Primary hydatid cyst of erector spinae muscle of upper back

Hydatid disease is a zoonosis caused by an infection with the larvae of the tapeworm Echinococcus granulosus, it mostly involves liver and lungs but it may exceptionally affect muscle. We report the case of a 29 years old man who was admitted to our surgical clinic with a primary hydatid cyst in erector spinae muscle of upper back diagnosed by clinic examination, imaging and serological testing. The treatment was a complete pericystectomy and chemotherapy by antiparasitic drugs. Hydatid disease is an endemic disease in sheep-producing regions. In human, this disease involves usually the liver and the lungs and exceptionally the muscle. The diagnosis may be challenging, as it should consider arguments such as history, physical examination, imaging and serological testing. The best treatment is pericystectomy with perioperative chemotherapy to reduce risk of occurrence. The hydatid cyst of erector spinae muscle is exceptional even in endemic area, the diagnosis may be challenging and the surgery is the gold standard of treatment

Analysis of mitochondrial DNA alteration in new phenotype ACOS

BACKGROUND: Mitochondria contain their own DNA (MtDNA) that is very sensitive to oxidative stress and as a consequence could be damaged in quantity. Oxidative stress is largely recognized to play a key role in the pathogenesis of asthma and COPD and might have a role in the new intermediate phenotype ACOS (asthma-COPD overlap syndrome). The aim of this study was to investigate MtDNA alterations, as an expression of mitochondrial dysfunction, in ACOS and to verify whether they might help in the identification of this new phenotype and in its differentiation from asthma and COPD. METHODS: Ten (10) ACOS according to Spanish guidelines, 13 ACOS according to GINA guidelines, 13 COPD, 14 asthmatic patients and ten normal subjects were enrolled. They further underwent a blood, induced sputum and exhaled nitric oxide collection. Content of MtDNA and nuclear DNA (nDNA) were measured in the blood cells of patients by Real Time PCR. RESULTS: ACOS patients showed an increase of MtDNA/nDNA ratio. Dividing ACOS according to guidelines, those from the Spanish showed a higher value of MtDNA/nDNA compared to those from GINA/GOLD (92.69 ± 7.31 vs 80.68 ± 4.16). Spanish ACOS presented MtDNA/nDNA ratio closer to COPD than asthma. MtDNA was higher in asthmatic, COPD, GINA and Spanish ACOS patients compared to healthy subjects (73.30 ± 4.47–137.0 ± 19.45–80.68 ± 4.16–92.69 ± 7.31 vs 65.97 ± 20.56). CONCLUSION: We found an increase of MtDNA/nDNA ratio in ACOS subjects that led us to conclude that there is presence of mitochondrial dysfunction in this disease, that makes it closer to COPD than to asthma. Although the MtDNA/nDNA ratio results are a useful marker for differential diagnosis from asthma, COPD and ACOS, further studies are needed to confirm the potentiality of MtDNA/nDNA ratio and to a better characterization of ACOS. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12890-016-0192-6) contains supplementary material, which is available to authorized users

ANALYSIS OF INDIA’S TRADE RELATION WITH AFRICA

The paper applies basic and augmented gravity model to estimate India’s trade potential with different African countries. Panel data for the period 2010-2017 is employed in the analysis. The results obtained from the model are then used to predict trade potential between India and African Countries. Results reveal that India's trade potential is tremendous in these countries. However, some important obstacles account for the low level of trade between India and African countries which specifically include negligible market access, trade facilitation issues and asymmetric information. To reap the trade potential and to enhance trade between India and African countries, India should put effort

Deteriorating agriculture: it's reasons and impacts on socio-economic profile of J&K state

In terms of dependence on livelihoods and employment, the state of Jammu and Kashmir can be considered as agrarian, hence the overwhelming majority of the people live in rural areas. There are many reasons that have led to a dwindling share of GDP of the sector at a time when it should have retained its role given large proportion of people depending on it. These include: Reduction in public expenditure in the sector after reforms, decrease in agricultural land due to conversion, lack of appropriate irrigation facilities, and acute lack of infrastructure, lack of quality pesticides, occasional flooding, and lack of research. This imbalance between production and employment has resulted into compromised socio-economic profile of the state which includes: Low per capita income, compromised Food security, large Capital outflow, and Low employment. Therefore, in a bid to arrest any further deterioration in its socioeconomic profile, it is imperative for the state to initiate a stream of measures that will enhance the productivity in the sector and safeguard it from undue competition from abroad

