geolocation of households of study participants. We aim to address how air pollution interacts with meteorological and weather parameters and other aspects of the urban environment, occupational classification, and socioeconomic status, to affect cardiometabolic risk factors and disease outcomes. This will help us generate evidence for cardiovascular health impacts of ambient air pollution in India needed for necessary policy advocacy. The other exploratory aims are to explore mediatory role of the epigenetic mechanisms (DNA methylation) and vitamin D exposure in determining the association between air pollution exposure and cardiovascular health outcomes. Other components of the GEOHealth program include building capacity and strengthening the skills of public health researchers in India through variety of training programs and international collaborations. This will help generate research capacity to address environmental and occupational health research questions in India. The expertise that we bring together in GEOHealth hub are public health, clinical epidemiology, environmental exposure science, statistical modeling, and policy advocacy

Revealing nature of GRB 210205A, ZTF21aaeyldq (AT2021any), and follow-up observations with the 4K×\times4K CCD Imager+3.6m DOT

Optical follow-up observations of optical afterglows of gamma-ray bursts are crucial to probe the geometry of outflows, emission mechanisms, energetics, and burst environments. We performed the follow-up observations of GRB 210205A and ZTF21aaeyldq (AT2021any) using the 3.6m Devasthal Optical Telescope (DOT) around one day after the burst to deeper limits due to the longitudinal advantage of the place. This paper presents our analysis of the two objects using data from other collaborative facilities, i.e., 2.2m Calar Alto Astronomical Observatory (CAHA) and other archival data. Our analysis suggests that GRB 210205A is a potential dark burst once compared with the X-ray afterglow data. Also, comparing results with other known and well-studied dark GRBs samples indicate that the reason for the optical darkness of GRB 210205A could either be intrinsic faintness or a high redshift event. Based on our analysis, we also found that ZTF21aaeyldq is the third known orphan afterglow with a measured redshift except for ZTF20aajnksq (AT2020blt) and ZTF19abvizsw (AT2019pim). The multiwavelength afterglow modelling of ZTF21aaeyldq using the afterglowpy package demands a forward shock model for an ISM-like ambient medium with a rather wider jet opening angle. We determine circumburst density of $n_{0}$ = 0.87 cm$^{-3}$, kinetic energy $E_{k}$ = 3.80 $\times 10^{52}$ erg and the afterglow modelling also indicates that ZTF21aaeyldq is observed on-axis ($\theta_{obs} < \theta_{core}$) and a gamma-ray counterpart was missed by GRBs satellites. Our results emphasize that the 3.6m DOT has a unique capability for deep follow-up observations of similar and other new transients for deeper observations as a part of time-domain astronomy in the future.Comment: Accepted for Special Issue of Journal of Astrophysics and Astronomy, 2022, Astrophysical jets and observational facilities: National perspective, 05 -09 April 2021, ARIES Nainita