End-stage liver disease Is a strong predictor of early mortality in cryptococcosis

Background. Cryptococcosis in the setting of end-stage liver disease (ESLD) has been associated with high mortality. We sought to compare the outcome of cryptococcal disease in patients with ESLD to that of human immunodeficiency virus (HIV)-positive patients and to those patients without HIV or ESLD. Methods. We assembled a retrospective cohort of 232 consecutive cases of cryptococcosis in our institution, from 2002 to 2014, inclusively. We analyzed the cases for comorbidities, type of infection, and survival. Data were analyzed with t tests, Fishers Exact test, and Kaplan-Meyer analysis. Results. Twenty-five (10.8%) patients with cryptococcal infection had concomitant ESLD; of these, 5 (20%) presented with peritonitis. Most (17 of 25, 68%) did not have any other cause of immunocompromise that has been more classically associated with cryptococcosis. Patients with ESLD had a significantly higher mortality than HIV-positive patients and HIV-negative patients without ESLD (HIVNE) (80% vs 13.6% and 22.7%, respectively; P < .001). In addition, fatal outcome in ESLD patients occurred more rapidly than in HIVNE patients, with a median survival of 6 days (vs 17), despite a comparable time to diagnosis (6.2 vs 6.6 days). Conclusions. Cryptococcosis is an important morbidity in patients with ESLD. Patients with ESLD who are infected with Cryptococcus have a high and rapid mortality. This suggests that a high level of vigilance for cryptococcal infection should be kept in patients with ESLD

A Non - Singular Cosmological Model with Shear and Rotation

We have investigated a non-static and rotating model of the universe with an imperfect fluid distribution. It is found that the model is free from singularity and represents an ever expanding universe with shear and rotation vanishing for large value of time.Comment: 10 pages, late

Uterine rupture: a preventable obstetric catastrophe

Background: Maternal health has long been acknowledged to be the cornerstone in public health. The objective of this study was to determine the incidence, etiology, risk factors, complications, treatment strategies, maternal and fetal outcome associated with uterine rupture and to determine how to decrease the maternal morbidity and mortality pertaining to it, as it is indeed a preventable obstetric catastrophe!Methods: This is a retrospective study which was carried out in our institute. Analysis of 45 cases of uterine rupture including scar dehiscence, registered/emergency, rupture occurring in the antepartum or intrapartum period, irrespective of previous vaginal or cesarean delivery was done between July 2017 to June 2019 out of 16,330 deliveries. None of the cases were excluded. Statistical analysis was done comparing the mortality in general population and study population and it was determined that it contributes to the maternal mortality significantly hence making it essential to promptly diagnose and treat the cases.Results: The incidence of rupture of uterus is average 0.27% (1 in 362). Out of 45 cases 9 (20%) were registered, and 36 (80%) were referred patients. The 20-30 years age group is the most vulnerable. Scarred uterus undergoing rupture were 34 (75.55%) as compared to rupture in intact uterus which were 11 (24.44%). The commonest modality of treatment used is suturing of tear which was done in 34 (75.55%) followed by total hysterectomy. There were 2 maternal deaths giving maternal mortality rate of 4.44% and perinatal mortality occurred in 18 (40%) cases.Conclusions: Uterine rupture is a dire emergency with a high incidence of maternal and fetal morbidity and mortality. Skilled attendance with accessible obstetric care, focused antenatal care, strict intrapartum monitoring and good surgical approach are key elements for the prevention and management of uterine rupture

Biochemical and Pathomorphological Study of Potassium Dichromate-induced Nephrotoxicity in Wistar Rat

An experiment was conducted to study biochemical and pathomorphological alterations induced by potassium dichromate toxicity. Forty colony bred Albino Wistar strain rats of both sexes, divided uniformly into four equal groups Group A, Group B, Group C, and Group D. Each Group contains five male and five female. Group A rats received only deionised water and served as control. Group B (low dose), Group C (mid dose) and Group D (high dose) rats were given potassium dichromate orally by gavage for 28 days at the rate of 0.625 mg/kg body weight (b.wt.), 1.25 mg/kg b.wt. and 2.5 mg/kg b.wt. respectively. A dose dependant significant rise in plasma alanine aminotransferase (ALT), plasma aspartate aminotransferase (AST), plasma alkaline phosphatase (ALP), creatinine and blood urea nitrogen was observed in treatment group, whereas, a significant decrease in total protein and albumin was observed in treatment group. Histopathological sections of kidney, liver, lung and testes revealed varying degrees of congestion, haemorrhage, degeneration and necrosis in rats of different treatment groups. The present study indicates nephric and hepatic toxicity in albino wistar rats due to potassium dichromate toxicity

ESTIMATION OF GUGGULSTERONE-Z IN GOKSHURADI GUGGULU USING REVERSED-PHASE HIGH-PERFORMANCE LIQUID CHROMATOGRAPHY

Objective: A study was aimed to estimate guggulsterone-Z (GZ) in Gokshuradi Guggulu (GG).Methods: An analytical method was developed and validated using Waters Alliance high-performance liquid chromatography system (Empower software), equipped with photodiode array detector. Separation was achieved using Phenomenex, C-18 (250 mm×4.6 mm, 5 μ) column. Mobile phase consisted of acetonitrile:water (70:30,v/v). Flow rate was set to 1 ml/min and detection was performed at 251 nm.Results and Discussion: Validation parameters such as linearity, precision, accuracy, limit of detection, limit of quantification, and robustness were performed. Amount of GZ was estimated using linearity equation.Conclusion: GG was found to contain 0.815±0.03 g% w/w GZ. Validated method may be used as one of the parameters to standardize the formulation

