Alleviation of oxidative stress induced by spider mite invasion through application of elicitors in bean plants

Spider mite invasion induces oxidative stress on bean plants and increased soluble sugars, phenole, proline and peroxidase activity, but decreased catalase activity and ascorbic acid and carotenoid concentration. Application of elicitors significantly enhanced spider mite tolerance by decreasing hydrogen peroxide, malondialdehyde, electrolyte leakage, and increasing peroxidase activity and antioxidant compounds reported previously, leading to increasing ion percentage in plant shoot. This finding suggests that elicitors might be activating antioxygenic enzymes and elevating antioxidants there by controlling free radical generation, hence preventing membrane peroxidation and denaturation of biomolecules resulting into improving plant growth.Keywords: Tetranychus urticae, Phaseolus vulgaris, salicylate, methyl jasmonate, antioxidants

Generalised tetanus: A rare complication of Richter’s hernia

We present a case report of generalized tetanus following umbilical Richter’s hernia in a 10 month old unimmunized boy. This case is reported because tetanus is a rare complication of Richter’s hernia and to emphasize the need for immunization of all unimmunized children with tetanus vaccine. Ahigh index of suspicion is important in the diagnosis of Richter’s herniain order to avoid complication, as diagnosis is often delayed or missed. The co-exiting tetany is also a rare co-morbidity of Richter’s hernia

Nonlinear Modeling and Analysis of Pressure Wave inside CEUP Fuel Pipeline

Operating conditions dependent large pressure variations are one of the working characteristics of combination electronic unit pump (CEUP) fuel injection system for diesel engines. We propose a precise and accurate nonlinear numerical model of pressure inside HP fuel pipeline of CEUP using wave equation (WE) including both viscous and frequency dependent frictions. We have proved that developed hyperbolic approximation gives more realistic description of pressure wave as compared to classical viscous damped wave equation. Frictional effects of various frequencies on pressure wave have been averaged out across valid frequencies to represent the combined effect of all frequencies on pressure wave. Dynamic variations of key fuel properties including density, acoustic wave speed, and bulk modulus with varying pressures have also been incorporated. Based on developed model we present analysis on effect of fuel pipeline length on pressure wave propagation and variation of key fuel properties with both conventional diesel and alternate fuel rapeseed methyl ester (RME) for CEUP pipeline

Co-morbidities in children hospitalized for community acquired pneumonia in Maiduguri, Nigeria

Background: Pneumonia is one of the commonest causes of morbidity and mortality in children, especially in developing countries. These children are also at risk of other morbidities, thus, increasing the morbidity and mortality.Objective: This study was conducted to examine the prevalence and pattern of co-morbidities in children admitted for community acquired pneumonia (CAP) in Maiduguri.Methodology: All children admitted into the Emergency Paediatric Unit (EPU) of the University of Maiduguri Teaching Hospital (UMTH), Maiduguri, in 2011, with CAP were prospectively followed until discharge or death. The children were evaluated for co-morbidities clinically and by examination of appropriate specimen where necessary.Result: A total of 115 children aged one month to 14 years were admitted for CAP during the study period. While majority of the children studied were underfive; 107 (93%), 65(56.5%) were males, 101 (87.8%) had one or multiple co morbidities, with about half of them 58 (50.4%) afflicted by malaria. Pre admission medication was commoner for orthodox than traditional medication. No significant difference in mortality outcome was however noticed between children with co-morbidity and those without comorbidity, p > 0.05.Conclusion: The occurrence of comorbid conditions among children hospitalized for CAP in Maiduguri is common; however, the presence of co-morbidity did not significantly affect the mortality outcome of their management. It is recommended that the presence of comorbidity be actively looked for in children hospitalized for pneumonia, so as to effect holistic treatment, and improve the outcome of management.Keywords: Pneumonia, Children. Co-morbidity, Maiduguri, Mortality outcom

