Okonkwo’s Fall: Multiple Perspectives

This article aims at exploring the causes of the fall of Okonkwo, the protagonist of the Nigerian Novel. Things Fall Apart by the renowned novelist, Chinua Achebe. Though the novel mainly deals with the fall of Igbo Culture where Okonkwo has played the sheet anchor role in the novel, Things Fall Apart at the hands of British establishment in Nigeria, the other vital reasons that make him vulnerable will also be discussed at length in this article. It is from the study of the novel, it is established that the Igbo society that refuses to change itself could be one of the reasons for the fall. However, it is very clear that the changes should take place spontaneously and not by force which the Igbo society has been the victim and the representative, Okonkwo its scapegoat. The writers of the article make sure that the reading of this article will be an eye opener in terms of Nigerian consciousness as revealed in the novel, Things Fall Apart

Network pharmacology: an efficient but underutilized approach in oral, head and neck cancer therapy—a review

The application of network pharmacology (NP) has advanced our understanding of the complex molecular mechanisms underlying diseases, including neck, head, and oral cancers, as well as thyroid carcinoma. This review aimed to explore the therapeutic potential of natural network pharmacology using compounds and traditional Chinese medicines for combating these malignancies. NP serves as a pivotal tool that provides a comprehensive view of the interactions among compounds, genes, and diseases, thereby contributing to the advancement of disease treatment and management. In parallel, this review discusses the significance of publicly accessible databases in the identification of oral, head, and neck cancer-specific genes. These databases, including those for head and neck oral cancer, head and neck cancer, oral cancer, and genomic variants of oral cancer, offer valuable insights into the genes, miRNAs, drugs, and genetic variations associated with these cancers. They serve as indispensable resources for researchers, clinicians, and drug developers, contributing to the pursuit of precision medicine and improved treatment of these challenging malignancies. In summary, advancements in NP could improve the globalization and modernization of traditional medicines and prognostic targets as well as aid in the development of innovative drugs. Furthermore, this review will be an eye-opener for researchers working on drug development from traditional medicines by applying NP approaches

Nevirapine Resistance and Breast-Milk HIV Transmission: Effects of Single and Extended-Dose Nevirapine Prophylaxis in Subtype C HIV-Infected Infants

Daily nevirapine (NVP) prophylaxis to HIV-exposed infants significantly reduces breast-milk HIV transmission. We assessed NVP-resistance in Indian infants enrolled in the "six-week extended-dose nevirapine" (SWEN) trial who received single-dose NVP (SD-NVP) or SWEN for prevention of breast-milk HIV transmission but who also acquired subtype C HIV infection during the first year of life.Standard population sequencing and cloning for viral subpopulations present at > or =5% frequency were used to determine HIV genotypes from 94% of the 79 infected Indian infants studied. Timing of infection was defined based on when an infant's blood sample first tested positive for HIV DNA. SWEN-exposed infants diagnosed with HIV by six weeks of age had a significantly higher prevalence of NVP-resistance than those who received SD-NVP, by both standard population sequencing (92% of 12 vs. 38% of 29; p = 0.002) and low frequency clonal analysis (92% of 12 vs. 59% of 29; p = 0.06). Likelihood of infection with NVP-resistant HIV through breast-milk among infants infected after age six weeks was substantial, but prevalence of NVP-resistance did not differ among SWEN or SD-NVP exposed infants by standard population sequencing (15% of 13 vs. 15% of 20; p = 1.00) and clonal analysis (31% of 13 vs. 40% of 20; p = 0.72). Types of NVP-resistance mutations and patterns of persistence at one year of age were similar between the two groups. NVP-resistance mutations did differ by timing of HIV infection; the Y181C variant was predominant among infants diagnosed in the first six weeks of life, compared to Y188C/H during late breast-milk transmission.Use of SWEN to prevent breast-milk HIV transmission carries a high likelihood of resistance if infection occurs in the first six weeks of life. Moreover, there was a continued risk of transmission of NVP-resistant HIV through breastfeeding during the first year of life, but did not differ between SD-NVP and SWEN groups. As with SD-NVP, the value of preventing HIV infection in a large number of infants should be considered alongside the high risk of resistance associated with extended NVP prophylaxis.ClinicalTrials.gov NCT00061321

