PICA WITH AN UNUSUAL FORM OF PRESENTATION: A CASE REPORT

ABSTRACTGeophagia is a condition involving the consumption of mud and is a form of eating disorder known as pica. Pica is an unusual craving for ingestion ofeither edible or inedible substances. Although, pica is not linked to solvent abuse, here we report a middle aged lady with mud eating that respondedto selective serotonin-reuptake inhibitors and cognitive behavior therapy.Keywords: Pica, Geophagia, Mud eating

Toward Automation of the Supine Pressor Test for Preeclampsia

Preeclampsia leads to increased risk of morbidity and mortality for both mother and fetus. Most previous studies have largely neglected mechanical compression of the left renal vein by the gravid uterus as a potential mechanism. In this study, we first used a murine model to investigate the pathophysiology of left renal vein constriction. The results indicate that prolonged renal vein stenosis after 14 days can cause renal necrosis and an increase in blood pressure (BP) of roughly 30 mmHg. The second part of this study aimed to automate a diagnostic tool, known as the supine pressor test (SPT), to enable pregnant women to assess their preeclampsia development risk. A positive SPT has been previously defined as an increase of at least 20 mmHg in diastolic BP when switching between left lateral recumbent and supine positions. The results from this study established a baseline BP increase between the two body positions in nonpregnant women and demonstrated the feasibility of an autonomous SPT in pregnant women. Our results demonstrate that there is a baseline increase in BP of roughly 10-14 mmHg and that pregnant women can autonomously perform the SPT. Overall, this work in both rodents and humans suggests that (1) stenosis of the left renal vein in mice leads to elevation in BP and acute renal failure, (2) nonpregnant women experience a baseline increase in BP when they shift from left lateral recumbent to supine position, and (3) the SPT can be automated and used autonomously

Disseminated Tuberculosis with Neurotuberculosis Presenting as Status Epilepticus: A Case Report

Disseminated Tuberculosis (TB) results when the infection spreads though lymphohaematogenous route involving multiple organ systems. Irrespective of the availability of diagnostic modalities and treatment, it is usually diagnosed late increasing the mortality. Though, it usually occurs in immunocompromised patients, yet, incidence of disseminated TB is rising in immunocompetent subjects. This case report describes a 48-year-old male who presented to the Emergency Department (ED) with status epilepticus. Investigations revealed neurotuberculosis along with generalised tubercular lymphadenopathy involving cervical, axillary, mediastinal and abdominal lymphnodes. Diagnosis was confirmed after Cerebrospinal Fluid (CSF) and lymphnode biopsy. He was started on first line antitubercular drugs and tapering dose of tab. Prednisolone over one month. He was discharged after two weeks of hospitalisation. At 15 days follow-up the patient was asymptomatic

Correlation of microvessel density with histopathological parameters of carcinoma breast

Background & objectives: Microvessel density (MVD) is a surrogate measure of tumour angiogenesis, and is well known for over two decades to identify individuals with a high risk of recurrence with greater prevision than traditional markers. This study aims to assess the utility of MVD and its correlation with the Nottingham Prognostic Index (NPI) and other routine histopathological parameters in carcinoma breast. Methods: This two year retrospective, cross-sectional and analytical study evaluated 143 women with breast cancer presenting to rural tertiary hospital in central India. These women were graded histopathologically, the immunophenotype was determined using ER (estrogen receptor), PR (progesterone receptor), Her2 neu (human epidermal growth factor receptor 2 neu) and Ki-67 proliferation index (Kiel-67) immunohistochemical markers and anti-CD34 antibody to stain the endothelial cell clusters displaying the microvessels. The NPI was generated for each participant based on the tumour size, histologic grade and involvement of lymph node. The parameters were compared with the CD34 scores. Differential and inferential statistics, including the independent t test, analysis of variance, Pearson's correlation coefficient, Spearman's rank correlation coefficient and point biserial correlation coefficient, were used for statistical analysis. Results: This study showed that CD34 values ranged from 6-36 microvessels/hpf, with 24.16±6.77 microvessels/hpf as the mean. The mean microvessel counts showed a significant positive correlation with the Bloom–Richardson histological grade, vascular invasion, LN (lymph node) positivity and NPI. However, there was no significant correlation of CD34 values with the participant's age, tumour size neither any significant association of CD34 values with the individual's immunophenotype. Interpretations & conclusions: A positive linear correlation of the microvessel counts and the NPI scores suggest that with an increase in tumour angiogenesis, there was increased proliferative potential. Based on the significant correlation between the microvessel counts and the vascular invasion of the tumour masses in this study, it can be assumed that there will be vascular invasion if the microvessel count is higher and vice-versa. Although it is established that angiogenesis and neovascularization are required for the expansion of the solid tumour tissue, the heterogeneous nature of this entity makes it difficult for obtaining a linear correlation. Hence, it is suggested that though neovascularization permits advanced tumour spread it, however, does not guarantee it

