Corridor Roof Causing Almost Decapitation: a Rare Case Report

Background: Cut throat injury can be homicidal, suicidal or accidental in manner. However, in the absence of tentative cuts, deep cut throat injury usually raised suspicion towards homicide, even against the circumstantial history provided by close relatives or eye witness. Decapitation or almost decapitation is usually noticed in homicidal assault using any heavy cutting weapon like sword and axe or in suicidal railway injury.Case Report: A 91-years old, otherwise healthy lady (empress of one high profile Company) died due to almost decapitation as a result of accidental fall of wheel chair and trapping of neck underneath roof of corridor while moving up in an elevator (lift). With suspicion of property dispute, the investigating police agency was not ready to accept it as a case of accident till the neck injury was clarified demonstrating associated injuries during autopsy and later during visit to scene of death.Conclusion: In high profile case, video recording of autopsy findings, even if not mandatory as per the law, should be made to remain in safer side. Although police should not be allowed during conduction of autopsy, it will be healthy practice to clarify any doubts then and there over autopsy table, if the case warrants so

Fatal Dog Bite Injury – A Case Report

Background: Dog bite is one of the most common childhood accidents causing significant morbidity and mortality in pediatrics age group (1). The exposed position compounded by the short stature of children makes the face very vulnerable to dog bite or animal bite injuries. Unlike wounds inflicted by assaults and accidents, animal bite wounds are distinctive as they are puncture type deep wounds which are injected by the bite force, with inoculums of pathogenic bacteria from the saliva of the attacking dog.Case Report: A case of a 2 month-old child who had succumbed to multiple facial and head bite injuries is presented. At autopsy, multiple bite wounds were noted on the upper part of body like face, head, chest and abdomen. Distinctive bite marks diagnostic of canine dentition were present, most prominently on the head, face and chest. Death was due to cranio-cerebral damage.Conclusion: Public health notification should occur for all dog bites. This would facilitate the development of regional dog bite registries with information on incidence and dogs at risk, which in turn could guide policies such as leash laws and licensing

Proof of concept: A bioinformatic and serological screening method for identifying new peptide antigens for Chlamydia trachomatis related sequelae in women

This study aimed to identify new peptide antigens from Chlamydia (C.) trachomatis in a proof of concept approach which could be used to develop an epitope-based serological diagnostic for C. trachomatis related infertility in women. A bioinformatics analysis was conducted examining several immunodominant proteins from C. trachomatis to identify predicted immunoglobulin epitopes unique to C. trachomatis. A peptide array of these epitopes was screened against participant sera. The participants (all female) were categorized into the following cohorts based on their infection and gynecological history; acute (single treated infection with C. trachomatis), multiple (more than one C. trachomatis infection, all treated), sequelae (PID or tubal infertility with a history of C. trachomatis infection), and infertile (no history of C. trachomatis infection and no detected tubal damage). The bioinformatics strategy identified several promising epitopes. Participants who reacted positively in the peptide 11 ELISA were found to have an increased likelihood of being in the sequelae cohort compared to the infertile cohort with an odds ratio of 16.3 (95% c.i. 1.65-160), with 95% specificity and 46% sensitivity (0.19-0.74). The peptide 11 ELISA has the potential to be further developed as a screening tool for use during the early IVF work up and provides proof of concept that there may be further peptide antigens which could be identified using bioinformatics and screening approaches. © 2013 The Authors

The Increasing Role of Rhythm Control in Patients With Atrial Fibrillation: JACC State-of-the-Art Review.

The considerable mortality and morbidity associated with atrial fibrillation (AF) pose a substantial burden on patients and health care services. Although the management of AF historically focused on decreasing AF recurrence, it evolved over time in favor of rate control. Recently, more emphasis has been placed on reducing adverse cardiovascular outcomes using rhythm control, generally by using safe and effective rhythm-control therapies (typically antiarrhythmic drugs and/or AF ablation). Evidence increasingly supports early rhythm control in patients with AF that has not become long-standing, but current clinical practice and guidelines do not yet fully reflect this change. Early rhythm control may effectively reduce irreversible atrial remodeling and prevent AF-related deaths, heart failure, and strokes in high-risk patients. It has the potential to halt progression and potentially save patients from years of symptomatic AF; therefore, it should be offered more widely

Tuberculous extensor tenosynovitis of the wrist with extensor pollicis longus rupture: a case report

<p>Abstract</p> <p>Introduction</p> <p>The tendon sheaths constitute an uncommon target of extra-articular tuberculosis.</p> <p>Case presentation</p> <p>We present a rare case of tuberculous tenosynovitis of the wrist involving the extensor tendon with rupture of the extensor pollicis longus tendon in a 55-year-old Indian man.</p> <p>Conclusion</p> <p>Prompt surgical debridement and tissue diagnosis are essential for the diagnosis and treatment of this type of infection. With an accurate and timely diagnosis, appropriate surgery and antituberculous treatment may eradicate these infections and prevent complications.</p