Large left ventricular pseudoaneurysm and spontaneous recanalized coronaries

35 year old with ruptured lateral wall of Left ventricle (LV) resulting in large pseudo aneurysm contained within the pericardium [Figure 1]. There was free flow of blood between the LV and pseudoaneurysm .He underwent endoventricular patch plasty of the defect after opening the wall of aneurysm [Figure 2]

Comparison of paravertebral and interpleural block in patients undergoing modified radical mastectomy

Background: Paravertebral and inter pleural blocks (IPB) reduce post-operative pain and decrease the effect of post-operative pain on lung functions after breast surgery. This study was designed to determine their effect on lung functions and post-operative pain in patients undergoing modified radical mastectomy. Materials and Methods: A total of 120 American Society of Anesthesiologists physical status 1 and 2 patients scheduled to undergo breast surgery were randomly allocated to receive IPB (Group IPB, n = 60) or paravertebral block (PVB) (Group PVB, n = 60) with 20 ml of 0.5% bupivacaine pre-operatively. A standard protocol was used to provide general anesthesia. Lung function tests, visual analog scale (VAS) for pain at rest and movement, analgesic consumption were recorded everyday post-operatively until discharge. Results: Lung functions decreased on 1 st post-operative day and returned to baseline value by 4 th post-operative day in both groups. VAS was similar in both groups. There was no significant difference in the consumption of opioids and diclofenac in both groups. Complete block was achieved in 48 patients (80%) in paravertebral group and 42 patients (70%) in inter pleural group. Conclusion: To conclude, lung functions are well-preserved in patients undergoing modified radical mastectomy under general anesthesia supplemented with paravertebral or IPB. IPB is as effective as PVB for post-operative pain relief. PVB has the added advantage of achieving a more complete block

Immunohistochemical expression of chemokine receptor CXCR3 and its ligand CXCL 11 in basal cell carcinoma

Introduction: Basal cell carcinoma (BCC) is the most common type of skin cancer worldwide. The pathogenesis of BCC involves interplay between various environmental and genetic factors. It is believed that chemokines play a significant role in the modulation of cancer growth by generating autocrine and paracrine signaling effects. The present study was conducted to elucidate the expression of chemokine, CXCL11, and its receptor CXCR3, and their interaction with tumor cells and peri-tumoral stroma in various subtypes of BCC. Aim and Objectives: The aim of this study was to evaluate the immunohistochemical expression of chemokine CXCL11 and its receptor CXCR3 in various subtypes of BCC. Materials and Methods: The study included 40 cases of histopathologically confirmed BCC. Clinical and histopathological features of various tumor subtypes were noted. Immunohistochemistry was performed using antibodies against CXCL11 and CXCR3, and these were assigned scores 0, 1, and 2 on the basis of immunohistochemical expression. Results: The median age of study participants was 65.0 ± 12.2 years with a male-to-female ratio of 1.5:1. The most common site was face, followed by neck, scalp, and back. The tumor subtypes included in the study were nodular (n = 20), pigmented (n = 8), infiltrating (n = 5), superficial (n = 4), and adenoid (n = 3). On immunohistochemistry, CXCR3 expression was seen in 34 (85%) cases with stromal inflammatory cells immunopositivity in 29 (72.5%) cases and tumor cells immunopositivity in 5 (12.5%) cases. CXCL11 expression was seen in 36 (90%) cases with weak expression in stroma and tumor in 18 cases and strong expression in the rest 18 cases. In individual subtypes, higher immunopositivity for CXCR3 and CXCL11 in tumor cells and peri-tumoral stroma was seen for nodular, infiltrating, and pigmented subtypes, compared to adenoid and superficial subtypes. Conclusion: Our study shows the enhanced expression of chemokine CXCL11 and its receptor CXCR3 in tumor cells and peri-tumoral stroma of BCC. This expression is greater in tumor cells of aggressive subtypes, i.e. nodular, infiltrating, and pigmented types. This suggests that receptor ligand pathway involving CXCR3 and CXCL11 plays a key role in pathogenesis of BCC, and blocking this pathway may result in inhibition of tumor growth. Thus, these chemokines may serve as future potential targets in developing novel therapeutic regimens against BCC

A survey of a population of anaesthesiologists from South India regarding practices for rapid sequence intubation in patients with head injury

