IBRUTINIB IN THE MANAGEMENT OF NON-HODGKIN'S LYMPHOMA: A CASE REPORT

Non-Hodgkin's lymphoma (NHL) is a diverse group of lymphoid neoplasms, the prevalence of which has increased over the past few decades. NHL is diverse in the manner of presentation, response to various treatment and prognosis. The current case report describes a 40-year-old man who was diagnosed with small lymphocytic lymphoma/chronic lymphocytic leukemia in 2006. The patient had disease progression during the course of 10 years from the time of diagnosis for which he received multiple lines of chemotherapy (chlorambucil/prednisolone; rituximab/cyclophosphamide/ fludarabine; bendamustine/rituximab; and ofatumumab). However, in 2016, his disease again showed signs of progression, and hence he was started on ibrutinib 140 mg 3 times daily. After treatment with ibrutinib, there were no clinical nodes and hepatosplenomegaly, and all counts also normalized. Since the commencement of this agent, no disease progression was observed for almost 16 months. However, in July 2017, again disease progression occurred, and the patient was started on with cyclophosphamide, vincristine, and prednisone (COP) regimen. He received one cycle of COP regimen and continued on treatment with ibrutinib, and the treatment was well tolerated. In December 2017, he expired due to the progression of the disease. Ibrutinib, a Bruton's tyrosine kinase inhibitor, appears to be safe and effective in providing long-term disease control even in refractory cases of NHL

Simulation of unsteady natural convection flow of a Casson viscoplastic fluid in a square enclosure utilizing a MAC algorithm

Non-Newtonian fluids are increasingly being deployed in energy systems and materials processing. Motivated by these developments, in the current study, a numerical simulation is performed on two-dimensional, unsteady buoyancy-driven flow in a square cavity filled with non-Newtonian fluid (Casson liquid). The enclosure geometry features vertical isothermal walls (with one at higher temperature than the other) and thermally insulated horizontal walls. The conservation equations for mass, momentum and energy are normalized via appropriate transformations and the resulting dimensionless partial differential boundary value problem is solved computationally with a Marker and Cell (MAC) algorithm which features a finite difference scheme along with a staggered grid system. The projection method is employed to evaluate the pressure term. Extensive visualizations of the impact of emerging physical parameters (Rayleigh number and Casson viscoplastic parameter) on streamline and isotherm distributions in the cavity are presented for fixed Prandtl number. Nusselt number i.e. heat transfer rate is increased with rising values of the Casson viscoplastic fluid parameter for any value of Rayleigh number. The density of streamlines increases with increasing values of Casson viscoplastic fluid parameter up to 1. Overall the Casson fluid parameter plays a vital role in controlling the convective heat transfer within the enclosure. The computations are relevant to hybrid solar collectors, materials fabrication (polymer melts) etc

Successful monitoring of the 11 April 2012 tsunami off the coast of Sumatra by Indian Tsunami Early Warning Centre

The Indian Tsunami Early Warning Centre (ITEWC) in Hyderabad monitored the 11 April 2012 tsunami off the coast of Sumatra, which was generated by a shallow strike-slip earthquake and it largest aftershock of magnitude Mw (mB) 8.5 and 8.2 respectively, that occurred inside the subducting slab of the Indian plate. The earthquake generated a small ocean-wide tsunami that has been recorded by various tide gauges and tsunami buoys located in the Indian Ocean region. ITEWC detected the earthquake within 3 min 52 s and issued six advisories (bulletins) according to its Standard Operating Procedure. The ITEWC performed well during the event, and avoided false alarms and unnecessary public evacuations, especially in the mainland part of India region

Clinical equivalence of Trusynth fast® and Vicryl rapide® polyglactin 910 fast absorbing sutures on maternal morbidity experienced by women following episiotomy repair: a single-blind, randomized study [version 2; peer review: 2 approved]