Validity and responsiveness of the French version of the Örebro musculoskeletal pain screening questionnaire in chronic low back pain

The assessment of a broad range of biopsychosocial aspects is important in the rehabilitation of patients with chronic low back pain (CLBP) for the prediction of outcome as well as for evaluation. The objective of this study was to test the responsiveness, construct validity and predictive value of the A-rebro Musculoskeletal Pain Screening Questionnaire (OMPSQ) compared to other instruments widely used to assess biopsychosocial aspects in patients with CLBP. 111 patients with CLBP admitted to an inpatient rehabilitation completed a set of questionnaires on biopsychosocial aspects at baseline and at discharge. Ninety-eight patients responded at three months for an assessment of the return to work status. Responsiveness of the OMPSQ, the ability to detect change in the construct of interest, was investigated by a set of hypotheses on correlations with widely used questionnaires. We tested the hypothesis that the changes in the OMPSQ would vary along with the responses in the Patient's Global Impression of Change. Prediction of disability at discharge, work status at three months and time to return to work was evaluated with linear, logistic and cox regression models. The OMPSQ showed good predictive values for disability and return to work and construct validity of the instrument was corroborated. Seventy-nine percent of our hypotheses for responsiveness could be confirmed, with the OMPSQ showing the second highest change during the rehabilitation. The OMPSQ can also be applied in patients with CLBP, but for the assessment of change in psychosocial variables one should add specific questionnaires

Endoscopic tympanoplasty vs microscopic tympanoplasty in tubotympanic csom: a comparative study of 44 cases

Background: Tympanoplasty is one of the commonest operations performed on the middle ear. Endoscopes are increasingly used for various middle ear surgeries. The objective was to determine merits and demerits of the endoscope as compared to the microscope in myringoplasty surgery and to compare the results of both group.Methods: Between the time period of January 2014 to September 2014, 44 patients underwent myringoplasty, 22 were endoscope assisted and 22 were microscope assisted. Results of surgery were compared at the end of 3 months post surgery.Results: In both groups, equal number of patients i.e. 15 (68.18%) had a successful outcome.Conclusion:Panoramic, wide angle, and magnified view provided by endoscope as well as ability to easily negotiate through EAC and provide uninterrupted image overcomes most of the disadvantage of microscope. In our study success rate was equal between endoscopic and microscopic technique. In terms of morbidity and postoperative recovery endoscope produced better results. Loss of depth perception and one handed technique are some of the disadvantage of endoscope that can be overcome with practice. Thus, Endoscopic tympanoplasty can be a good alternative of microscopic tympanoplasty

Thermal Particle Creation in Cosmological Spacetimes: A Stochastic Approach

The stochastic method based on the influence functional formalism introduced in an earlier paper to treat particle creation in near-uniformly accelerated detectors and collapsing masses is applied here to treat thermal and near-thermal radiance in certain types of cosmological expansions. It is indicated how the appearance of thermal radiance in different cosmological spacetimes and in the two apparently distinct classes of black hole and cosmological spacetimes can be understood under a unifying conceptual and methodological framework.Comment: 17 pages, revtex (aps, eqsecnum), submitted to PRD, April 199

Uniformly Accelerated Charge in a Quantum Field: From Radiation Reaction to Unruh Effect

We present a stochastic theory for the nonequilibrium dynamics of charges moving in a quantum scalar field based on the worldline influence functional and the close-time-path (CTP or in-in) coarse-grained effective action method. We summarize (1) the steps leading to a derivation of a modified Abraham-Lorentz-Dirac equation whose solutions describe a causal semiclassical theory free of runaway solutions and without pre-acceleration patholigies, and (2) the transformation to a stochastic effective action which generates Abraham-Lorentz-Dirac-Langevin equations depicting the fluctuations of a particle's worldline around its semiclassical trajectory. We point out the misconceptions in trying to directly relate radiation reaction to vacuum fluctuations, and discuss how, in the framework that we have developed, an array of phenomena, from classical radiation and radiation reaction to the Unruh effect, are interrelated to each other as manifestations at the classical, stochastic and quantum levels. Using this method we give a derivation of the Unruh effect for the spacetime worldline coordinates of an accelerating charge. Our stochastic particle-field model, which was inspired by earlier work in cosmological backreaction, can be used as an analog to the black hole backreaction problem describing the stochastic dynamics of a black hole event horizon.Comment: Invited talk given by BLH at the International Assembly on Relativistic Dynamics (IARD), June 2004, Saas Fee, Switzerland. 19 pages, 1 figur

Rotating dust solutions of Einstein's equations with 3-dimensional symmetry groups, Part 3: All Killing fields linearly independent of u^{\alpha} and w^{\alpha}

This is the third and last part of a series of 3 papers. Using the same method and the same coordinates as in parts 1 and 2, rotating dust solutions of Einstein's equations are investigated that possess 3-dimensional symmetry groups, under the assumption that each of the Killing vectors is linearly independent of velocity $u^{\alpha}$ and rotation $w^{\alpha}$ at every point of the spacetime region under consideration. The Killing fields are found and the Killing equations are solved for the components of the metric tensor in every case that arises. No progress was made with the Einstein equations in any of the cases, and no previously known solutions were identified. A brief overview of literature on solutions with rotating sources is given.Comment: One missing piece, signaled after eq. (10.7), is added after (10.21). List of corrections: In (3.7) wrong subscript in vorticity; In (3.10) wrong subscript in last term of g_{23}; In (4.23) wrong formulae for g_{12} and g_{22}; In (7.17) missing factor in velocity; In (7.18) one wrong factor in g_{22}; In (10.9) factor in vorticity; In (10.15) - (10.20) y_0 = 0; In (10.20) wrong second term in y. The rewriting typos did not influence result