Deteriorating agriculture: it's reasons and impacts on socio-economic profile of J&K state

In terms of dependence on livelihoods and employment, the state of Jammu and Kashmir can be considered as agrarian, hence the overwhelming majority of the people live in rural areas. There are many reasons that have led to a dwindling share of GDP of the sector at a time when it should have retained its role given large proportion of people depending on it. These include: Reduction in public expenditure in the sector after reforms, decrease in agricultural land due to conversion, lack of appropriate irrigation facilities, and acute lack of infrastructure, lack of quality pesticides, occasional flooding, and lack of research. This imbalance between production and employment has resulted into compromised socio-economic profile of the state which includes: Low per capita income, compromised Food security, large Capital outflow, and Low employment. Therefore, in a bid to arrest any further deterioration in its socioeconomic profile, it is imperative for the state to initiate a stream of measures that will enhance the productivity in the sector and safeguard it from undue competition from abroad

Intraoperative parathyroid hormone monitoring in guiding adequate parathyroidectomy

Background: Parathyroidectomy has been traditionally performed through bilateral neck exploration (BNE). However, with the use of intraoperative parathyroid hormone (IOPTH) assay along with preoperative localization studies, focused parathyroidectomy can be performed with good surgical success rate, multiglandular disease can be predicted, and hence recurrence and surgical failure can be prevented. Furthermore, it predicts eucalcemia in the postoperative period. The aim of this study was to evaluate the usefulness of IOPTH assay in guiding adequate parathyroidectomy in patients of primary hyperparathyroidism. Materials and Methods: Between year 2015 and 2017, 45 patients of primary hyperparathyroidism underwent parathyroidectomy with IOPTH assay employed as an intraoperative tool to guide the surgical procedure. Blood samples were collected: (1) at preincision time, (2) preexcision of gland, (3) 5-min postexcision of gland, and (4) 10-min postexcision of gland. On the basis of the Irvin criterion, an intraoperative PTH drop >50% from the highest either preincision or preexcision level after parathyroid excision was considered a surgical success. Otherwise, BNE was performed and search for other parathyroid glands done. Results: Ten-min postexcision PTH levels dropped >50% in 34 (75.6%) patients. True positive among them were 31 (68.8%), true negative 8 (17.7%), false positive 3 (6.6%), and false negative 3 (6.6%). We performed focused exploration at the outset in 40 (88.9%) patients and bilateral exploration for five patients as guided by preoperative localizing studies. Hence, IOPTH was helpful in guiding further exploration in 8 (17.7%) patients and prevented further exploration in 32 (71.1%) patients and also was able to predict eucalcemia in 97.7% patients at 6 months. Thus, IOPTH was able to obviate or to ask for additional procedure in 88.8% of patients. However, in three (6.6%) patients, IOPTH would guide unnecessary exploration and in equally, that is, three (6.6%) patients may require reoperation for unidentified parathyroids. Conclusion: IOPTH in adjunct with other localizing studies is very helpful for carrying out successful parathyroidectomy in uniglandular disease and predicting postoperative eucalcemia. However, more importantly, its role is valuable in equivocal imaging, in such cases, it prevents unnecessary exploration or helps in adequate parathyroidectomy

