Incidence of Co-infection of Malaria and Typhoid and their Diagnostic Dilemmas

Background: This study was carried out to know the incidence of co-existence of typhoid and malaria in western part of Uttar Pradesh. Both these infections are common febrile illnesses prevalent in tropical countries including India.Materials and Methods: A total of 300 blood samples were collected from the patients presenting with fever for more than one week. Diagnosis of typhoid was carried out using Widal test and blood culture and for diagnosis of malaria blood film examination was done.Results: Out of total 300 patients, 31 (10.3%) were positive for malarial parasite and 82 (27.3%) were positive for typhoid by Widal test while 12 (4%) were positive for typhoid by blood culture. Rate of co-infection was found out to be 21 (6.7%) with Widal test and 3 (1%) with blood culture.Conclusion: As there is paucity of data on co-infection of malaria and typhoid from this part of country, this study was carried out to know their prevalence. As both these illnesses present with same clinical features, the clinicians must look for co-existence of these infections. Hence, to facilitate the diagnosis and treatment more such studies must be carried out from different parts of the country

Photoperiod as a proximate factor in control of seasonality in the subtropical male Tree Sparrow, Passer montanus

Abstract Background Most species of birds exhibit well-defined seasonality in their various physiological and behavioral functions like reproduction, molt, bill color etc. such that they occur at the most appropriate time of the year. Day length has been shown to be a major source of temporal information regulating seasonal reproduction and associated events in a number of avian species. The present study aims to investigate the role of photoperiod in control of seasonal cycles in the subtropical male tree sparrow (Passer montanus) and to compare its responses at Shillong (Latitude 25°34'N, Longitude 91°53'E) with those exhibited by its conspecifics and related species at other latitudes. Results Initial experiment involving study of seasonal cycles revealed that the wild tree sparrows posses definite seasonal cycles of testicular volume, molt and bill color. These cycles were found remarkably linked to annual solar cycle suggesting the possibility of their photoperiodic control. To confirm this possibility in the next experiment, the photosensitive birds were exposed to three different light-dark regimes that were close to what they experience at this latitude: 9L/15D (close to shortest day length), 12L/12D (equinox day length) and 14L/10D (close to longest day length) for 18 months. Tree sparrows showed testicular growth followed by regression and development of photorefractoriness, molting and bill color changes only under long daily photoperiods (12 L and 14 L) but not under short daily photoperiod (9 L). Birds, under stimulatory photoperiods, did not show reinitiation of the above responses after the completion of initiation regression cycle even after their exposure to these photoperiods for 18 months. This precludes the possibility of circannual rhythm generation and suggests the involvement of photoperiodic mechanism in control of their seasonal cycles. Further, replacement of body and primary feathers progressed with gonadal regression only under long days suggesting that the two high energy demanding events of reproduction and molt are phased at two different times in the annual cycle of the bird and are photoperiodically regulated. Results of the final experiment involving exposure of photosensitive birds to a variety of photoperiodic treatments (9L/15D, 10L/14D, 11L/13D, 12L/12D, 14L/10D and 16L/8D) for 30 days suggested that the light falling for 11 h or more is important in inducing testicular growth and function in this species. Conclusion These results clearly indicate that despite of small photofluctuation, subtropical tree sparrows are capable of fine discrimination of photoperiodic information and use day length as a proximate environmental factor to time their seasonal responses similar to their conspecifics and related species at other latitudes suggesting the conservation of photoperiodic control mechanism in them.</p

Involvement of endogenous circadian rhythm in photoperiodic ovarian response of subtropical tree sparrow, Passer montanus

Investigations on the mechanism of photoperiodic time measurement in regulation of ovarian growth and function have been done in the subtropical population of tree sparrow (Passer montanus). Photosensitive female tree sparrows were subjected to various intermittent light dark cycles of different durations such as: 2L/ 2D, 3L/ 3D, 4L/ 4D, 6L/ 6D, 8L/ 8D and 12L/ 12D along with two control groups: one under short days (9L/ 15D) and the other under long days (14L/ 10D) for 30 days. Birds, under short days, did not show follicular enlargement while those experiencing long days exhibited ovarian growth confirming their photosensitive at the beginning of the experiment. Further, the birds under all the intermittent light regimes showed gonadal response except the birds under 8L/ 8D. The mean follicular diameter was significantly greater in the birds under 2L/ 2D as compared to the birds under 12L/12D. On the other hand, no significant variation in follicular diameter was observed among the birds maintained under 2L/ 2D, 3L/ 3D, 4L/ 4D and 6L/ 6D light dark cycles. Further, no significant variation was observed between the groups of birds exposed under 2L/ 2D and14L/10D (gonadostimulatory control group). Histomorphometric analysis of the ovary revealed a significant increase in the thickness of the follicular wall and follicular differentiation in the birds under gonadostimulatory light dark cycles. No significant different in body weight was observed in the birds under any of the light regimes. The above results are in agreement with the avian external coincidence model of photoperiodic time measurement and indicate that an endogenous circadian rhythm is involved during the initiation of the gonadal growth in the female tree sparrow. They further suggest that multiple flashes of light are more effective in inducing follicular growth than a broad pulse of light of same duration

