Ostry zespół wieńcowy u 16-letniego chłopca — opis przypadku

Spontaneous coronary artery dissection is a rare but important cause of acute coronary syndromes in young patients.16-year-old boy presented as acute anterior wall myocardial infarction for which he was thrombolysed. Coronary angiogramshowed spiral luminal filling defects, with extensive contrast staining of proximal left anterior descending arteryand its branches. The patient refused angioplasty, which was advised, and was managed conservatively. Three weekslater he presented with acute coronary syndrome with unstable angina. Repeated angiogram showed complete healingof dissection. The hospital course of the patient was uncomplicated. This shows, that sometimes higher grade dissectionbeside intervention, can respond to conservative management as well.Samoistne rozwarstwienie tętnicy wieńcowej jest rzadką, lecz ważną, przyczyną ostrych zespołów wieńcowych u młodych pacjentów. W niniejszej pracy przedstawiono przypadek 16-letniego chłopca, u którego wystąpił ostry zawał ściany przedniej. Zastosowano leczenie trombolityczne. W koronarografii stwierdzono ubytki wypełnienia w kształcie spiralnym z silnym zakontrastowaniem proksymalnego odcinka gałęzi międzykomorowej przedniej i jej gałęzi. Zalecono wykonanie angioplastyki wieńcowej, jednak chory nie wyraził zgody na zabieg i w związku z tym zastosowano leczenie zachowawcze. Po 3 tygodniach u pacjenta wystąpił ostry zespół wieńcowy w postaci niestabilnej dławicy piersiowej. W wykonanym powtórnie angiogramie stwierdzono całkowite wygojenie rozwarstwienia. Hospitalizacja chorego przebiegała bez powikłań. Opisany przypadek pokazuje, że w niektórych rozwarstwieniach znacznego stopnia można uzyskać dobrą odpowiedź na leczenie zachowawcze bez zabiegów interwencyjnych

A study of knowledge beliefs and attitudes regarding aids and human sexuality among medical college, engineering college and university Undergraduates of gorakhpur.

Research Problem: i) What is the level of knowledge and altitude of undergraduates about AIDS and human sexuality? ii) What arc the preferred modes of obtaining such knowledge?. Objectives: To assess the knowledge, beliefs and attitudes of undergraduate students regarding AIDS and human sexuality. Study Design: Self administered questionnaire. Setting and Participants: 1289 undergraduates from B.R.D. Medical College., M. M. M. Engineering College and University of Gorakhpur. Study Variables: Knowledge, beliefs and attitudes regarding AIDS and sexuality. Outcome Variables: Proportion of students having correct knowledge and positive attitudes. Statistical Analysis: By proportions. Result: l.evcl of knowledge about AIDS was generally high. Most of the students obtained knowledge about it through mass media. Few students had misconceptions about transmission of 1IIV infection. Knowledge about sex was obtained mainly from friends (36%) and books (31.31%). Most of the students preferred doctors (44.15%) and friends (43.66%) for asking something about sex. and not their parents (4.37%) or teachers (4.61%). 59.13% of boys and 34.49% of girls thought that students of their age had sex. Conclusion and Recommendations: The most peculiar fact in (his study is that students have no reliable means of obtaining correct information about subjects related to sex. Medical profession contributed very little in providing such knowledge. Most of them relied on their friends for such information. So. emphasis is to be given on recommending proper education material for the youth

Cataract and its risk factor among adults residing in South Bihar, India

Background: Cataract is considered as one of the most common causes of visual impairment and the leading cause of blindness in the world. Age related cataract occurs in people above 50 years of age and the its pathogenesis is multifactorial. Therefore, the present study was aimed to assess the prevalence and risk factors for cataract.Methods: Community based cross sectional study was conducted among adults residing at urban areas of South Bihar. The data was collected by interview method, using pre-tested semi-structured questionnaire which contains socio-demographic data, dietary habits, history of diabetes or hypertension, family history of cataract and long-term sun exposure.Results: Among 240 participants, 94 (39.2%) were male and 146 (60.8%) were female. Maximum participants were aged more than 70 years. The prevalence of cataract was 52.1%.Conclusions: The prevalence of cataract was quite high and was significantly associated with age, long term sun exposure and family history of cataract

Community attitudes towards Amur tigers (Panthera tigris altaica) and their prey species in Yanbian, Jilin province, a region of northeast China where tigers are returning

