Egg shell morphology of an amblyceran louse, Hohorstiella rampurensis (Phthiraptera) infesting ring dove, Streptopelia decaocta

Scanning electron microscopy (SEM) study showed that miniature rice grain like egg shell of Hohorstiella rampurensis was covered by obliquely placed opercular disc. The apophyses were present only on one side of the egg shell. There were 25-35 long elongated rod like apophyses (apically turned), which were arranged in 3-4 rows and occurred in pair. The nature of egg shell of H. rampurensis characteristically differed from that of H. lata (the only species of Hohorstiella studied, so far). The study further indicates about the role of egg morphology as a guide to louse taxonomy

Cardiac Allograft Vasculopathy: Pathogenesis and Role of Coronary Computed Tomography Angiography in the Diagnosis and Surveillance

Cardiac allograft vasculopathy (CAV) is an entity unique to the cardiac transplant patients and remains the leading cause of mortality after the first year of transplantation causing chronic allograft rejection. It is an accelerated form of coronary artery disease, occurring diffusely, starting from the small distal vessels and ultimately extending to intramyocardial and epicardial vessels of the allograft. Multiple traditional metabolic risk factors known to cause atherosclerosis have been identified as a trigger for CAV. Moreover, several nontraditional environmental risk factors such as viral infections, donor’s age, underlying cardiac disease and mechanism of donor brain death have also been implicated. The pathogenesis of CAV is complex with involvement of both immunological and non-immunological mechanisms and still remains poorly understood. Clinical diagnosis of CAV is difficult as symptoms of angina are usually lacking because of denervated nature of the allograft and it is identified when the graft is already compromised. Currently, invasive testing stands as the gold standard for its diagnosis; however its utility has been questioned. Coronary CT angiography (CCTA) has emerged as a promising noninvasive tool for the diagnosis of CAV. This review discusses the risk factors, pathogenesis and diagnosis of CAV and utility of CCTA in its diagnosis and surveillance

Analyzing the Efficacy of an LLM-Only Approach for Image-based Document Question Answering

Recent document question answering models consist of two key components: the vision encoder, which captures layout and visual elements in images, and a Large Language Model (LLM) that helps contextualize questions to the image and supplements them with external world knowledge to generate accurate answers. However, the relative contributions of the vision encoder and the language model in these tasks remain unclear. This is especially interesting given the effectiveness of instruction-tuned LLMs, which exhibit remarkable adaptability to new tasks. To this end, we explore the following aspects in this work: (1) The efficacy of an LLM-only approach on document question answering tasks (2) strategies for serializing textual information within document images and feeding it directly to an instruction-tuned LLM, thus bypassing the need for an explicit vision encoder (3) thorough quantitative analysis on the feasibility of such an approach. Our comprehensive analysis encompasses six diverse benchmark datasets, utilizing LLMs of varying scales. Our findings reveal that a strategy exclusively reliant on the LLM yields results that are on par with or closely approach state-of-the-art performance across a range of datasets. We posit that this evaluation framework will serve as a guiding resource for selecting appropriate datasets for future research endeavors that emphasize the fundamental importance of layout and image content information

Diagnostic accuracy of cardiac testing for coronary artery disease in potential liver transplant recipients: A systematic review and meta-analysis

Background: The incidence of coronary artery disease (CAD) in Liver transplant (LT) patients is much higher than prior estimates and the morbidity and mortality are significant in this group of patients. Coronary angiography is the gold standard for detection of CAD, a non-invasive test that allows appropriate risk stratification would be preferred. In this systematic review and meta-analysis, we sought to assess the pooled diagnostic accuracy of various noninvasive cardiac imaging tests in detecting CAD in patients listed for LT. Methods: We performed a systematic review and meta-analysis of studies comparing sensitivity and specificity of non-invasive tests to that of coronary angiography in diagnosing coronary artery disease in patients undergoing liver transplantation. Results: Five studies (616 participants) evaluated myocardial perfusion imaging (MPI); five studies (1243 participants) dobutamine stress echocardiography (DSE); and three (87 participants), other tests. MPI had a pooled sensitivity of 0.62 (95% CI 0.37, 0.83), specificity of 0.60 (95% CI 0.39, 0.79), diagnostic odds ratio (DOR) of 2.5 (95% CI 1.7, 5.64) and Area under the curve (AUC) 0.649. DSE had a pooled sensitivity of 0.25 (95%CI 0.09, 0.51), specificity of 0.68 (95% CI 0.44, 0.84) and DOR of 0.7 (95% CI 0.12, 3.84). Conclusions: Our results show that both MPI and DSE are not effective screening tools for detecting CAD in patients with end-stage liver disease (ESLD). Future studies are needed to evaluate the role of real-time myocardial contrast echocardiography (RTMCE) and coronary artery calcium score (CAC) with coronary CT angiography in patients with ESLD

