A metaphysical exposition of Akshara Brahma in Swaminarayan Philosophy

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A study of prevalence of sexually transmitted infections & response to syndromic treatment among married women of reproductive age group in rural area of Parol Primary Health Centre under Thane district, Mahrashtra , India

Objectives To study prevalence of Sexually Transmitted Infections (STIs - symptomatic, clinical & laboratorial) & response to syndromic treatment in among STI groups. Design Community based interventional study Setting Rual area-Parol Primary Health Centre(PHC), District Thane, Maharashtra state. Poulation Women of reproductive age groups 15 -45 years Methods Community based interventional study, conducted among representative group of 415 women of reproductive age groups, by simple random sampling technique in Parol PHC, District Thane, Maharashtra state. All symptomatic & asymptomatic women were counseled for examination & investigations & given syndromic treatment. Follow-up done to assess impact of syndromic treatment. Main Outcome Prevalence of STI symptomatically was 39%, clinically 32.3% & Laboratorial 26%. After syndromic treatment, prevalence of STIs has statistically significantly reduced. Statistical Analysis Z-test Results Of the surveyed women (415), prevalence of STI symptomatically was 39%, clinically 32.3% & Laboratorial 26%. The most common presenting symptom was vaginal discharge (36.4%) followed by Burning Micturition (24.7%), Vulval itching (17.3%), Lower abdominal pain (13%) & Genital ulcer (8.6%). Clinically, 55.2% women were diagnosed as cervicitis & 44.8% as PID. Laboratorial diagnosed STIs were - vaginal candidiasis 46.3%, Bacterial vaginosis 25%, Trichmoniasis 19.4 %, Genital Herpes 7.4% & HIV 1.9%. After syndromic treatment, prevalence of STIs has statistically significantly reduced. Conclusion: Syndromic Rx & health education can definitely reduce STIs

A study of prevalence of Sexually Transmitted Infections & response to syndromic treatment among married women of reproductive age group in rural area of Parol Primary Health Centre under Thane district

Objectives To study prevalence of Sexually Transmitted Infections (STIs - symptomatic, clinical & laboratorial)& response to syndromic treatment in among STI groups. Design Community based interventional study Setting Rual area-Parol Primary Health Centre(PHC), District Thane, Maharashtra state. Poulation Women of reproductive age groups 15 -45 years Methods Present Community based interventional study was conducted among representative group of 415 women of reproductive age groups who were selected by simple random sampling technique in Parol PHC, District Thane, Maharashtra state. All symptomatic & asymptomatic women were counseled for examination & investigations & given syndromic treatment. Follow-up done to assess impact of syndromic treatment. Main Outcome Prevalence of STI symptomatically was 39%, clinically 32.3% & Laboratorial 26%. After syndromic treatment, prevalence of STIs was significantly reduced. Statistical Analysis Z test Results Of the surveyed women (415), prevalence of STI symptomatically was 39%, clinically 32.3% & Laboratorial 26%. The most common presenting symptom was vaginal discharge (36.4%) followed by Burning Micturition (24.7%), Vulval itching (17.3%), Lower abdominal pain (13%) & Genital ulcer (8.6%). Clinically, 55.2% women were diagnosed as cervicitis & 44.8% as PID. Laboratorial diagnosed STIs were - vaginal candidiasis 46.3%, Bacterial vaginosis 25%, Trichmoniasis 19.4 %, Genital Herpes 7.4% & HIV 1.9%. After syndromic treatment, prevalence of STIs has statistically significantly reduced. Conclusion Syndromic Rx & health education can definitely reduce STIs

Comparison of ferric carboxymaltose and iron sucrose for treatment of iron deficiency anemia in pregnancy at tertiary care centre, Western India

