Nevirapine induced Stevens-Johnson syndrome: a case report

Stevens-Johnson syndrome (SJS) is a severe mucocutaneous skin reaction with extensive necrosis and detachment of the epidermis. Nevirapine is one of the high risk agents implicated in development of SJS. Here, we present a case of 27 years old male with HIV infection who was diagnosed to have SJS following administration of nevirapine

Tuberculosis and Indoor Biomass and Kerosene Use in Nepal: A Case–Control Study

BackgroundIn Nepal, tuberculosis (TB) is a major problem. Worldwide, six previous epidemiologic studies have investigated whether indoor cooking with biomass fuel such as wood or agricultural wastes is associated with TB with inconsistent results.ObjectivesUsing detailed information on potential confounders, we investigated the associations between TB and the use of biomass and kerosene fuels.MethodsA hospital-based case-control study was conducted in Pokhara, Nepal. Cases (n = 125) were women, 20-65 years old, with a confirmed diagnosis of TB. Age-matched controls (n = 250) were female patients without TB. Detailed exposure histories were collected with a standardized questionnaire.ResultsCompared with using a clean-burning fuel stove (liquefied petroleum gas, biogas), the adjusted odds ratio (OR) for using a biomass-fuel stove was 1.21 [95% confidence interval (CI), 0.48-3.05], whereas use of a kerosene-fuel stove had an OR of 3.36 (95% CI, 1.01-11.22). The OR for use of biomass fuel for heating was 3.45 (95% CI, 1.44-8.27) and for use of kerosene lamps for lighting was 9.43 (95% CI, 1.45-61.32).ConclusionsThis study provides evidence that the use of indoor biomass fuel, particularly as a source of heating, is associated with TB in women. It also provides the first evidence that using kerosene stoves and wick lamps is associated with TB. These associations require confirmation in other studies. If using kerosene lamps is a risk factor for TB, it would provide strong justification for promoting clean lighting sources, such as solar lamps

Global, regional, and national under-5 mortality, adult mortality, age-specific mortality, and life expectancy, 1970–2016: a systematic analysis for the Global Burden of Disease Study 2016

BACKGROUND: Detailed assessments of mortality patterns, particularly age-specific mortality, represent a crucial input that enables health systems to target interventions to specific populations. Understanding how all-cause mortality has changed with respect to development status can identify exemplars for best practice. To accomplish this, the Global Burden of Diseases, Injuries, and Risk Factors Study 2016 (GBD 2016) estimated age-specific and sex-specific all-cause mortality between 1970 and 2016 for 195 countries and territories and at the subnational level for the five countries with a population greater than 200 million in 2016. METHODS: We have evaluated how well civil registration systems captured deaths using a set of demographic methods called death distribution methods for adults and from consideration of survey and census data for children younger than 5 years. We generated an overall assessment of completeness of registration of deaths by dividing registered deaths in each location-year by our estimate of all-age deaths generated from our overall estimation process. For 163 locations, including subnational units in countries with a population greater than 200 million with complete vital registration (VR) systems, our estimates were largely driven by the observed data, with corrections for small fluctuations in numbers and estimation for recent years where there were lags in data reporting (lags were variable by location, generally between 1 year and 6 years). For other locations, we took advantage of different data sources available to measure under-5 mortality rates (U5MR) using complete birth histories, summary birth histories, and incomplete VR with adjustments; we measured adult mortality rate (the probability of death in individuals aged 15-60 years) using adjusted incomplete VR, sibling histories, and household death recall. We used the U5MR and adult mortality rate, together with crude death rate due to HIV in the GBD model life table system, to estimate age-specific and sex-specific death rates for each location-year. Using various international databases, we identified fatal discontinuities, which we defined as increases in the death rate of more than one death per million, resulting from conflict and terrorism, natural disasters, major transport or technological accidents, and a subset of epidemic infectious diseases; these were added to estimates in the relevant years. In 47 countries with an identified peak adult prevalence for HIV/AIDS of more than 0·5% and where VR systems were less than 65% complete, we informed our estimates of age-sex-specific mortality using the Estimation and Projection Package (EPP)-Spectrum model fitted to national HIV/AIDS prevalence surveys and antenatal clinic serosurveillance systems. We estimated stillbirths, early neonatal, late neonatal, and childhood mortality using both survey and VR data in spatiotemporal Gaussian process regression models. We estimated abridged life tables for all location-years using age-specific death rates. We grouped locations into development quintiles based on the Socio-demographic Index (SDI) and analysed mortality trends by quintile. Using spline regression, we estimated the expected mortality rate for each age-sex group as a function of SDI. We identified countries with higher life expectancy than expected by comparing observed life expectancy to anticipated life expectancy on the basis of development status alone. FINDINGS: Completeness in the registration of deaths increased from 28% in 1970 to a peak of 45% in 2013; completeness was lower after 2013 because of lags in reporting. Total deaths in children younger than 5 years decreased from 1970 to 2016, and slower decreases occurred at ages 5-24 years. By contrast, numbers of adult deaths increased in each 5-year age bracket above the age of 25 years. The distribution of annualised rates of change in age-specific mortality rate differed over the period 2000 to 2016 compared with earlier decades: increasing annualised rates of change were less frequent, although rising annualised rates of change still occurred in some locations, particularly for adolescent and younger adult age groups. Rates of stillbirths and under-5 mortality both decreased globally from 1970. Evidence for global convergence of death rates was mixed; although the absolute difference between age-standardised death rates narrowed between countries at the lowest and highest levels of SDI, the ratio of these death rates-a measure of relative inequality-increased slightly. There was a strong shift between 1970 and 2016 toward higher life expectancy, most noticeably at higher levels of SDI. Among countries with populations greater than 1 million in 2016, life expectancy at birth was highest for women in Japan, at 86·9 years (95% UI 86·7-87·2), and for men in Singapore, at 81·3 years (78·8-83·7) in 2016. Male life expectancy was generally lower than female life expectancy between 1970 and 2016, an

