Peripheral arterial disease - high prevalence in rural black South Africans

Background. The prevalence of peripheral arterial disease (PAD) worldwide  has been estimated at between 4.5% and 29%. PAD has been associated  with male gender, advanced age, diabetes, hypertension,  hypercholesterolaemia and smoking. Clinical experience with amputations at Mthatha General Hospital, a district hospital in the Eastern Cape, suggests that PAD is common, but the actual prevalence has not been  determined. The Eastern Cape is a rural area and patients attending the hospital are mostly Xhosa-speakers.Objectives. To assess the prevalence of PAD and associated risk factors among patients attending the hospital.Methods. Five hundred and forty-two patients over 50 years of age  attending the outpatient department were systematically selected. Gender, body mass index (BMI), blood pressure, capillary blood glucose and smoking status were determined. The ankle-brachial pressure index (ABPI) was measured by Doppler ultrasound, and PAD was defined as a ratio less than 0.9. Results. Of 542 patients (315 females, 227 males), 159 (29.3%) had an ABPI of less than 0.9. The mean age was 62.4 years and the range 50 - 95 years. In a stepwise logistical regression analysis smoking had a significant adjusted odds ratio for PAD of 4.29 (2.68- 6.95), diabetes 1.72 (1.11-  2.69) and male sex 1.69 (1.06 - 2.68). Obesity as measured by BMI and hypertension were not associated with PAD.Conclusion and recommendations. Prevalence of PAD was relatively high in this sample of rural black patients when compared with findings from other countries. Preventive interventions should focus on control of diabetes and smoking cessation. Surprisingly, the prevalence was higher in those witha normal BMI and without hypertension, and risk factors in this community should be studied further. Physicians in this setting should be more aware of the possibility of undetected PAD

Gliomatosis peritonei arising in setting of immature teratoma of ovary: a case report

A 14 years old girl presented to the gynecology OPD with pain abdomen and huge abdominal lump since 2 months. On clinical examination, a large mass of 20x15 cm size was found extended upto the xiphoid process. Serum studies showed rise of CA-125 up to 406.9U/mL and LDH up to 310U/L. USG shows right ovarian cyst of 14.8x14.1x12.8 cm with internal calcification. MRI revealed a well encapsulated mass of 21x19x17cm with solid and cystic mass and upward peritoneal extension. Exploratory laparotomy was performed with right sided salpingo- ophorectomy with infracolic omentectomy, as the omentum appeared granular. She had an uneventful post-operative recovery. Subsequently HPE showed immature teratoma NORRIS grade 3 with co-existent peritoneal gliomatosis (grade 0). She is under regular follow-up and decided to give six cycles of combination chemotherapy with BEP at regional cancer hospital

Rare case reports of ruptured ectopic pregnancy

Two patients of 30-35 years of age presented in Gynecological emergency of Agartala Government Medical College at unstable condition with the diagnosis of ruptured ectopic pregnancy. Both the cases were taken for emergency laparotomy after initial resuscitation, investigations & arrangement of blood products. In both the cases rupture were found in right side and hence right sided salpingectomy done in both the cases. Both the tubes (affected) after laparotomy were sent for histopathological examination where both the reports came to be partial mole. Ectopic hydatiform mole (either complete or partial) are rare events, among these Ectopic partial moles are rarer. Both the cases were in regular follow up & ß-HCG levels came to the base level within 6-7 wks. The 1st case became pregnant after 9 months of laparotomy

Effect of local chemistry and structure on thermal transport in doped GaAs

Using a first-principles approach, we analyze the impact of \textit{DX} centers formed by S, Se, and Te dopant atoms on the thermal conductivity of GaAs. Our results are in good agreement with experiments and unveil the physics behind the drastically different effect of each kind of defect. We establish a causal chain linking the electronic structure of the dopants to the thermal conductivity of the bulk solid, a macroscopic transport coefficient. Specifically, the presence of lone pairs leads to the formation of structurally asymmetric \textit{DX} centers that cause resonant scattering of incident phonons. The effect of such resonances is magnified when they affect the part of the spectrum most relevant for thermal transport. We show that these resonances are associated with localized vibrational modes in the perturbed phonon spectrum. Finally, we illustrate the connection between flat adjacent minima in the energy landscape and resonant phonon scattering through detailed analyses of the energy landscape of the defective structures.Comment: 7 pages, 7 figure

Spatial beam dynamics in graded-index multimode fibers under Raman amplification:a variational approach

We investigate the spatial beam dynamics inside a multimode graded-index fiber under Raman amplification by adopting a semi-analytical variational approach. The variational analysis provides us with four coupled ordinary differential equations that govern the beam's dynamics under Raman gain and are much faster to solve numerically compared to the full nonlinear wave equation. Their solution also provides considerable physical insight and allows us to study the impact of important nonlinear phenomena such as self-focusing and cross-phase modulation. We first show that the variational results corroborate well with full numerical simulations and then use them to investigate the signal's dynamics under different initial conditions such as the initial widths of the pump and signal beams. This allows us to quantify the conditions under which the quality of a signal beam can improve, without collapse of the beam owing to self-focusing. While time-consuming full simulations may be needed when gain saturation and pump depletion must be included, the variational method is useful for gaining valuable physical insight and for studying dependence of the amplified beam's width and amplitude on various physical parameters in a faster fashion.Comment: 7 pages, 6 figure