MULTIPLE CUTANEOUS PILOLEIOMYOMA WITH UTERINE FIBROIDS (REED'S SYNDROME): A RARE CASE REPORT

Cutaneous leiomyomas comprise approximately 5% of all leiomyomas. Solitary occurrence is more common than generalized. Multiple cutaneous piloleiomyomas are rare, painful and difficult-to-treat benign tumors originating in the arrectores pilorum muscles of the hair follicles. Multiple Cutaneous piloleiomyomas are associated with uterine fibroids in women (Reed's syndrome) and it is a marker of a condition called hereditary leiomyomatosis and renal cell cancer (HLRCC). We report a case of multiple cutaneous piloleiomyoma with uterine fibroid in an adult female. Because of its rarity and association with renal cell cancer, it deserves a mention in literature. KEYWORDS: Cutaneous leiomyoma; Uterine leiomyoma; Painful nodules

MULTIPLE CUTANEOUS PILOLEIOMYOMA WITH UTERINE FIBROIDS (REED\u27S SYNDROME): A RARE CASE REPORT

Cutaneous leiomyomas comprise approximately 5% of all leiomyomas. Solitary occurrence is more common than generalized. Multiple cutaneous piloleiomyomas are rare, painful and difficult-to-treat benign tumors originating in the arrectores pilorum muscles of the hair follicles. Multiple Cutaneous piloleiomyomas are associated with uterine fibroids in women (Reed\u27s syndrome) and it is a marker of a condition called hereditary leiomyomatosis and renal cell cancer (HLRCC). We report a case of multiple cutaneous piloleiomyoma with uterine fibroid in an adult female. Because of its rarity and association with renal cell cancer, it deserves a mention in literature. KEYWORDS: Cutaneous leiomyoma; Uterine leiomyoma; Painful nodules

Non-optimal apparent temperature and cardiovascular mortality: the association in Puducherry, India between 2011 and 2020

BACKGROUND: Cardiovascular diseases (CVDs), the leading cause of death worldwide, are sensitive to temperature. In light of the reported climate change trends, it is important to understand the burden of CVDs attributable to temperature, both hot and cold. The association between CVDs and temperature is region-specific, with relatively few studies focusing on low-and middle-income countries. This study investigates this association in Puducherry, a district in southern India lying on the Bay of Bengal, for the first time. METHODS: Using in-hospital CVD mortality data and climate data from the Indian Meteorological Department, we analyzed the association between apparent temperature (T(app)) and in-hospital CVD mortalities in Puducherry between 2011 and 2020. We used a case-crossover model with a binomial likelihood distribution combined with a distributed lag non-linear model to capture the delayed and non-linear trends over a 21-day lag period to identify the optimal temperature range for Puducherry. The results are expressed as the fraction of CVD mortalities attributable to heat and cold, defined relative to the optimal temperature. We also performed stratified analyses to explore the associations between T(app) and age-and-sex, grouped and considered together, and different types of CVDs. Sensitivity analyses were performed, including using a quasi-Poisson time-series approach. RESULTS: We found that the optimal temperature range for Puducherry is between 30 degrees C and 36 degrees C with respect to CVDs. Both cold and hot non-optimal T(app) were associated with an increased risk of overall in-hospital CVD mortalities, resulting in a U-shaped association curve. Cumulatively, up to 17% of the CVD deaths could be attributable to non-optimal temperatures, with a slightly higher burden attributable to heat (9.1%) than cold (8.3%). We also found that males were more vulnerable to colder temperature; females above 60 years were more vulnerable to heat while females below 60 years were affected by both heat and cold. Mortality with cerebrovascular accidents was associated more with heat compared to cold, while ischemic heart diseases did not seem to be affected by temperature. CONCLUSION: Both heat and cold contribute to the burden of CVDs attributable to non-optimal temperatures in the tropical Puducherry. Our study also identified the age-and-sex and CVD type differences in temperature attributable CVD mortalities. Further studies from India could identify regional associations, inform our understanding of the health implications of climate change in India and enhance the development of regional and contextual climate-health action-plans

"Climate change and health?": Knowledge and perceptions among key stakeholders in Puducherry, India

Climate change has far-reaching impacts on human health, with low- and middle-income countries, including India, being particularly vulnerable. While there have been several advances in the policy space with the development of adaptation plans, little remains known about how stakeholders who are central to the strengthening and implementation of these plans perceive this topic. We conducted a qualitative study employing key interviews with 16 medical doctors, researchers, environmentalists and government officials working on the climate change agenda from Puducherry, India. The findings were analysed using the framework method, with data-driven thematic analysis. We elucidated that despite elaborating the direct and indirect impacts of climate change on health, there remains a perceived gap in education and knowledge about the topic among participants. Knowledge of the public health burden and vulnerabilities influenced the perceived health risks from climate change, with some level of scepticism on the impacts on non-communicable diseases, such as cardiovascular diseases. There was also a felt need for multi-level awareness and intervention programmes targeting all societal levels along with stakeholder recommendations to fill these gaps. The findings of this study should be taken into consideration for strengthening the region's climate change and health adaptation policy. In light of limited research on this topic, our study provides an improved understanding of how key stakeholders perceive the impacts of climate change on health in India

Experimental Designs and Combinatorial Systems Associated with Latin Squares and Sets of Mutually Orthogonal Latin Squares

14 pages, 1 article*Experimental Designs and Combinatorial Systems Associated with Latin Squares and Sets of Mutually Orthogonal Latin Squares* (Hedayat, A.; Shrikhande, S. S.) 14 page

Student Motivation and Perseverance: Do They Explain College Graduation?

  We examine whether college students’ persistence in finding a suitable major field of study influences the likelihood of graduation. We find that students who make an effort to select a suitable major early in their college careers graduate in a more timely fashion. Although changing majors is associated with delayed graduation, struggling students can improve graduation likelihood by switching to a more suitable major. However, performance improvement after switching is necessary for successful completion of a degree. These results indicate that colleges and universities should allocate resources to supporting students in their search for an appropriate major and empower students by providing course guidance and counseling.

The association between apparent temperature and hospital admissions for cardiovascular disease in limpopo province, South Africa

Cardiovascular diseases (CVDs) have a high disease burden both globally and in South Africa. They have also been found to be temperature-sensitive globally. The association between temperature and CVD morbidity has previously been demonstrated, but little is known about it in South Africa. It is important to understand how changes in temperature in South Africa will affect CVD morbidity, especially in rural regions, to inform public health interventions and adaptation strategies. This study aimed to determine the short-term effect of apparent temperature (T(app)) on CVD hospital admissions in Mopani District, Limpopo province, South Africa. A total of 3124 CVD hospital admissions records were obtained from two hospitals from 1 June 2009 to 31 December 2016. Daily T(app) was calculated using nearby weather station measurements. The association was modelled using a distributed lag non-linear model with a negative binomial regression over a 21-day lag period. The fraction of morbidity attributable to non-optimal T(app), i.e., cold (6-25 degrees C) and warm (27-32 degrees C) T(app) was reported. We found an increase in the proportion of admissions due to CVDs for warm and cold T(app) cumulatively over 21 days. Increasing CVD admissions due to warm T(app) appeared immediately and lasted for two to four days, whereas the lag-structure for the cold effect was inconsistent. A proportion of 8.5% (95% Confidence Interval (CI): 3.1%, 13.7%) and 1.1% (95% CI: -1.4%, 3.5%) of the total CVD admissions was attributable to cold and warm temperatures, respectively. Warm and cold T(app) may increase CVD admissions, suggesting that the healthcare system and community need to be prepared in the context of global temperature changes

Microscopic and biochemical monitoring of endosomal trafficking and extracellular vesicle secretion in an endogenous in vivo model

Extracellular vesicle (EV) secretion enables cell–cell communication in multicellular organisms. During development, EV secretion and the specific loading of signalling factors in EVs contributes to organ development and tissue differentiation. Here, we present an in vivo model to study EV secretion using the fat body and the haemolymph of the fruit fly, Drosophila melanogaster. The system makes use of tissue-specific EV labelling and is amenable to genetic modification by RNAi. This allows the unique combination of microscopic visualisation of EVs in different organs and quantitative biochemical purification to study how EVs are generated within the cells and which factors regulate their secretion in vivo. Characterisation of the system revealed that secretion of EVs from the fat body is mainly regulated by Rab11 and Rab35, highlighting the importance of recycling Rab GTPase family members for EV secretion. We furthermore discovered a so far unknown function of Rab14 along with the kinesin Klp98A in EV biogenesis and secretion