Minimal information for studies of extracellular vesicles (MISEV2023): From basic to advanced approaches

Extracellular vesicles (EVs), through their complex cargo, can reflect the state of their cell of origin and change the functions and phenotypes of other cells. These features indicate strong biomarker and therapeutic potential and have generated broad interest, as evidenced by the steady year-on-year increase in the numbers of scientific publications about EVs. Important advances have been made in EV metrology and in understanding and applying EV biology. However, hurdles remain to realising the potential of EVs in domains ranging from basic biology to clinical applications due to challenges in EV nomenclature, separation from non-vesicular extracellular particles, characterisation and functional studies. To address the challenges and opportunities in this rapidly evolving field, the International Society for Extracellular Vesicles (ISEV) updates its 'Minimal Information for Studies of Extracellular Vesicles', which was first published in 2014 and then in 2018 as MISEV2014 and MISEV2018, respectively. The goal of the current document, MISEV2023, is to provide researchers with an updated snapshot of available approaches and their advantages and limitations for production, separation and characterisation of EVs from multiple sources, including cell culture, body fluids and solid tissues. In addition to presenting the latest state of the art in basic principles of EV research, this document also covers advanced techniques and approaches that are currently expanding the boundaries of the field. MISEV2023 also includes new sections on EV release and uptake and a brief discussion of in vivo approaches to study EVs. Compiling feedback from ISEV expert task forces and more than 1000 researchers, this document conveys the current state of EV research to facilitate robust scientific discoveries and move the field forward even more rapidly

Clinico pathological study of gestational trophoblastic disease – A two years study