Background: Iron deficiency anemia is the most common haematological health problem among pregnant women but can be prevented by effective measure. The study aimed to evaluate the efficacy and safety of intravenous ferric carboxymaltose (FCM) in comparison with intravenous Iron sucrose (IS) for treatment of iron deficiency anemia in pregnancy. Methods: A prospective interventional comparative study was conducted from (June 2021-June 2022) at a tertiary care hospital. Pregnant women diagnosed with moderate to severe iron deficiency anaemia were screened for the study. One hundred patients were randomized to receive either intravenous FCM or IS. Treatment effectiveness was assessed by repeat Haemoglobin (Hb) and RBC indices measurement after 4 weeks of completion of therapy. Safety was assessed by analysis of adverse drug reactions during infusion and 2 hours after infusion. Results: Mean rise in Hb at 4 weeks was significantly higher in FCM group (1.67±0.47 Vs 1.07±0.25; p<0.0001) as compared to IS group.  There was also rise in other biochemical parameters like MCV and MCHC in both groups. Numbers of visits were significantly less in FCM group. No serious adverse events were noted in either group. Conclusions: Intravenous ferric carboxymaltose is more effective and safer as compared to intravenous iron sucrose in the management of anemia during pregnancy. It has advantage to administer large dose in single sitting which reduce overall cost of therapy and hence will lead to better compliance in community setting

A Study on Knowledge, Attitude & Practice Regarding Mosquito Borne Diseases in an Urban Area of Bhavnagar

Abstract : Introduction: Objective: Method

21.神経芽細胞腫肝転移例の1年生存(第589回千葉医学会例会・第2回千葉大学小児外科教室例会)

Additional file 2: Table S1. A list of phosphoPSMs identified by MASCOT and SEQUEST

Integrating transcriptomic and proteomic data for accurate assembly and annotation of genomes

© 2017 Wong et al.; Published by Cold Spring Harbor Laboratory Press. Complementing genome sequence with deep transcriptome and proteome data could enable more accurate assembly and annotation of newly sequenced genomes. Here, we provide a proof-of-concept of an integrated approach for analysis of the genome and proteome of Anopheles stephensi, which is one of the most important vectors of the malaria parasite. To achieve broad coverage of genes, we carried out transcriptome sequencing and deep proteome profiling of multiple anatomically distinct sites. Based on transcriptomic data alone, we identified and corrected 535 events of incomplete genome assembly involving 1196 scaffolds and 868 protein-coding gene models. This proteogenomic approach enabled us to add 365 genes that were missed during genome annotation and identify 917 gene correction events through discovery of 151 novel exons, 297 protein extensions, 231 exon extensions, 192 novel protein start sites, 19 novel translational frames, 28 events of joining of exons, and 76 events of joining of adjacent genes as a single gene. Incorporation of proteomic evidence allowed us to change the designation of more than 87 predicted noncoding RNAs to conventional mRNAs coded by protein-coding genes. Importantly, extension of the newly corrected genome assemblies and gene models to 15 other newly assembled Anopheline genomes led to the discovery of a large number of apparent discrepancies in assembly and annotation of these genomes. Our data provide a framework for how future genome sequencing efforts should incorporate transcriptomic and proteomic analysis in combination with simultaneous manual curation to achieve near complete assembly and accurate annotation of genomes

Surgery, Octreotide, Temozolomide, Bevacizumab, Radiotherapy, and Pegvisomant Treatment of an AIP Mutation-Positive Child

UK India Education Research Initiative and the British Council (75-2014; to P.D.)Council of Scientific and Industrial Research, University Grants Commission, for financial support (2061330632; to A.R.).Medical Research Council (MR/M018539/1; to M.K

Global burden and strength of evidence for 88 risk factors in 204 countries and 811 subnational locations, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021