Tinjauan Deskriptif: Karakteristik Faktor-Faktor Health Seeking Behavior pada Pasien Disorder of Sex Development

Angka kejadian DSD 1:4, 500-5.500. Walalupun angka kejadian DSD masih rendah namun menurut penelitian banyak pasien terdiagnosis DSD ketika umur >2 tahun bahkan ada yang terdiagnosis ketika dewasa. Terdapat pasien yang mengalami late diagnose disebabkan oleh kurangnya Health Seeking Behavior. Penelitian ini bertujuan untuk mengidentifikasi faktor internal dan eksternal Health Seeking Behavior pasien DSD di RSUP Dr. Mohammad Hoesin Palembang pada tahun 2013-2017. Penelitian ini merupakan penelitian deskriptif dengan pendekatan cross sectional menggunakan data primer dan sekunder. Sampel diambil dengan menggunakan metode total sampling dari seluruh data rekam medik yang memenuhi kriterian inklusi. Dari 120 data pasien yang diperoleh, didapatkan 61 sampel pasien DSD di RSUP Dr. Mohammad Hoesin Palembang pada tahun 2013-2017. Pasien terdiagnosis paling banyak saat umur >6 - ≥12 tahun sebanyak 22 pasien (36,1%). Pasien dengan jenis kelamin laki-laki lebih banyak yaitu ditemukan 54 pasien (88,5%). Orang tua pasien yang mengantar anaknya paling banyak berumur 26-35 tahun untuk umur Ibu (52,5%) dan 36-45 tahun untuk umur Ayah (39,3%). Pendidikan terakhir orang tua pasien DSD merupakan tamat SMA (78,7%). Status ekonomi orang tua pasien DSD yang datang ke RSMH paling banyak ditemukan golongan kelas atas (50,8%) dan pasien terbanyak berasal dari Palembang (23%). Pasien DSD di RSUP Dr. Mohammad Hoesin Palembang masih banyak tergolong late diagnose ditinjau dari beberapa faktor Health Seeking Behavior

A Hidden Markov Model for Analysis of Frontline Veterinary Data for Emerging Zoonotic Disease Surveillance

Surveillance systems tracking health patterns in animals have potential for early warning of infectious disease in humans, yet there are many challenges that remain before this can be realized. Specifically, there remains the challenge of detecting early warning signals for diseases that are not known or are not part of routine surveillance for named diseases. This paper reports on the development of a hidden Markov model for analysis of frontline veterinary sentinel surveillance data from Sri Lanka. Field veterinarians collected data on syndromes and diagnoses using mobile phones. A model for submission patterns accounts for both sentinel-related and disease-related variability. Models for commonly reported cattle diagnoses were estimated separately. Region-specific weekly average prevalence was estimated for each diagnoses and partitioned into normal and abnormal periods. Visualization of state probabilities was used to indicate areas and times of unusual disease prevalence. The analysis suggests that hidden Markov modelling is a useful approach for surveillance datasets from novel populations and/or having little historical baselines

Utilisation of an operative difficulty grading scale for laparoscopic cholecystectomy

Background A reliable system for grading operative difficulty of laparoscopic cholecystectomy would standardise description of findings and reporting of outcomes. The aim of this study was to validate a difficulty grading system (Nassar scale), testing its applicability and consistency in two large prospective datasets. Methods Patient and disease-related variables and 30-day outcomes were identified in two prospective cholecystectomy databases: the multi-centre prospective cohort of 8820 patients from the recent CholeS Study and the single-surgeon series containing 4089 patients. Operative data and patient outcomes were correlated with Nassar operative difficultly scale, using Kendall’s tau for dichotomous variables, or Jonckheere–Terpstra tests for continuous variables. A ROC curve analysis was performed, to quantify the predictive accuracy of the scale for each outcome, with continuous outcomes dichotomised, prior to analysis. Results A higher operative difficulty grade was consistently associated with worse outcomes for the patients in both the reference and CholeS cohorts. The median length of stay increased from 0 to 4 days, and the 30-day complication rate from 7.6 to 24.4% as the difficulty grade increased from 1 to 4/5 (both p < 0.001). In the CholeS cohort, a higher difficulty grade was found to be most strongly associated with conversion to open and 30-day mortality (AUROC = 0.903, 0.822, respectively). On multivariable analysis, the Nassar operative difficultly scale was found to be a significant independent predictor of operative duration, conversion to open surgery, 30-day complications and 30-day reintervention (all p < 0.001). Conclusion We have shown that an operative difficulty scale can standardise the description of operative findings by multiple grades of surgeons to facilitate audit, training assessment and research. It provides a tool for reporting operative findings, disease severity and technical difficulty and can be utilised in future research to reliably compare outcomes according to case mix and intra-operative difficulty