Geospatial Analysis of Geo-Ecotourism Site Suitability Using AHP and GIS for Sustainable and Resilient Tourism Planning in West Bengal, India

The current study intended to geospatially analyze the potentiality and site suitability of geo-ecotourism in West Bengal, India. The state of West Bengal is a great platform for diverse tourism and has enormous potential to cultivate geo-ecotourism, as has come up in recent years. The current effort throws some valuable light on the possibility of turning the many geologically, geomorphologically and ecologically significant tourist spots of West Bengal into geo-ecotourism sites, aided with geospatial techniques. The study deals with the qualitative and quantitative investigation of the potentiality of the whole state by dividing it into several geo-ecotourism zones, based on its physiographic setting and Land Use Land Cover (LULC) features, using satellite image data. The application of geospatial technology combined with Remote Sensing (RS) and Geographic Information System (GIS) was employed for this geospatial analysis to portray the potential zones using cartographic and statistical techniques. Furthermore, nine criteria were selected to run the Analytic Hierarchy Process (AHP) method to determine the site suitability for geo-ecotourism. The present submission attempts to record the mapping and analysis of geo-ecotourism of West Bengal employing a secondary database, an expert’s opinions and primary observations, with the application of the AHP method and GIS. The outcomes of the study were found to be very significant, as they indicate a proviso for geo-ecotourism development in the state and will contribute to the formation of location-specific planning and the sustainable management of geo-ecotourism

Additional file 1: of Patient awareness/knowledge towards oral cancer: a cross-sectional survey

Survey Instrument. (PDF 249 kb

Assessing Groundwater Dynamics and Potentiality in the Lower Ganga Plain, India

The present study intended to assess groundwater storage dynamics (GWS) and identify potential zones using the Multi-Criteria Decision Making (MCDM) method and geospatial technology in the Murshidabad district of West Bengal, India. The study district is located in the Ganga–Padma–Bhagirathi rivers’ floodplain and covers approximately a 5324 km2 area, comprising 26 blocks in five sub-divisions. The study portrayed a quantitative investigation of the pre-monsoon and post-monsoon season’s variability of GWS from 2000 to 2020, taking Landsat TM/Landsat 8 OLI/SRTM satellite data. The geo-spatio-temporal analysis of groundwater storage variability for 20 years was carried out by such remotely sensed data with the geospatial method to portray the dynamics and uncover the potential zones of GWS using various cartographic and statistical techniques. We determined nine parameters for the study, and the analytical hierarchy process (AHP) method was employed for the computation. The present estimation and assessment include the MCDM method, covering assorted parameters and the variations and aspects of GWS in the pre- and post-monsoon seasons from 2000 to 2020. The outcome illustrates that a decline in water storage has taken place in most of the blocks of Murshidabad district on average during the study period, which indicates a water stress provison in the near future. However, the micro (block)-level scenario of the spatiotemporal dynamics of GWS and the potential zonation in the Murshidabad District were investigated to form a location-specific micro-level arrangement for the sustainable management of water

Targeting dendritic cells in humanized mice receiving adoptive T cells via monoclonal antibodies fused to Flu epitopes.

The targeting of vaccine antigens to antigen presenting cells (APC), such as dendritic cells (DCs), is a promising strategy for boosting vaccine immunogenicity and, in turn, protective and/or therapeutic efficacy. However, in vivo systems are needed to evaluate the potential of this approach for testing human vaccines. To this end, we examined human CD8(+) T-cell expansion to novel DC-targeting vaccines in vitro and in vivo in humanized mice. Vaccines incorporating the influenza matrix protein-1 (FluM1) antigen fused to human specific antibodies targeting different DC receptors, including DEC-205, DCIR, Dectin-1, and CD40, elicited human CD8(+) T-cell responses, as defined by the magnitude of specific CD8(+) T-cells to the targeted antigen. In vitro we observed differences in response to the different vaccines, particularly between the weakly immunogenic DEC-205-targeted and more strongly immunogenic CD40-targeted vaccines, consistent with previous studies. However, in humanized mice adoptively transferred (AT) with mature human T cells (HM-T), vaccines that performed weakly in vitro (i.e., DEC-205, DCIR, and Dectin-1) gave stronger responses in vivo, some resembling those of the strongly immunogenic CD40-targeted vaccine. These results demonstrate the utility of the humanized mouse model as a platform for studies of human vaccines. Vaccine 2016 Sep 22; 34(41):4857-65