Malaria mosquito control using edible fish in western Kenya: preliminary findings of a controlled study

<p>Abstract</p> <p>Background</p> <p>Biological control methods are once again being given much research focus for malaria vector control. This is largely due to the emerging threat of strong resistance to pesticides. Larvivorous fish have been used for over 100 years in mosquito control and many species have proved effective. In the western Kenyan highlands the larvivorous fish <it>Oreochromis niloticus </it>L. (Perciformes: Cichlidae) (formerly <it>Tilapia nilotica</it>) is commonly farmed and eaten but has not been previously tested in the field for malaria mosquito control.</p> <p>Methods</p> <p>This fish was introduced into abandoned fishponds at an altitude of 1,880 m and the effect measured over six months on the numbers of mosquito immatures. For comparison an untreated control pond was used. During this time, all ponds were regularly cleared of emergent vegetation and fish re-stocking was not needed. Significant autocorrelation was removed from the time series data, and t-tests were used to investigate within a pond and within a mosquito type any differences before and after the introduction of <it>O. niloticus</it>. Mulla's formula was also used on the raw data to calculate the percentage reduction of the mosquito larvae.</p> <p>Results</p> <p>After <it>O. niloticus </it>introduction, mosquito densities immediately dropped in the treated ponds but increased in the control pond. This increase was apparently due to climatic factors. Mulla's formula was applied which corrects for that natural tendency to increase. The results showed that after 15 weeks the fish caused a more than 94% reduction in both <it>Anopheles gambiae s.l</it>. and <it>Anopheles funestus </it>(Diptera: Culicidae) in the treated ponds, and more than 75% reduction in culicine mosquitoes. There was a highly significantly reduction in <it>A. gambiae s.l</it>. numbers when compared to pre-treatment levels.</p> <p>Conclusion</p> <p>This study reports the first field trial data on <it>O. niloticus </it>for malaria mosquito control and shows that this species, already a popular food fish in western Kenya, is an apparently sustainable mosquito control tool which also offers a source of protein and income to people in rural areas. There should be no problem with acceptance of this malaria control method since the local communities already farm this fish species.</p

Endocytosis of the Anthrax Toxin Is Mediated by Clathrin, Actin and Unconventional Adaptors

The anthrax toxin is a tripartite toxin, where the two enzymatic subunits require the third subunit, the protective antigen (PA), to interact with cells and be escorted to their cytoplasmic targets. PA binds to cells via one of two receptors, TEM8 and CMG2. Interestingly, the toxin times and triggers its own endocytosis, in particular through the heptamerization of PA. Here we show that PA triggers the ubiquitination of its receptors in a β-arrestin-dependent manner and that this step is required for clathrin-mediated endocytosis. In addition, we find that endocytosis is dependent on the heterotetrameric adaptor AP-1 but not the more conventional AP-2. Finally, we show that endocytosis of PA is strongly dependent on actin. Unexpectedly, actin was also found to be essential for efficient heptamerization of PA, but only when bound to one of its 2 receptors, TEM8, due to the active organization of TEM8 into actin-dependent domains. Endocytic pathways are highly modular systems. Here we identify some of the key players that allow efficient heptamerization of PA and subsequent ubiquitin-dependent, clathrin-mediated endocytosis of the anthrax toxin

Stress factors and stress management interventions: the heuristic of “bottom up” an update from a systematic review

Organizations have increasingly sought to adopt innovative interventions to prevent stress-related issues. In the field of manufacturing, however, the effectiveness of these interventions remains unclear because a systematic and specific review of existing primary evidence has not been undertaken. The present systematic literature review sought to address the foregoing limitation in the literature by summarizing the main source of stress and effectiveness of stress management interventions as grounded in the context of manufacturing. Our review was limited to only randomized clinical trials (RCTs) and quasi-experimental studies and concerned employees from the manufacturing sector. Twenty-two studies on primary, secondary and tertiary interventions across four continents (Asia, Europe, USA and South America) were selected and analyzed in terms of stress factors, methodological properties and outcomes. Most of these were RCT studies (68% Vs 32%) with a majority of secondary interventions (N = 11, 50%), followed by primary (N = 5, 22%), tertiary (N = 3, 13%), and two (9%) mixed interventions. The main outcomes included an improvement of psychological wellbeing, decreased stress reactivity and an increment of general health. There was a predominance of interventions utilizing skills programs and/or cognitive-behavioral techniques. The main source of stress reported related to professional identity, organizational deficiencies, interpersonal conflicts, physical complaints and poor work environment. Taken together, the findings provide important theoretical and practical implications for advancing the study of stress factors and the use of stress management interventions in the workplace. The prerequisite for a successful intervention is to address the real problems experienced by professionals and help them to cope with their difficult situations. The strategy of “bottom-up” offers a potential means of enhancing employees’ health and well-being; however, the most effective means of implementing these interventions needs to be understood better