Adductor insertion avulsion syndrome, "thigh splints”: relevance of radiological follow-up

We present a case of chronic osteomyelitis in a 13-year-old girl which was originally diagnosed as adductor insertion avulsion syndrome ("thigh splints”) on the basis of the clinical presentation, patient history, initial radiographs and MRI examination. However, at follow-up with persistent pain and altered radiographic and MRI appearances, surgical biopsy was indicated. Histopathological findings confirmed a bone abscess. This case underlines the necessity of clinical follow-up and imaging in certain patients with apparent thigh splint

Author Correction: Sensory Primary Cilium is a Responsive cAMP Microdomain in Renal Epithelia

Correction to: Scientific Reports https://doi.org/10.1038/s41598-019-43002-2, published online 25 April 2019 The legend for Figure 1c is incomplete. ‘Time-lapse images represent the intracellular calcium level in response to fluid-shear stress (arrow) by epithelial and endothelial cells treated without (control, vehicle) and with tolvaptan (0.1 μM). Color bar indicates intracellular calcium level from low (black) to high (red). Corresponding brightfield images are shown in Supplementary Fig. S1.’ should read: ‘Time-lapse images represent the intracellular calcium level in response to fluid-shear stress (arrow) by epithelial and endothelial cells that were first treated with vehicle alone (control), and then treated with tolvaptan (0.1 μM) for 20 hours. Color bar indicates intracellular calcium level from low (black) to high (red). Corresponding brightfield images are shown in Supplementary Fig. S1.

Retinal laser services in Bhutan: A 3-year national survey

Background: We conducted this study to report on the indications and types of retinal laser therapy (RLT) performed in Bhutan, knowing which is critical for proper planning and successful delivery of the services. Methods: We reviewed the laser registers maintained in the laser rooms and vitreoretinal (VR) operating theatres (including paediatric cases managed under anaesthesia) over three years at the national and the two regional referral hospitals (RRHs). Intraoperative laser treatments (endolaser) were excluded. Patient demography, indications and types of RLT were recorded and quantified. Comparisons of the expected and observed frequencies used Chisquared tests. Results: A total of 685 patients, including 8 cases of bilateral retinopathy of prematurity (ROP) received RLT. The majority of patients (411 cases, 60.0%, p < 0.0001) were males. The mean age was 54.1  ± 14.1 years, median 56 years. The most common indications for RLT were diabetic retinopathy (DR) and diabetic macular oedema (DMO) (542 cases, 66.0%), followed by retinal vein occlusion (RVO) (91 cases, 13.3%). Pan-retinal photocoagulation was the most common type of RLT performed (337 cases, 49.2%), followed by modified grid laser (207 cases, 30.2%), sectoral laser (41 cases, 6.0%), and prophylactic laser photocoagulation (33 cases, 4.8%). Conclusions: The majority of patients were within working-age. Common indications for RLT were preventable such as DR, DMO and RVO, indicating need to control systemic diseases such as diabetes, hypertension, and dyslipidaemia. Currently, regular RLT is provided only at the national referral hospital in Thimphu, and periodically in the eastern and central RRHs when the retinal specialist visits. There is need to extend the retinal services to the eastern and central RRHs to improve accessibility and patient coverage in these regions challenged with difficult terrain and poor public transport system

Gaps in Capacity in Primary Care in Low-Resource Settings for Implementation of Essential Noncommunicable Disease Interventions

Objective. The objective was to evaluate the capacity of primary care (PC) facilities to implement basic interventions for prevention and management of major noncommunicable diseases (NCDs), including cardiovascular diseases and diabetes. Methods. A cross-sectional survey was done in eight low- and middle-income countries (Benin, Bhutan, Eritrea, Sri Lanka, Sudan, Suriname, Syria, and Vietnam) in 90 PC facilities randomly selected. The survey included questions on the availability of human resources, equipment, infrastructure, medicines, utilization of services, financing, medical information, and referral systems. Results and Conclusions. Major deficits were identified in health financing, access to basic technologies and medicines, medical information systems, and the health workforce. The study has provided the foundation for strengthening PC to address noncommunicable diseases. There are important implications of the findings of this study for all low- and middle-income countries as capacity of PC is fundamental for equitable prevention and control of NCDs

Timescapes of Himalayan hydropower: promises, project life cycles, and precarities

In this paper, we review the existing social science scholarship focused on hydropower development in the Himalayan region, using an interpretive lens attuned to issues of time and temporality. While the spatial politics of Himalayan hydropower are well examined in the literature, an explicit examination of temporal politics is lacking. In this paper, we present a conceptual framework organized around the heuristic of timescapes, highlighting temporal themes implicit in the existing literature. In three sections, we explore the temporal politics of anticipation that shape hydropower dreams, the intersecting temporalities and rhythms that modulate the life cycles of hydropower projects, and the ways that geological and hydrological time affect both hydropower development and broader Himalayan futures. Along the way, we pose a series of questions useful for framing future research given the significant climatic, geophysical, and sociopolitical changes underway in the Himalayan bioregion, calling for greater analytical attention to time, temporality, and temporal ethics in future studies of hydropower in the Himalayas and beyond.Austin Lord, Georgina Drew, Mabel Denzin Gerga