Background: Understanding the health consequences associated with exposure to risk factors is necessary to inform public health policy and practice. To systematically quantify the contributions of risk factor exposures to specific health outcomes, the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 aims to provide comprehensive estimates of exposure levels, relative health risks, and attributable burden of disease for 88 risk factors in 204 countries and territories and 811 subnational locations, from 1990 to 2021. Methods: The GBD 2021 risk factor analysis used data from 54 561 total distinct sources to produce epidemiological estimates for 88 risk factors and their associated health outcomes for a total of 631 risk–outcome pairs. Pairs were included on the basis of data-driven determination of a risk–outcome association. Age-sex-location-year-specific estimates were generated at global, regional, and national levels. Our approach followed the comparative risk assessment framework predicated on a causal web of hierarchically organised, potentially combinative, modifiable risks. Relative risks (RRs) of a given outcome occurring as a function of risk factor exposure were estimated separately for each risk–outcome pair, and summary exposure values (SEVs), representing risk-weighted exposure prevalence, and theoretical minimum risk exposure levels (TMRELs) were estimated for each risk factor. These estimates were used to calculate the population attributable fraction (PAF; ie, the proportional change in health risk that would occur if exposure to a risk factor were reduced to the TMREL). The product of PAFs and disease burden associated with a given outcome, measured in disability-adjusted life-years (DALYs), yielded measures of attributable burden (ie, the proportion of total disease burden attributable to a particular risk factor or combination of risk factors). Adjustments for mediation were applied to account for relationships involving risk factors that act indirectly on outcomes via intermediate risks. Attributable burden estimates were stratified by Socio-demographic Index (SDI) quintile and presented as counts, age-standardised rates, and rankings. To complement estimates of RR and attributable burden, newly developed burden of proof risk function (BPRF) methods were applied to yield supplementary, conservative interpretations of risk–outcome associations based on the consistency of underlying evidence, accounting for unexplained heterogeneity between input data from different studies. Estimates reported represent the mean value across 500 draws from the estimate's distribution, with 95% uncertainty intervals (UIs) calculated as the 2·5th and 97·5th percentile values across the draws. Findings: Among the specific risk factors analysed for this study, particulate matter air pollution was the leading contributor to the global disease burden in 2021, contributing 8·0% (95% UI 6·7–9·4) of total DALYs, followed by high systolic blood pressure (SBP; 7·8% [6·4–9·2]), smoking (5·7% [4·7–6·8]), low birthweight and short gestation (5·6% [4·8–6·3]), and high fasting plasma glucose (FPG; 5·4% [4·8–6·0]). For younger demographics (ie, those aged 0–4 years and 5–14 years), risks such as low birthweight and short gestation and unsafe water, sanitation, and handwashing (WaSH) were among the leading risk factors, while for older age groups, metabolic risks such as high SBP, high body-mass index (BMI), high FPG, and high LDL cholesterol had a greater impact. From 2000 to 2021, there was an observable shift in global health challenges, marked by a decline in the number of all-age DALYs broadly attributable to behavioural risks (decrease of 20·7% [13·9–27·7]) and environmental and occupational risks (decrease of 22·0% [15·5–28·8]), coupled with a 49·4% (42·3–56·9) increase in DALYs attributable to metabolic risks, all reflecting ageing populations and changing lifestyles on a global scale. Age-standardised global DALY rates attributable to high BMI and high FPG rose considerably (15·7% [9·9–21·7] for high BMI and 7·9% [3·3–12·9] for high FPG) over this period, with exposure to these risks increasing annually at rates of 1·8% (1·6–1·9) for high BMI and 1·3% (1·1–1·5) for high FPG. By contrast, the global risk-attributable burden and exposure to many other risk factors declined, notably for risks such as child growth failure and unsafe water source, with age-standardised attributable DALYs decreasing by 71·5% (64·4–78·8) for child growth failure and 66·3% (60·2–72·0) for unsafe water source. We separated risk factors into three groups according to trajectory over time: those with a decreasing attributable burden, due largely to declining risk exposure (eg, diet high in trans-fat and household air pollution) but also to proportionally smaller child and youth populations (eg, child and maternal malnutrition); those for which the burden increased moderately in spite of declining risk exposure, due largely to population ageing (eg, smoking); and those for which the burden increased considerably due to both increasing risk exposure and population ageing (eg, ambient particulate matter air pollution, high BMI, high FPG, and high SBP). Interpretation: Substantial progress has been made in reducing the global disease burden attributable to a range of risk factors, particularly those related to maternal and child health, WaSH, and household air pollution. Maintaining efforts to minimise the impact of these risk factors, especially in low SDI locations, is necessary to sustain progress. Successes in moderating the smoking-related burden by reducing risk exposure highlight the need to advance policies that reduce exposure to other leading risk factors such as ambient particulate matter air pollution and high SBP. Troubling increases in high FPG, high BMI, and other risk factors related to obesity and metabolic syndrome indicate an urgent need to identify and implement interventions

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P < 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely