Scrub typhus in pregnancy-a case series with variable presentation from mild to severe disease

Scrub typhus is an uncommon cause of acute febrile illness during pregnancy. It can lead to adverse maternal and fetal outcomes if not diagnosed early and treated appropriately. It manifests as mild febrile disease to severe form with multiorgan dysfunction. It might be clinically difficult to diagnose scrub typhus, hence it is important that those presenting with an acute febrile illness in endemic regions should have targeted investigations for early detection. Here we present successful management of three cases of scrub typhus in pregnancy with variable presentation of scrub typhus. Two of these presented in antenatal period whereas one in postnatal period resembling abdominal tuberculosis all three were tested COVID-19 (real time polymerase chain reaction) negative

Prevalence of cervical intraepithelial neoplasia and cervical carcinoma in a tertiary care hospital at Rajshahi

Background: Cervical intraepithelial neoplasia (CIN) is a precancerous cervical condition with the potential to develop into cervical carcinoma if untreated. While research on CIN and cervical carcinoma exists in various regions, the Rajshahi area lacks such investigations. Examining the prevalence of CIN and cervical carcinoma in this region is essential. This study aimed to assess the prevalence of CIN and cervical carcinoma in a tertiary care hospital at Rajshahi in Bangladesh. Methods: This cross-sectional descriptive study was conducted at the department of pathology, Rajshahi medical college, and the department of gynaecology and obstetrics, Rajshahi medical college hospital, Rajshahi, Bangladesh from July 2019 to June 2022. A total of 1000 VIA test-positive cases of cervical lesions were enrolled as study subjects purposively. Data were processed and analyzed by the MS office tools. Results: Cervical carcinoma was identified through cytological analysis in 4.6% of cases, with 7.6% exhibiting high-grade squamous intraepithelial lesions (HSIL) and 13.1% showing low-grade squamous intraepithelial lesions (LSIL). Through histopathological analysis, cervical carcinoma found in 5.3% of cases, CIN-grade III (CIN-III) in 7.1%, and CIN-II and CIN-I in 2.2%, 16.4% of cases, respectively. Human papillomavirus (HPV) vaccination rate was 0.70%. Conclusions: The prevalence of CIN and cervical carcinoma in the Rajshahi region of Bangladesh is alarmingly high. These findings underscore the pressing need for the immediate implementation of a comprehensive vaccination and awareness development program for cervical carcinoma

Efficacy of tolvaptan in reduction of kidney cyst volume and restoration of kidney function in ADPKD in tertiary care hospital

Background: Autosomal dominant polycystic kidney disease (ADPKD) is a frequent cause of end-stage renal disease. Despite improvements in blood pressure and conventional treatment, there seems not any significant impact on the need for renal replacement therapy in these cases. Inhibition of cyclic adenosine monophosphate pathway by tolvaptan was efficient in preclinical/animal studies and in clinical studies involving ADPKD patients; tolvaptan (vasopressin V2 receptor antagonist) has been recently released in the market to delay disease progression. Aims and Objectives: The aim of this study is to evaluate the role of tolvaptan in reduction of total kidney volume (TKV), total renal cyst volume, and decrease of progression of renal impairment and restoration of kidney function. Materials and Methods: We have screened 60 cases, of whom 54 were assigned to either tolvaptan group (36) or placebo (18). Overall 36 cases completed the trial (24 from tolvaptan group and 12 cases from placebo group). Estimated GFR (glomerular filtration rate) calculated and stages were noted. TKV and total cyst volume measured by ultrasonography at days 0, 30, 90, and 180 along with other vitals. The total number of patients enrolled was randomly divided into two broad groups by concealed envelop technique: Intervention group (with tolvaptan) and placebo or control group. The intervention group was given tolvaptan along with standard conventional management for ADPKD as per relevant stages. The placebo group was given placebo tablets with same size and color (multivitamin tablet) along with standard conventional management for ADPKD as per relevant stages. The periodic estimation of cyst volume, kidney volume, serum creatinine level, and estimated glomerular filtration rate recorded and analyzed with ANOVA method with confidence interval 95%. Results: Analysis of the data showed fewer ADPKD-related events per cases of follow-up with tolvaptan than with placebo. These results were confirmed by the analysis of the 1st time and after 6 months of study. Our data suggest that increase of TKV and total cyst volume was less in tolvaptan group as compared to placebo group. Overall, treatment effect on the growth of TKV was 0.219% per month with a P<0.0001. Conclusions: The administration of tolvaptan for 6 months was associated with slowed kidney growth and functional decline and with a reduced frequency of ADPKD-related complications among patients with a relatively preserved GFR

A dyad of lymphoblastic lysosomal cysteine proteases degrades the antileukemic drug L-asparaginase

l-Asparaginase is a key therapeutic agent for treatment of childhood acute lymphoblastic leukemia (ALL). There is wide individual variation in pharmacokinetics, and little is known about its metabolism. The mechanisms of therapeutic failure with l-asparaginase remain speculative. Here, we now report that 2 lysosomal cysteine proteases present in lymphoblasts are able to degrade l-asparaginase. Cathepsin B (CTSB), which is produced constitutively by normal and leukemic cells, degraded asparaginase produced by Escherichia coli (ASNase) and Erwinia chrysanthemi. Asparaginyl endopeptidase (AEP), which is overexpressed predominantly in high-risk subsets of ALL, specifically degraded ASNase. AEP thereby destroys ASNase activity and may also potentiate antigen processing, leading to allergic reactions. Using AEP-mediated cleavage sequences, we modeled the effects of the protease on ASNase and created a number of recombinant ASNase products. The N24 residue on the flexible active loop was identified as the primary AEP cleavage site. Sole modification at this site rendered ASNase resistant to AEP cleavage and suggested a key role for the flexible active loop in determining ASNase activity. We therefore propose what we believe to be a novel mechanism of drug resistance to ASNase. Our results may help to identify alternative therapeutic strategies with the potential of further improving outcome in childhood ALL

Minimal cost multifactor experiments for agricultural research involving hard-to-change factors

Multifactor experiments are very common in agricultural research. Randomizing run orders in multifactor experiments often witness in large number of factorwise level changes which will increase the cost and time of the experiments. Minimal cost multifactor experiments are such experiments where the cost of the experiment is minimum which can be achieved by choosing a factorial run order where the total number of factor level change is minimum as cost of the experiment is directly proportional to the number of level changes of factors. Here, a method of constructing minimal cost 2-level multifactor experiments with minimum number of factorwise level changes has been proposed. As for a same factorial combination, there may exist more than one minimally changed factorial run order, an exhaustive search was also performed to obtain all possible minimally changed run order for two level multifactorial experiments with three factors. Due to restricted randomization, adaption of these run orders may witness the effect of systematic time trend. Hence, the usual method of analysis may not be a feasible solution due to lack of randomization. Here, the analytical procedure of experiments using minimal cost multifactorial run order has also been highlighted based on a real experimental data. The work has been carried out at ICAR-Indian Agricultural Statistics Research Institute, New Delhi during 2019-20. The data from the real experiment used for explaining the analysis procedure has been collected from Climate Change Facility of ICAR-Indian Agricultural Research Institute farm, New Delhi, India based on experiments conducted during 2014-15

Measurement of the cross-section and charge asymmetry of WW bosons produced in proton-proton collisions at s=8\sqrt{s}=8 TeV with the ATLAS detector

This paper presents measurements of the $W^+ \rightarrow \mu^+\nu$ and $W^- \rightarrow \mu^-\nu$ cross-sections and the associated charge asymmetry as a function of the absolute pseudorapidity of the decay muon. The data were collected in proton--proton collisions at a centre-of-mass energy of 8 TeV with the ATLAS experiment at the LHC and correspond to a total integrated luminosity of 20.2~\mbox{fb^{-1}}. The precision of the cross-section measurements varies between 0.8% to 1.5% as a function of the pseudorapidity, excluding the 1.9% uncertainty on the integrated luminosity. The charge asymmetry is measured with an uncertainty between 0.002 and 0.003. The results are compared with predictions based on next-to-next-to-leading-order calculations with various parton distribution functions and have the sensitivity to discriminate between them.Comment: 38 pages in total, author list starting page 22, 5 figures, 4 tables, submitted to EPJC. All figures including auxiliary figures are available at https://atlas.web.cern.ch/Atlas/GROUPS/PHYSICS/PAPERS/STDM-2017-13

Search for new phenomena in final states with an energetic jet and large missing transverse momentum in pp collisions at √ s = 8 TeV with the ATLAS detector

Results of a search for new phenomena in final states with an energetic jet and large missing transverse momentum are reported. The search uses 20.3 fb−1 of √ s = 8 TeV data collected in 2012 with the ATLAS detector at the LHC. Events are required to have at least one jet with pT > 120 GeV and no leptons. Nine signal regions are considered with increasing missing transverse momentum requirements between Emiss T > 150 GeV and Emiss T > 700 GeV. Good agreement is observed between the number of events in data and Standard Model expectations. The results are translated into exclusion limits on models with either large extra spatial dimensions, pair production of weakly interacting dark matter candidates, or production of very light gravitinos in a gauge-mediated supersymmetric model. In addition, limits on the production of an invisibly decaying Higgs-like boson leading to similar topologies in the final state are presente

Search for direct stau production in events with two hadronic tau-leptons in root s=13 TeV pp collisions with the ATLAS detector

A search for the direct production of the supersymmetric partners ofτ-leptons (staus) in final stateswith two hadronically decayingτ-leptons is presented. The analysis uses a dataset of pp collisions corresponding to an integrated luminosity of139fb−1, recorded with the ATLAS detector at the LargeHadron Collider at a center-of-mass energy of 13 TeV. No significant deviation from the expected StandardModel background is observed. Limits are derived in scenarios of direct production of stau pairs with eachstau decaying into the stable lightest neutralino and oneτ-lepton in simplified models where the two staumass eigenstates are degenerate. Stau masses from 120 GeV to 390 GeV are excluded at 95% confidencelevel for a massless lightest neutralino