Community attitudes towards large carnivores are of central importance to their conservation in human-dominated landscapes. In this study, we evaluate community attitudes and perceptions towards the Amur tiger (Panthera tigris altaica), Amur leopard (Panthera pardus orientalis) and bears (Ursus thibetanus and Ursus arctos), as well as their prey species, namely sika deer (Cervus nippon), roe deer and wild boar (Sus scrofa), in Yanbian Korean Autonomous Prefecture, Jilin province, northeast China. We surveyed 139 households and found that community members' perceptions of large carnivores and their prey species were influenced by their predominant economic activities; their prior interactions with wildlife; their household income level; and whether they were either long-term residents of Yanbian or had migrated to the region from elsewhere in China. We recorded fairly neutral attitudes towards large carnivores among the communities we surveyed, but strongly negative attitudes were shown towards wild boar, particularly where respondents had lost agricultural products to crop raiding by wild boar. We recommend conservation stakeholders in northeast China utilise this finding to encourage support for large carnivore recovery and conservation by targeting messaging around the importance of the tiger as a key predator of wild boar in the ecosystem. Furthermore, our findings suggest that government provided compensation paid for cattle lost to large carnivore predation (notably, by tigers) may be helping to reduce animosity from cattle owners towards large carnivores. However, we also highlight that compensation for loss of livestock is therefore performing a useful role in mitigating human-wildlife conflict, that there are potentially unintended consequences of the current compensation program, for example it fails to dissuade livestock grazing in protected areas

Epidemiology and Clinicopathological Profile of Renal Cell Carcinoma: A Review from Tertiary Care Referral Centre

Renal cell carcinoma (RCC) accounts for 3% of all adult cancers and 85% of all kidney tumours. Incidence of RCC is lower in Asian region, particularly in India, probably due to lack of reporting. Most of the data about RCC are from Western countries; and data from India are scarce, especially regarding para-neoplastic syndromes. We sought to determine the epidemiology, clinicopathological profile and management of RCCin a tertiary care centre in Western India. This was a retrospective study that involved data analysis of records of RCC patients who presented to our institution from April 2016 to February 2020. Laboratory investigations, including tests for paraneoplastic syndrome (PNS), and relevant radiologic investigations were performed and treatment was offered according to the stage, patient factors and available modalities. A total 142 RCC patients were included in the study. The median age of presentation was 58 years. Most of the patients (67%) were symptomatic, and 33% of the patients were asymptomatic, and the RCC was diagnosed incidentally. A large number of patients (56.3%) had PNS. The most common histopathologic type of RCC was clear cell carcinoma (68.8%), followed by papillary (20%) and chromophobe (8%) carcinoma. 40% of carcinomas with sarcomatoid differentiation were seen in patients under 50 years of age. Two cases of multicystic RCC were both seen in patients less than 50 years of age. 65.5% of the patients presented at Stage 1 and 2. Most surgeries (71.2%) were done in a minimally invasive manner. A significant number of patients were asymptomatic, in which RCC was detected incidentally. The age of presentation was earlier, yet the patients had a higher tumour stage. More than half of the patients had PNSs. Despite growing trend towards Western data, the significantly higher number of patients with PNSs and early age of presentation suggest inherent differences in tumour biology, possibly related to differences in genetic and environmental factors

Metagenomics Analysis of Thrombus Samples Retrieved from Mechanical Thrombectomy

Purpose The purpose of this study was to assess the microbiota in middle cerebral artery thrombi retrieved in mechanical thrombectomy arising out of symptomatic carotid plaque within 6 hours of acute ischemic stroke. Thrombi were subjected to next-generation sequencing for a bacterial signature to determine their role in atherosclerosis. Materials and Methods We included 4 human middle cerebral artery thrombus samples (all patients were male). The median age for the patients was 51±13.6 years. Patients enrolled in the study from Pacific Medical University and Hospital underwent mechanical thrombectomy in the stroke window period. All patients underwent brain magnetic resonance angiography (MRA) and circle of Willis and neck vessel MRA along with the standard stroke workup to establish stroke etiology. Only patients with symptomatic carotid stenosis and tandem lesions with ipsilateral middle cerebral artery occlusion were included in the study. Thrombus samples were collected, stored at –80 degrees, and subjected to metagenomics analysis. Results Of the 4 patients undergoing thrombectomy for diagnosis with ischemic stroke, all thrombi recovered for bacterial DNA in qPCR were positive. More than 27 bacteria were present in the 4 thrombus samples. The majority of bacteria were Lactobacillus, Stenotrophomonas, Pseudomonas, Staphylococcus, and Finegoldia. Conclusion Genesis of symptomatic atherosclerotic carotid plaque leading to thromboembolism could be either due to direct mechanisms like acidification and local inflammation of plaque milieu with lactobacillus, biofilm dispersion leading to inflammation like with pseudomonas fluorescence, or enterococci or indirect mechanisms like Toll 2 like signaling by gut microbiota

DESIGN AND PERFORMANCE VERIFICATION OF NEWLY DEVELOPED DISPOSABLE STATIC DIFFUSION CELL FOR DRUG DIFFUSION/PERMEABILITY STUDIES