Background: Episiotomy procedure enlarges the vaginal outlet to facilitate childbirth. Polyglactin 910 fast-absorbing sutures are widely used for the repair of episiotomy because of their rapid absorption and less inflammatory response. This study was designed for subjective assessment of perineal pain post-episiotomy repair, with Trusynth Fast® and Vicryl Rapide® polyglactin 910 fast-absorbing sutures. Method: This was a single-blind, randomized, prospective study conducted between January 7, 2021 and July 14, 2021 across two centers in India. Primiparous or multiparous women (18—40 years), who required episiotomy during vaginal delivery were included, and either Trusynth Fast® (n=47) or Vicryl Rapide® (n=49) suture was used for their episiotomy repair. The primary endpoint, perineal pain was assessed with visual analogue scale at all follow-up visits. The secondary endpoints, quantity of local anesthesia, number of sutures used, time to repair episiotomy, intraoperative suture handling, analgesics used, early and late wound complications, wound re-suturing, time to complete healing, presence of residual sutures, return to sexual activity, dyspareunia, and adverse events were also recorded. Results: The study showed no significant difference in perineal pain between the two groups at any visit. A statistically significant difference (p<0.05) in total score of episiotomy healing scale on day 2 (0.13±0.34 versus 0.35±0.56) and swelling on day 2 (8.51 versusversus 28.57%) was noted between Trusynth Fast® and Vicryl Rapide® group. Non-significant difference was observed between the groups regarding anesthesia, number of sutures, time to repair episiotomy, intraoperative suture handling, analgesics, puerperal fever, wound infection, dehiscence, hematoma, urinary incontinence, re-suturing, time to complete healing, return to sexual activity and dyspareunia. Conclusion: Trusynth Fast® suture is clinically equivalent to Vicryl Rapide® suture and can be used for episiotomy repair with minimal risk of perineal pain and wound complications. Clinical Trials Registry of India Registration: CTRI/2020/12/029925; Registered on December 18, 202

Outbreak of pandemic influenza A/H1N1 2009 in Nepal

<p>Abstract</p> <p>Background</p> <p>The 2009 flu pandemic is a global outbreak of a new strain of H1N1 influenza virus. Pandemic influenza A (H1N1) 2009 has posed a serious public health challenge world-wide. Nepal has started Laboratory diagnosis of Pandemic influenza A/H1N1 from mid June 2009 though active screening of febrile travellers with respiratory symptoms was started from April 27, 2009.</p> <p>Results</p> <p>Out of 609 collected samples, 302 (49.6%) were Universal Influenza A positive. Among the influenza A positive samples, 172(28.3%) were positive for Pandemic influenza A/H1N1 and 130 (21.3%) were Seasonal influenza A. Most of the pandemic cases (53%) were found among young people with ≤ 20 years. Case Fatality Ratio for Pandemic influenza A/H1N1 in Nepal was 1.74%. Upon Molecular characterization, all the isolated pandemic influenza A/H1N1 2009 virus found in Nepal were antigenically and genetically related to the novel influenza A/CALIFORNIA/07/2009-LIKE (H1N1)v type.</p> <p>Conclusion</p> <p>The Pandemic 2009 influenza virus found in Nepal were antigenically and genetically related to the novel A/CALIFORNIA/07/2009-LIKE (H1N1)v type.</p

Short-Term Effect of Different Teaching Methods on Nasopharyngeal Carcinoma for General Practitioners in Jakarta, Indonesia

In Indonesia, Nasopharyngeal Carcinoma (NPC) is the most frequent cancer of the head and neck region. At first presentation in the hospital most patients already have advanced NPC. Our previous study showed that general practitioners (GPs) working in Yogyakarta, Indonesia lack the knowledge necessary for early detection of NPC. By providing training on early symptoms of NPC we hope that the diagnosis and referral will occur at an earlier stage. Here we assess the current NPC knowledge levels of GPs in Jakarta, evaluate improvement after training, compare the effectiveness of two training formats, and estimate the loss of recall over a two week period