Background and Aims: Evidence and utility of the individual steps of the rapid sequence induction and tracheal intubation protocols have been debated, especially in the setting of traumatic brain injury. The purpose of this survey was to determine preferences in the current approach to rapid sequence intubation ( RSI) in head injury patients among a population of anaesthesiologists from South India. Methods: A questionnaire was E-mailed to all the members of the Indian Society of Anaesthesiologists′ South Zone Chapter to ascertain their preferences, experience and comfort level with regard to their use of rapid sequence intubation techniques in adult patients with head injury. Participants were requested to indicate their practices for RSI technique for a head-injured patient upon arrival at the Emergency Medical Services department of their hospital. Results: The total response rate was 56.9% (530/932). Of the total respondents, 35% of the clinicians used cricoid pressure routinely, most respondents (68%) stated that they pre-oxygenate the patients for about 3 min prior to RSI, thiopentone (61%) and propofol (34%) were commonly used prior to intubation. Rocuronium was the muscle relaxant of choice for RSI among the majority (44%), compared to succinylcholine (39%). Statistical analyses were performed after the initial entry onto a spreadsheet. Data were summarised descriptively using frequency distribution. Conclusion: In a rapid sequence intubation situation, the practice differed significantly among anaesthesiologists. Owing to disagreements and paucity of evidence-based data regarding the standards of RSI, it is apparent that RSI practice still has considerable variability in clinical practice

Interplay between intrinsic defects, doping, and free carrier concentration in SrTiO[subscript 3] thin films

Using both computational and experimental analysis, we demonstrate a rich point-defect phase diagram in doped strontium titanate as a function of thermodynamic variables such as oxygen partial pressure and electronic chemical potential. Computational modeling of point-defect energetics demonstrates that a complex interplay exists between dopants, thermodynamic parameters, and intrinsic defects in thin films of SrTiO[subscript 3] (STO). We synthesize STO thin films via pulsed laser deposition and explore this interplay between intrinsic defects, doping, compensation, and carrier concentration. Our point-defect analysis (i) demonstrates that careful control over growth conditions can result in the tunable presence of anion and cation vacancies, (ii) suggests that compensation mechanisms will pose intrinsic limits on the dopability of perovskites, and (iii) provides a guide for tailoring the properties of doped perovskite thin films.United States. Dept. of Energy (Grant No. DE-SC0002623)National Science Foundation (U.S.) (NCSA) (Grant No. TG-DMR090027)United States. Dept. of Energy. Division of Materials Sciences and Engineering (Contract No. DE-AC02-05CH11231

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Not AvailableThere is a preference for organic vegetables, including Chinese potato [Plectranthus rotundifolius (Poir.) Spreng. or Solenostemon rotundifolius (Poir.) J.K. Morton], due to concerns regarding plant health, safe food, and sustainable yields. However, organic technologies in this crop is lacking. Comparison of crop growth, biomass production, yield, quality, soil properties, nutrient uptake, and cost-benefit analysis between organic and conventional systems in Chinese potato has not been thoroughly investigated. Field experiments were done from 2014 to 2016 at the Indian Council of Agricultural Research-Central Tuber Crops Research Institute, Thiruvananthapuram, India, to assess differences due to conventional (I1); integration of animal manure, chemical fertilizers and plant growth-promoting rhizobacteria (I2), and organic treatments, traditional farmer practice comprised animal manure @ 15 t·ha−1 and ash @ 2 t·ha−1 (O1); use of animal manure @ 10 t·ha−1, green manure @ 10–15 t·ha−1, neem cake @ 1 t·ha−1 and ash @ 2 t·ha−1 (O2), and organic + plant growth- promoting rhizobacteria as above, but instead of ash the bacterium Azospirillum, and a P and K solubilizer @ 3 kg∙ha−1 (O3) were examined for effects on productivity, tuber quality, soil productivity,and economics of production of Chinese potato. Organic management improved biomass partitioning to tubers, harvest index, higher pH ( + 1.14, + 0.23 unit), organic C ( + 15%, + 21.33%), available N and P, tuber K, P and Zn uptake over conventional and integrated practices, respectively. Tuber yield, gross income (avg. US$7777.13∙ha−1), and profit (avg. US$5721.80∙ha−1), were unaffected. Organic production may be an alternative for Chinese potato with responses equal to conventional production while possibly delivering improved soil health.Not Availabl