Impact of pericardial adhesions on diastolic function as assessed by vortex formation time, a parameter of transmitral flow efficiency

<p>Abstract</p> <p>Background</p> <p>Pericardial adhesions are a pathophysiological marker of constrictive pericarditis (CP), which impairs cardiac filling by limiting the total cardiac volume compliance and diastolic filling function. We studied diastolic transmitral flow efficiency as a new parameter of filling function in a pericardial adhesion animal model. We hypothesized that vortex formation time (VFT), an index of optimal efficient diastolic transmitral flow, is altered by patchy pericardial-epicardial adhesions.</p> <p>Methods</p> <p>In 8 open-chest pigs, the heart was exposed while preserving the pericardium. We experimentally simulated early pericardial constriction and patchy adhesions by instilling instant glue into the pericardial space and using pericardial-epicardial stitches. We studied left ventricular (LV) function and characterized intraventricular blood flow with conventional and Doppler echocardiography at baseline and following the experimental intervention.</p> <p>Results</p> <p>Significant decreases in end-diastolic volume, ejection fraction, stroke volume, and late diastolic filling velocity reflected the effects of the pericardial adhesions. The mean VFT value decreased from 3.61 ± 0.47 to 2.26 ± 0.45 (P = 0.0002). Hemodynamic variables indicated the inhibiting effect of pericardial adhesion on both contraction (decrease in systolic blood pressure and +dP/dt decreased) and relaxation (decrease in the magnitude of -dP/dt and prolongation of Tau) function.</p> <p>Conclusion</p> <p>Patchy pericardial adhesions not only negatively impact LV mechanical functioning but the decrease of VFT from normal to suboptimal value suggests impairment of transmitral flow efficiency.</p

Management of granulomatous lobular mastitis: an international multidisciplinary consensus (2021 edition)

Granulomatous lobular mastitis (GLM) is a rare and chronic benign inflammatory disease of the breast. Difficulties exist in the management of GLM for many front-line surgeons and medical specialists who care for patients with inflammatory disorders of the breast. This consensus is summarized to establish evidence-based recommendations for the management of GLM. Literature was reviewed using PubMed from January 1, 1971 to July 31, 2020. Sixty-six international experienced multidisciplinary experts from 11 countries or regions were invited to review the evidence. Levels of evidence were determined using the American College of Physicians grading system, and recommendations were discussed until consensus. Experts discussed and concluded 30 recommendations on historical definitions, etiology and predisposing factors, diagnosis criteria, treatment, clinical stages, relapse and recurrence of GLM. GLM was recommended as a widely accepted definition. In addition, this consensus introduced a new clinical stages and management algorithm for GLM to provide individual treatment strategies. In conclusion, diagnosis of GLM depends on a combination of history, clinical manifestations, imaging examinations, laboratory examinations and pathology. The approach to treatment of GLM should be applied according to the different clinical stage of GLM. This evidence-based consensus would be valuable to assist front-line surgeons and medical specialists in the optimal management of GLM.Improving the Ability of Diagnosis and Treatment of Difficult Disease