Water Connection: Everyday Religion and Environments in Kathmandu Valley

This case study aims to explore the relationship between ‘everyday religion’ and prospects for urban sustainability in the context of on-going changes -in Kathmandu. It argues that everyday religion plays a role in furnishing the incentive for urban residents to sustainably manage ‘culturalized nature’ in the city. In particular, I examine water, the practices surrounding its use, and how these practices connect various social realms. I suggest that water in Kathmandu valley plays an important role as a connector encompassing life and death, religion and environment, as well as politics and development

AN EPIDEMIOLOGICAL SURVEY STUDY TO KNOW THE SLEEPING AND WAKE UP TIME OF ELDERLY AND ITS RELATION TO HEALTH

Vridh Awsatha compared with Geriatric Population is the state of “Vata Vridhi” related with various Vatavridhi disorders. The older individuals often suffer from multiple medical problems. Like, osteoarthritis, shortness of breath, congestive heart failure, all can lead to difficulty with sleep initiation and maintenance. Trouble with sleep is strongly correlated with complaints about health and depression. Studies examining the prevalence of sleep disturbances in patients with chronic medical diseases have reported that 31% of arthritis and 66% of chronic pain patients report difficulty falling asleep, while 81% of arthritis, 85% of chronic pain, and 33% of diabetes patients report difficulty staying asleep. In a recent National Sleep Foundation survey of adults aged 65 years and over, those with more medical conditions, including cardiac and pulmonary disease and depression, reported significantly more sleep complaints. Objective: This study has been conducted to evaluate the sleeping and waking time of elderly and Diseases pattern with sleep status. Methodology: Interview based Questionnaire was prepared to know the sleep timings, waking up timings of elderly. 96 subjects of both sex was selected from OPD of AIIA, and nearby place and collected data was analyzed by using odd’s. Conclusion: According to the study the health status is directly affected by the timings of sleeping and waking up i.e. people who wake up early tends to be healthier. So, to add the quality in the end years of life, sleep will be main domain to work upon

Exotic associations and presentations of an age old disease: spectrum of tuberculosis in a developing country

Background:To create an awareness of the associations of tuberculosis with various other infections and its atypical clinical manifestations is important especially in regions where tuberculosis continues to be a major public health problem.Methods: This was an observational study of tubercular cases received in the Department of Pathology during the period January 2014 to January 2015.Results: A case series of exotic associations of tuberculosis, along with two cases at unusual sites, not suspected clinically, subsequently diagnosed by pathological examination and ancillary techniques.Conclusions: Tuberculosis continues to be a major cause of morbidity and mortality especially in the developing world. This series of cases goes to demonstrate the seemingly endless forms and presentations of this age-old disease and the importance of timely diagnosis and specific treatment

Adenomatoid odontogenic tumor with impacted mandibular canine: a case report

The Adenomatoid Odontogenic Tumor (AOT) is a rare, slow growing, benign, odontogenic epithelial tumor with characteristic clinical and histological features; which usually arise in the second or third decade. It is a tumor composed of odontogenic epithelium in a variety of histoarchitectural patterns which are embedded in a mature connective tissue stroma. It is mostly encountered in young patients with a greater predilection for females. Maxilla is the predilection site of occurrence, most commonly associated with an unerupted maxillary canine. It presents as a symptom-free lesion and is frequently discovered during routine radiographic examination. This case report describes an unusual case of 20 year old male with only a one month history of tumor in the anterior mandible. The tumor was a well circumscribed intraosseous lesion with an embedded tooth. Histological evidence of calcification was present. The present case lends support to the categorization of AOT as a mixed odontogenic tumo

Prospective study comparing the safety and efficacy of totally tubeless percutaneous nephrolithotomy vs standard percutaneous nephrolithotomy

Background: To evaluate the feasibility and safety of totally tubeless percutaneous nephrolithotomy (PCNL) Vs standard PCNL.Methods: From August 2014 to January 2016, 66 patients underwent PCNL in our institute. Of this group, 35 patients underwent traditional nephrostomy drainage following PCNL. A tubeless procedure was performed in the remaining 31 patients. These  groups were compared with respect to age, stone burden, intraoperative events, postoperative pain, analgesic requirements, soakage, postoperative change in hemoglobin, hospitalization time and complication rates.Results: Two groups were comparable with respect to age, stone burden (2.03 cm Vs. 2.12 cm) and intraoperative events. The mean pain score (day2 - 4.95 vs. 2.95) (day3 - 4.33 vs. 1.44) and analgesic requirement (mg diclofenac) (day2 - 140.22 vs. 65.31) (day3 - 124.44 vs. 43.89) was significantly less for group 2 on day 2 and 3. There was significant problem of soakage from nephrostomy tract in group 1. Patients in group 2 returned faster to normal activities but there was no difference found in drop in hemoglobin, complication rates even in subset of patients with large stone burden. No patient required readmission in the follow-up for pain, obstruction or infection in group 2. One patient developed urinoma which resolved conservativelyConclusions: In selected cases totally tubeless PCNL is feasible and safe

Effects of estradiol on neural responses to social signals in female tungara frogs

ABSTRACT Estradiol plays an important role in mediating changes in female sexual behavior across reproductive cycles. In the túngara frog [Physalaemus (=Engystomops) pustulosus], the relationship between gonadal activity and female sexual behavior, as expressed by phonotaxis, is mediated primarily by estradiol. Estradiol receptors are expressed in auditory and motivational brain areas and the hormone could serve as an important modulator of neural responses to conspecific calls. To better understand how estradiol modifies neural responses to conspecific social signals, we manipulated estradiol levels and measured expression of the immediate early gene egr-1 in the auditory midbrain, thalamus and limbic forebrain in response to conspecific or heterospecific calls. We found that estradiol and conspecific calls increased egr-1 expression in the auditory midbrain and limbic forebrain, but in the thalamus, only conspecific calls were effective. In the preoptic area, estradiol enhanced the effect of the conspecific call on egr-1 expression, suggesting that the preoptic area could act as a hormonal gatekeeper to phonotaxis. Overall, the results suggest that estradiol has broad influences on the neural circuit involved in female reproduction, particularly those implicated in phonotaxis