Detection of Anaplastic Lymphoma Kinase Gene Re-Arrangement in Non-Small Cell Lung Carcinoma in the Indian Population: Comparison of Techniques and Immunohistochemistry Clones

Objective: Predictive and prognostic markers have revolutionized personalized therapy in non-small cell lung carcinoma (NSCLC). Crizotinib is now approved for locally advanced or metastatic NSCLC that is anaplastic lymphoma kinase (ALK) positive by either Fluorescence in situ hybridization (FISH) or immunohistochemistry (IHC). The current study aimed to detect the incidence of ALK gene re-arrangement in the Indian population, to compare the various IHC antibodies with FISH as a gold standard, and to analyze the morphology of cases with ALK phenotype. Material and Method: A case series of 614 cases of NSCLC were included. IHC for detection of ALK phenotype was compared with FISH using 5A4 clone (Labvision, USA), ALK-1(Dako, Denmark) and D5F3 clone (Ventana, USA). Results: ALK gene rearrangement was evident in 4.07% of the cases. Cases with ALK phenotype had unique histomorphology with presence of mucin or signet ring cells in association with necrosis, high tumour grade and poor differentiation. Comparison of various antibody clones used in IHC revealed that the sensitivity and specificity using the D5F3 clone (100%, 100%) and 5A4 clone (87.5%, 100%) were similar while the ALK-1 clone had the lowest sensitivity and specificity (50%, 95.5%). Conclusion: The incidence of ALK gene rearrangement in NSCLC in the current Indian study is within the worldwide reported range of 3-5%. This is the first study from the Indian subcontinent to compare various IHC antibodies used for detection of ALK phenotype. IHC using D5F3 clone and 5A4 clone may be considered as a rapid reliable and inexpensive method for detection of ALK gene rearrangement

Effect of vitamin D supplementation on bone health parameters of healthy young Indian women

Summary There is a huge prevalence of hypovitaminosis D in the Indian population. We studied the efficacy and safety of oral vitamin D supplementation in apparently healthy adult women. Monthly cholecalciferol given orally, 60,000 IU/month during summers and 120,000 IU/month during winters, safely increases 25-hydroxyvitamin D (25 (OH)D) levels to near normal levels. Introduction There is a huge burden of hypovitaminosis D in the Indian population. The current recommendation for vitamin D supplementation is not supported by sufficient evidence. Methods Study subjects included 100 healthy adult women of reproductive age group from hospital staff. They wer

"Rx - The mistakes we make!!": A short study

Context: There is concern regarding the irrational production, prescription and use of drugs in India. Aim: This study aimed to describe the quality of prescriptions by dental practitioners of one particular college in a short period of time. Materials and Methods: A survey of all prescriptions dispensed from the various departments of K.L.E.S.′s Institute of Dental Sciences, Belgaum, Karnataka, was conducted by collecting them from the patients exiting the college premises. The prescriptions were photocopied and handed back to the patients. The samples were collected over a period of 7 days. The samples were then analyzed for their content based on an ideal prescription format and the results were tabulated. Results: The findings of the study suggest that most of the prescriptions given are woefully inadequate in content. Conclusions: It can be concluded that a clear policy about the standard of prescriptions and periodic internal monitoring is the answer for quality prescriptions. Computerization of the prescription format is also a thought-provoking alternative

Palmistry: A tool for dental caries prediction!

Background: Dermatoglyphics can prove to be an extremely useful tool for preliminary investigations in conditions with a suspected genetic base. Since caries is a multifactorial disease with the influence of genetic pattern, early prediction for high-risk children can help in using effective and efficient caries preventive measures that are a part of the pedodontist arsenal. Aims and Objectives: This study was done to determine the genetic aspect involved in the occurrence of dental caries through a cost-effective means, which can be used in field studies. Materials and Methods: 550 kindergarten school children in the age group 3-6 years were examined during a school examination camp. Of these, only 336 children were included in the study. They were divided into four groups as follows: caries-free males (df score=0), caries-free females, caries males (df score≥10), caries females. The handprints of each child were taken and the frequency of occurrence of type of dermatoglyphic pattern on fingertip of each digit was noted. Separate df scores were recorded. SPSS software and test of proportions were used for the analysis. Results and Conclusion: Handprints of caries-free children, especially females, showed maximum ulnar loops. The caries group showed maximum occurrence of whorls (r=2:1), which were more prevalent in females on the left hand 3rd digit than in males where the whorls were found on the right hand 3 rd digit, and also low total ridge count, especially in males