Clinical study of neoplastic thyroid swellings

The prospective study of 108 patients of thyroid malignancy were studied with regard to surgical management in SKIMS, Srinagar. Thyroidmalignancy constituted 0.12%of total hospital admissions. It was seenmainly in patients belonging to rural areas (66.67%).The commonest observed thyroidmalignancywas papillary carcinoma (48.15%), followed by follicular carcinoma (37.04%), anaplastic carcinoma (7.41%), medullary carcinoma (5.55%) and malignant lymphoma (1.85%). Femaleswere affectedmore commonlywith a female tomale ration of 3.1:1.Patients ranged in age from 8 years to 70 years. Maximum number of cases with papillary carcinoma (34.62%), follicular carcinoma (40%) and anaplastic carcinoma (66.67%) presented in 4th, 5th and 6th decades of life respectivelywith a mean age of 34.85 years, 42.40 years and 61.25 years for papillary, follicular and anaplastic carcinoma respectively. Swelling in front of neckwas themost common (96.29%) presenting symptom, followed by hoarseness of voice. The majority of patients were having hard swellings with nodular surfaces and the swelling were free.No patient had retrosternal extension of thyroid swelling. 18.51% of patients had clinically palpable lymph nodes. Fine needle aspiration cytology was an important adjuvant to pre-operative diagnosis having sensitivity of 92.59%and specificity of 100%.Thyroid scan detected cold nodule/nodules inmaximumnumber (90.74%) of patients. Indirect laryngoscopy detected vocal cord palsy in 14.81% patients pre-operatively. Total thyroidectomy was performed in maximum (83.33%) number of patients followed by near total thyroidectomy. The main post-operative complications were hypoparathyroidism (12.96%) and recurrent laryngeal nerve palsy (11.11%). Anaplastic carcinoma was found a rapidlygrowing tumour,with a limited surgical scope.Department of General Surgery SKIMS, Soura, Srinagar (India

Evaluating conservative treatment for acute appendicitis with lump formation

Background: Interval appendectomy after acute appendicitis with lump formation (phlegmon) remains controversial. We conducted this study to determine the risk of recurrent appendicitis following initial non-operative treatment for appendicitis, and evaluate factors associated with recurrence. Secondarily, we evaluate the efficacy of interval appendectomy versus no appendectomy. Materials and Methods: Patients who received conservative treatment for appendicitis with lump formation were prospectively studied from June 2006 to June 2008. These patients were followed for recurrence of appendicitis. Results: Of 763 patients with acute appendicitis some 220 patients had lump formation (28.8%). Median age was 28 years. Conservative treatment was successful in 213 (96.8%) patients. The rate of recurrence was 13.1%, all occurring within six months after the index admission. Mean follow-up was 26±18 months. Conclusion: Conservative treatment of appendicitis with lump formation is efficient and the recurrence rate is low. Routine interval appendectomy after initial conservative treatment for lump formation is not a cost-effective intervention and not recommended

Primary Retroperitoneal Hydatid Cyst: a Rare Case Report

Hydatid disease is a parasitic tapeworm infestation that usually involves liver and lungs. Primary retroperitoneal hydatid without liver and lung involvement is very rare. Surgery is the principle method of treatment for large retroperitoneal hydatid, whenever feasible. We report a case of primary retroperitoneal hydatid cyst in 29-year-old male patient

Probing the Phytochemical Composition and Antioxidant Activity of <i>Moringa oleifera</i> under Ideal Germination Conditions

Moringa oleifera is a rich source of polyphenols whose contents and profile may vary according to environmental conditions, harvest season, and plant tissue. The present study aimed to characterize the profile of phenolic compounds in different tissues of M. oleifera grown under different temperatures (25, 30, and 35 °C), using HPLC/MS, as well as their constituent phytochemicals and in vitro antioxidant activities. The in vitro antioxidant activity of the extracts was evaluated using the 2,2-diphenyl-1-picrylhydrazyl (DPPH), 2,2-azino-bis-3-ethylenebenzothiozoline-6-sulfonicacid (ABTS), and ferric-reducing antioxidant power (FRAP) methods. The polyphenolic compounds were mainly found in the leaves at 30 °C. UPLC/QTOF-MS allowed for the identification of 34 polyphenolic components in seedlings, primarily consisting of glucosides, phenols, flavonoids, and methoxy flavones. At 30 °C, the specific activities of antioxidative enzymes were the highest in leaves, followed by seedlings and then seeds. The leaf and seed extracts also exhibited a greater accumulation of proline, glycine betaine, and antioxidants, such as ascorbic acid, and carotenoids, as measured by the inhibition of ROS production. We found that changes in the expression levels of the validated candidate genes Cu/Zn-SOD, APX, GPP, and TPS lead to significant differences in the germination rate and biochemical changes. These findings demonstrate that M. oleifera plants have high concentrations of phytochemicals and antioxidants, making them an excellent choice for further research to determine their use as health-promoting dietary supplements