Antibiotic resistance pattern of Pseudomonas aeruginosa isolated from pus samples at tertiary care cancer hospital

Background: Pseudomonas aeruginosa is one of the most frequent opportunistic microorganisms causing infections in cancer patients. The aim of the study was to determine the antibiotic susceptibility of Pseudomonas aeruginosa and multidrug-resistant (MDR) isolates in cancer patients. Methods: A retrospective study was conducted from January 2022 to December 2022 at Government Cancer Hospital, Aurangabad. A total of 143 pus samples were collected from both IPD and OPD patients. Pus samples were collected as per standard procedure and were inoculated on blood and MacConkey agar. The isolates were identified by standard protocols using biochemical tests. The antibiotic susceptibility pattern of each isolate was checked as per Clinical and Laboratory Standards Institute (CLSI) guidelines 2022 using Kirby-Bauer's disc diffusion method and VITEK 2 Automation. Data analysis was done by statical method with statistical software SPSS version 22. Results: Out of 143 clinical samples 33 samples (23%) were positive for Pseudomonas aeruginosa growth. mean age of patients was 50 years old out of 33 isolates 12 (36%) isolates were multidrug-resistant, 11 (33%) isolates were extensively drug-resistant and 1 (3%) were pan-drug-resistant. The majority of isolates were responsive to polymyxin B 32 (96%) and colistin 32 (96%); However, the resistance to gentamycin, ceftazidime, and amikacin was higher, at 66%, 60%, and 57%, respectively.   Conclusions: This hospital-based retrospective study will help to implement better infection control strategies and improve the knowledge of antibiotic resistance patterns among clinicians. Thus, there is a need for an antibiotic stewardship program to monitor the resistant pattern in a tertiary care   cancer hospital

Graft-Versus-Host Disease in Recipients of Male Unrelated Donor Compared with Parous Female Sibling Donor Transplants

Optimal donor selection is critical for successful allogeneic hematopoietic cell transplantation (HCT). Donor sex and parity are well-established risk factors for graft-versus-host disease (GVHD), with male donors typically associated with lower rates of GVHD. Well-matched unrelated donors (URDs) have also been associated with increased risks of GVHD as compared with matched sibling donors. These observations raise the question of whether male URDs would lead to more (or less) favorable transplant outcomes as compared with parous female sibling donors. We used the Center for International Blood and Marrow Transplant Research registry to complete a retrospective cohort study in adults with acute myeloid leukemia, acute lymphoblastic leukemia, or myelodysplastic syndrome, who underwent T-cell replete HCT from these 2 donor types (parous female sibling or male URD) between 2000 and 2012. Primary outcomes included grade 2 to 4 acute GVHD (aGVHD), chronic GVHD (cGVHD), and overall survival. Secondary outcomes included disease-free survival, transplant-related mortality, and relapse. In 2813 recipients, patients receiving male URD transplants (n = 1921) had 1.6 times higher risk of grade 2 to 4 aGVHD (P \u3c .0001). For cGVHD, recipient sex was a significant factor, so donor/recipient pairs were evaluated. Female recipients of male URD grafts had a higher risk of cGVHD than those receiving parous female sibling grafts (relative risk [RR] = 1.43, P \u3c .0001), whereas male recipients had similar rates of cGVHD regardless of donor type (RR = 1.09, P = .23). Donor type did not significantly affect any other end point. We conclude that when available, parous female siblings are preferred over male URDs

Does the Hematopoietic Cell Transplantation Specific Comorbidity Index Predict Transplant Outcomes? A Validation Study in a Large Cohort of Umbilical Cord Blood and Matched Related Donor Transplants

AbstractThe hematopoietic cell transplantation specific comorbidity index (HCT-CI) has been recently proposed to predict the probability of nonrelapse mortality (NRM) and overall survival (OS) in allogeneic HCT recipients while taking into account any pretransplant comorbidity. We tested the validity of the HCT-CI in a cohort of 373 adult HCT recipients (184 matched-related donor and 189 unrelated umbilical cord blood) who received a myeloablative (N = 150) or nonmyeloablative (N = 223) conditioning regimen. HCT-CI scores of 0, 1, 2, and ≥3 were present in 58 (16%), 56 (15%), 64 (17%), and 195 (52%) patients, respectively. Pulmonary conditions were the most common comorbidity. Cumulative incidence of NRM at 2 years was 10%, 20%, 24%, and 28% for HCT-CI scores of 0, 1, 2, and ≥3, respectively (P = .01). The corresponding probability of OS at 2 years was 72%, 67%, 51%, and 48%, respectively (P < .01). On multivariate analyses adjusted for recipient age, disease risk, donor source, and conditioning regimen intensity, the relative risks for NRM for HCT-CI scores of 1, 2, and ≥3 (compared to a score of 0) were 2.0 (95% confidence intervals, 0.8–5.3), 2.6 (1.0–6.7), and 3.2 (1.4-7.4), respectively. The risks for overall mortality were 1.2 (0.6-2.1), 2.0 (1.1-3.4), and 2.1 (1.3-3.3), respectively. In subgroup analyses, the HCT-CI score did not consistently predict NRM and OS among different donor sources and conditioning regimens. The HCT-CI, although a useful tool for capturing pretransplant comorbidity and risk-assessment, needs to be further validated prior to adopting it for routine clinical use