Introduction: Gestational trophoblastic disease is one of the most fascinating of all the gynecologic neoplasms partly due to their comparative rarity in western hemisphere but also because of their unique status as tumors derived from the tissues of one individual and growing in other. Aims: To study and establish the histopathological diagnosis and clinicopathological correlations.Methods: A study of 85 cases with gestational trophoblastic disease diagnosed in the Department of Pathology, GIMS District Hospital, KALABURAGI during the period from September 2018 to August 2020. Biopsies and hysterectomy specimens were processed routinely, embedded in paraffin, stained with H&E. Studied as per proforma. Results: Maximum cases were in the age group of 21-30 years (52.9%). Common in first, second and fourth pregnancies and in ‘A’ blood group. Most of the patients belonged to Hindu (72.8%) community. Common presenting symptom was bleeding per vagina (100%).Histopathological examination of specimens revealed hydatid form mole 84.7%, invasive mole 1.17%, choriocarcinoma 4.7%, placental site trophoblastic tumor 1.18% and placental site trophoblastic reaction 8.2%. Summary & Conclusion: The incidence of gestational trophoblastic disease was more in the South-East Asian Countries as evidenced from the review of literature, but unfortunately these are the countries where an organized study of these tumors in the form of National Registries as in USA, UK and Japan is lacking. Hence, the diagnosis and follow-up of these patients is essential for the early detection of malignant trophoblastic disease and reduce the mortality rates

Spindle cell carcinoma in the maxilla: A rare case and literature review

In India, oral squamous cell carcinoma accounts for 90%–95% of oral malignancies. The WHO classifies spindle cell carcinoma (SpCC) under malignant epithelial tumors of squamous cell carcinoma (SCC) and is a rare entity accounting for only 1% of SCCs. It is an aggressive biphasic neoplasm exhibiting high mortality rate owing to increased metastasis and recurrence which signifies the need for recognition and treatment of this perplexed tumor. We present a case of maxillary SpCC where histopathological evaluation alone was indecisive, requiring immunohistochemistry for confirmation of the diagnosis

Stature estimation using odontometry and skull anthropometry

<b>Objective:</b> To investigate the possibility of estimating height from odontometry and anthropometric data of the skull for the positive identification of height in forensic investigations concerned with fragmentary human remains. <b> Materials and Methods:</b> The study was carried out on 100 Mysorean patients, 50 males, and 50 females. Measurements of mesiodistal widths of the six maxillary anterior teeth, circumference of the skull, and height were made directly on each patient. Anteroposterior diameter of the skull was obtained on the lateral cephalograph. The data collected were subjected to statistical methods. The known heights of the combined data, data for males, and females were regressed against the odontometric and anthropometric variables using linear regression analysis. <b> Results:</b> Significant sexual dimorphism was observed for the parameters studied (<i> P <</i> 0.05). Highly significant correlation was found between height and other parameters when combined data and data for males were regressed. The equation relating height to the combined mesiodistal width of maxillary anterior teeth was derived as height = 982.421 &#x002B; 13.65 x combined mesiodistal width of maxillary anterior teeth (<i> P <</i> 0.0001). Similarly equations were obtained by regressing height to head circumference and skull diameter (<i> P <</i> 0.0001 for both). The above findings may hence provide reliable method of estimation of height from skeletal remains in the forensic setup

A scanning electron microscopic study of smear layer remaining following use of Greater Taper rotary instruments

The aim of this in vitro study was to evaluate the smear layer in the root canal following the use of Ni-Ti hand ProTaper, HERO shaper and Twisted rotary instruments. Fifteen freshly extracted single rooted human mandibular premolar teeth were selected. Crowns of all teeth were cut off at the cemento-enamel junction with a carborundum disc. The roots were then randomly divided into three groups of 5 samples each. The working length of all teeth was established by the insertion of an endodontic instrument into the canal until its tip is visible at the apical foramen and then subtracted by 0.5 mm. A sequential crown down technique was carried out in all the three groups as follows: Group-I- Specimens in this group were instrumented with ProTaper Ni-Ti hand instruments. Group-II- Specimens were instrumented with HERO shapers. Group-III - The specimens in this group were instrumented with Twisted rotary instruments. Irrigation was done with 3% NaOCl and 15% EDTA in all the three groups. Teeth were carefully split with hammer and chisel and stored in small labeled bottles containing normal saline until SEM evaluation. Results showed that when comparing ProTaper files, Twisted rotary instruments and HERO shaper instruments, HERO shaper series of rotary instruments showed maximum amount of smear layer followed by the Twisted rotary instruments. Hand instruments produced least amount of smear layer