Objectives: The present study describes a disposable static diffusion cell for in vitro diffusion studies to achieve better results as compared to well existing Franz diffusion cell (FDC) in terms of the absence of bubbles, variable receptor compartment, ease of handling, and faster results.Materials and Methods: The cell consists of a cup-shaped donor compartment made of semi permeable that could be either cellophane membrane or, animal skin fitted to a rigid frame, which is supported on a plastic plate that contains a hole for the sample withdrawal. The receptor compartment is a separate unit, and it could be any container up to 500ml volume capacity. The most preferred receptor compartment is glass beaker. In the present study, goatskin was used as semi-permeable membrane and verification of its performance was carried out through diffusion studies using gel formulations of one each of the four-selected biopharmaceutical classification system (BCS) class drugs. Metronidazole, diclofenac sodium, fluconazole, and sulfadiazine were used as model drugs for BCS Class I, II, III, and IV, respectively.Results: The newly developed diffusion cell (NDDC) was found to provide faster and more reproducible results as compared to FDC. At the time interval of 24 h, the cell was found to exhibit a higher diffusion of metronidazole, diclofenac sodium, fluconazole, and sulfadiazine by 0.65, 0.65, 0.32, and 0.81 folds, respectively. The faster release obtained with NDDC was attributed to a larger surface area of skin as compared to that in FDC.Conclusion: It was concluded that better reproducibility of results could be achieved with NDDC

Predicting the impact of climate change on range and genetic diversity patterns of the endangered endemic Nilgiri tahr (Nilgiritragus hylocrius) in the western Ghats, India

[Context] Climate change is considered an important factor affecting the distribution and genetic diversity of species. While many studies have described the influence of climate change on population structure at various scales, little is known about the genetic consequences of a changing climate on endemic species.[Objectives] To assess possible changes in the distribution and genetic structure of the endangered Nilgiri tahr (Nilgiritragus hylocrius), which is endemic to the Western Ghats in India, under climate change and human disturbances.[Methods] We integrated tahr occurrence and nuclear DNA data with environmental geo-datasets to project the response of tahr populations to future climate change with respect to its distribution, genetic diversity and population structure. We screened the environmental variables using MaxEnt to identify a manageable set of predictors to be used in an ensemble approach, based on ten species distribution modelling techniques, to quantify the current tahr distribution. We then projected the distribution and genetic structure under two climate change scenarios.[Results] We found that suitable habitat for tahr (9,605 km2) is determined predominantly by a combination of climatic, human disturbance and topographic factors that result in a highly fragmented habitat throughout its distribution range in the Western Ghats. Under the severe high emissions RCP8.5 scenario tahr populations may lose more than half of their available habitat (55.5%) by 2070. Application of spatial Bayesian clustering suggests that their current genetic structure comprise four genetic clusters, with three of them reflecting a clear geographic structure. However, under climate change, two of these clusters may be lost, and in the future a homogenization of the genetic background of the remaining populations may arise due to prevalence of one gene pool cluster in the remaining populations.[Conclusions] Our interdisciplinary approach that combines niche modelling and genetic data identified the climate refugia (i.e., the remaining stable habitats that overlap with the current suitable areas), where the tahr populations would be restricted to small, isolated and fragmented areas. Essential factors to avert local extinctions of vulnerable tahr populations are a reduction of human disturbances, dispersal of tahr between fragmented populations, and the availability of corridors.This research was supported by the Department of Biotechnology, Ministry of Science and Technology, Government of India, and by a German Research Foundation (DFG) fellowship awarded to RK (project number 273837911).Peer reviewe

Feasibility of achieving the 2025 WHO global tuberculosis targets in South Africa, China, and India: a combined analysis of 11 mathematical models.

BACKGROUND: The post-2015 End TB Strategy proposes targets of 50% reduction in tuberculosis incidence and 75% reduction in mortality from tuberculosis by 2025. We aimed to assess whether these targets are feasible in three high-burden countries with contrasting epidemiology and previous programmatic achievements. METHODS: 11 independently developed mathematical models of tuberculosis transmission projected the epidemiological impact of currently available tuberculosis interventions for prevention, diagnosis, and treatment in China, India, and South Africa. Models were calibrated with data on tuberculosis incidence and mortality in 2012. Representatives from national tuberculosis programmes and the advocacy community provided distinct country-specific intervention scenarios, which included screening for symptoms, active case finding, and preventive therapy. FINDINGS: Aggressive scale-up of any single intervention scenario could not achieve the post-2015 End TB Strategy targets in any country. However, the models projected that, in the South Africa national tuberculosis programme scenario, a combination of continuous isoniazid preventive therapy for individuals on antiretroviral therapy, expanded facility-based screening for symptoms of tuberculosis at health centres, and improved tuberculosis care could achieve a 55% reduction in incidence (range 31-62%) and a 72% reduction in mortality (range 64-82%) compared with 2015 levels. For India, and particularly for China, full scale-up of all interventions in tuberculosis-programme performance fell short of the 2025 targets, despite preventing a cumulative 3·4 million cases. The advocacy scenarios illustrated the high impact of detecting and treating latent tuberculosis. INTERPRETATION: Major reductions in tuberculosis burden seem possible with current interventions. However, additional interventions, adapted to country-specific tuberculosis epidemiology and health systems, are needed to reach the post-2015 End TB Strategy targets at country level. FUNDING: Bill and Melinda Gates Foundation