Screening of anti-dengue activity in methanolic extracts of medicinal plants

<p>Abstract</p> <p>Background</p> <p>Dengue fever regardless of its serotypes has been the most prevalent arthropod-borne viral diseases among the world population. The development of a dengue vaccine is complicated by the antibody-dependent enhancement effect. Thus, the development of a plant-based antiviral preparation promises a more potential alternative in combating dengue disease.</p> <p>Methods</p> <p>Present studies investigated the antiviral effects of standardised methanolic extracts of <it>Andrographis paniculata, Citrus limon, Cymbopogon citratus, Momordica charantia, Ocimum sanctum </it>and <it>Pelargonium citrosum </it>on dengue virus serotype 1 (DENV-1).</p> <p>Results</p> <p><it>O. sanctum </it>contained 88.6% of total flavonoids content, an amount that was the highest among all the six plants tested while the least was detected in <it>M. charantia</it>. In this study, the maximum non-toxic dose (MNTD) of the six medicinal plants was determined by testing the methanolic extracts against Vero E6 cells <it>in vitro</it>. Studies also determined that the MNTD of methanolic extract was in the decreasing order of <it>M. charantia </it>><it>C. limon </it>><it>P. citrosum, O. sanctum </it>><it>A. paniculata </it>><it>C. citratus</it>. Antiviral assay based on cytopathic effects (CPE) denoted by degree of inhibition upon treating DENV1-infected Vero E6 cells with MNTD of six medicinal plants showed that <it>A. paniculata </it>has the most antiviral inhibitory effects followed by <it>M. charantia</it>. These results were further verified with an <it>in vitro </it>inhibition assay using MTT, in which 113.0% and 98.0% of cell viability were recorded as opposed to 44.6% in DENV-1 infected cells. Although methanolic extracts of <it>O. sanctum </it>and <it>C. citratus </it>showed slight inhibition effect based on CPE, a significant inhibition was not reflected in MTT assay. Methanolic extracts of <it>C. limon </it>and <it>P. citrosum </it>did not prevent cytopathic effects or cell death from DENV-1.</p> <p>Conclusions</p> <p>The methanol extracts of <it>A. paniculata </it>and <it>M. charantia </it>possess the ability of inhibiting the activity of DENV-1 in <it>in vitro </it>assays. Both of these plants are worth to be further investigated and might be advantageous as an alternative for dengue treatment.</p

Purification and Characterization of a Sperm Motility Inhibiting Factor from Caprine Epididymal Plasma

Several studies have been reported on the occurrence of sperm motility inhibiting factors in the male reproductive fluids of different mammalian species, but these proteins have not been adequately purified and characterized. A novel sperm motility inhibiting factor (MIF-II) has been purified from caprine epididymal plasma (EP) by Hydroxylapatite gel adsorption chromatography, DEAE-Cellulose ion-exchange chromatography and chromatofocusing. The MIF-II has been purified to apparent homogeneity and the molecular weight estimated by Sephacryl S-300 gel filtration is 160 kDa. MIF-II is a dimeric protein, made up of two subunits each having a molecular mass of 80 kDa as shown by SDS-PAGE. The isoelectric point of MIF-II is 5.1 as determined by chromatofocusing and isoelectric focusing. It is a heat labile protein and maximal active at the pH 6.9 to 7.5. The sperm motility inhibiting protein factor at 2 µg/ml (12.5 nM) level showed maximal motility-inhibiting activity. The observation that the epididymal plasma factor lowered the intracellular cAMP level of spermatozoa in a concentration-dependent manner suggests that it may block the motility of caprine cauda spermatozoa by interfering the cAMP dependent motility function. The results revealed that the purified protein factor has the potential of sperm motility inhibition and may serve as a vaginal contraceptive. The antibody raised against the MIF-II has the potential for enhancement of forward motility of cauda-spermatozoa. This antibody may thus be useful for solving some of the problems of male infertility due to low sperm motility

Dissipative and Non-dissipative Single-Qubit Channels: Dynamics and Geometry

Single-qubit channels are studied under two broad classes: amplitude damping channels and generalized depolarizing channels. A canonical derivation of the Kraus representation of the former, via the Choi isomorphism is presented for the general case of a system's interaction with a squeezed thermal bath. This isomorphism is also used to characterize the difference in the geometry and rank of these channel classes. Under the isomorphism, the degree of decoherence is quantified according to the mixedness or separability of the Choi matrix. Whereas the latter channels form a 3-simplex, the former channels do not form a convex set as seen from an ab initio perspective. Further, where the rank of generalized depolarizing channels can be any positive integer upto 4, that of amplitude damping ones is either 2 or 4. Various channel performance parameters are used to bring out the different influences of temperature and squeezing in dissipative channels. In particular, a noise range is identified where the distinguishability of states improves inspite of increasing decoherence due to environmental squeezing.Comment: 12 pages, 4 figure