Developments in MCMC diagnostics and sparse Bayesian learning models

This dissertation consists of three research articles on the topic of Markov chain Monte Carlo (MCMC) diagnostics and sparse Bayesian learning models. The first article consists of MCMC diagnostic tools based on Kullback Leibler (KL) divergence and smoothing methods. These tools can assess the joint convergence of multiple variables and detect non convergence when MCMC chains get stuck at a particular mode of a multi modal stationary distribution. Further, in case of non convergence of multiple MCMC chains, the visualization tool can be used to investigate reasons for non convergence. The second article deals with assessing posterior propriety of some sparse Bayesian learning models. Relevance Vector Machine (RVM) is a popular sparse Bayesian learning model that assumes improper prior over its hyperparameters. We prove that this improper prior leads to an improper posterior. Further, we also provide necessary and sufficient conditions for posterior propriety of RVM. Additionally, we also prove the posterior impropriety of some Bayesian learning models that have a prior structure similar to that of RVM. In the third article, we propose to replace multiple penalties of RVM with a single penalty. The new model is named as single penalty relevance vector machine (SPRVM) and is analyzed using a semi Bayesian approach. The SPRVM allows for computation of Monte Carlo standard errors since we prove the geometric ergodicity of its associated Gibbs sampler. Such a Monte Carlo standard error cannot be computed in the case of RVM since the rate of convergence of its associated Gibbs sampler is not known. Thus, through these three articles we hope to make valuable additions to the literature of MCMC diagnostics and sparse Bayesian learning models

Rhinocerebral mucormycosis: report of a rare case

Background: Mucormycosis is one of the rapidly progressing and lethal form of fungal infection which involves the nose and paranasal sinuses of the head and the neck regions. Mucormycosis also remains a threat to patients with uncontrolled diabetes or other predisposing systemic conditions. It manifests as rhinocerebral, pulmonary, gastrointestinal, cutaneous or disseminated form. The underlying conditions can influence clinical presentation and often delay diagnosis, with resultant poor outcomes.Case Details: We report a case of rhinocerebral mucormycosis in a 75 year-old diabetic patient with emphasise on diagnosis, treatment and survival options of patient from this potentially fatal fungal infection. Extra oral examination revealed mild non-tender swelling on the face, unable to see from left eye, impaired sense of smell, difficulty in speech and nasal stuffiness. Intra-oral examination showed necrosis of mucosa and underlying bone in relation to canine to the tuberosity area of the left vestibular region of the maxilla.Conclusion: Timely diagnosis is critical to survival and minimization of morbidity. Institution of surgical and medical therapy is critical in maximizing the likelihood of good outcome.Keywords: Mucormycosis, fungal, systemic, maxillary sinu

Chronic cholecystitis with follicular lymphoid hyperplasia: nomenclature and diagnostic dilemmas

Background: To revisit the nomenclature, prevalence, histogenesis and the diagnostic dilemmas in cases of cholecystitis with lymphoid hyperplasia received in a private laboratory in one-year duration.Methods: A total of 51 cases of cholecystectomy were examined histopathologically to identify and review all the cases with emphasis on cholecystitis with marked lymphoid infiltration.Results: Out of 51 cholecystectomy specimens, some rare entities were observed such as 4 cases (8%) of xanthomatous change, 2 cases (4%) of cholecystitis with follicular lymphoid hyperplasia and a case of hyalinizing cholecystitis.Conclusions: The literature on cholecystitis with marked lymphoid infiltrate (with or without follicle formation) was overlapping and thus confusing. The same has been simplified with review of literature

Evaluation of coronary artery risk factors in premenopausal women (

Background: The present study was designed to evaluate the association of conventional coronary risk factors in the angiographically proven cases of younger women (<45 years) with significant CAD along with clinical profile and coronary angiographic findings.Methods: This was a hospital-based prospective study conducted at a tertiary-care center in India. A total of 200 premenopausal women (age ≤45 years) who presented with chest pain likely to be of cardiac origin were enrolled. Each patient was subjected to routine clinical investigations, examination of complete lipid profile, follicular stimulating hormone (FSH), luteinizing hormone (LH), and prolactin; and underwent non-invasive cardiac examination and coronary angiography.Results: Mean age of patients was 39.1±4.98 years. A total of 64 (32%) patients had history of spontaneous abortions and 80 (40%) patients presented with ST-elevated myocardial infarction. Increased FSH, LH and prolactin levels was found in 70 (35%), 20 (10%), and 88 (44%) patients, respectively. Total 196 (98%) patients underwent coronary angiography which revealed presence of significant CAD in 122 (63%) cases and of which 80 patients underwent coronary angioplasty and 12 underwent coronary artery bypass grafting. Of all, 8 death were reported up to the mean follow-up of 11 months.Conclusions: The study stated that premenopausal females (<45 years) represent a special subgroup where non-conventional risk factors play an important role in occurrence of CAD. So, careful history taking with detailed menstrual and obstetric history should be considered in such group of patients