'Love with Less Salt': evaluation of a sodium reduction mass media campaign in China.

OBJECTIVE: This study examines the impact of a salt reduction campaign on knowledge, attitudes, intentions, behaviours and barriers to behaviour change relating to salt consumption in two provinces of China. METHODS: In 2019, the 'Love with Less Salt' campaign ran on China Central Television and on local television channels in Shandong and Anhui provinces. Data for this study come from two representative household surveys conducted among a sample of adults aged 25-65 years in Shandong and Anhui provinces: precampaign (n=2000) and postcampaign (n=2015). Logistic regression was performed to estimate the effects of the campaign on knowledge, attitudes, intentions, behaviours and barriers to behaviour change. RESULTS: Overall, 13% of postcampaign respondents recalled seeing the campaign, and reactions towards the campaign were positive. Postcampaign respondents were more likely to plan to reduce their purchase of foods high in salt than precampaign respondents (OR=1.45, p=<0.05). Campaign-aware respondents were significantly more likely than campaign-unaware respondents to report higher levels of knowledge, attitudes and behaviours regarding salt reduction. CONCLUSIONS: Findings reveal that salt reduction mass media campaigns can be an effective public health tool to support efforts to reduce salt consumption in China. Continued and sustained mass media investments are likely to be effective in addressing high salt consumption nationwide.

Mammary Analogue Secretory Carcinoma of Submandibular gland.

Introduction: Mammary Analogue Secretory Carcinoma of salivary glands (MASC) is a low-grade carcinoma of salivary glands of the head-neck region. It bears histological resemblance to Secretory Carcinoma of the breast and Acinic Cell Carcinoma (ACC) of the parotid gland. Its clinical behaviour and aggressiveness vary amongst individuals and experience in MASC of the submandibular gland are limited. Case Report: We report a 16-year-old female with binary neck swelling in the submandibular region. The hard swelling in the submandibular region was a MASC and the soft cystic mass was a synchronous congenital lymphatic cyst in the neck. We report two unusual features, an extremely rare involvement of MASC of submandibular salivary gland and the presence of a congenital lymphatic cyst in the area adjacent to the main tumour mass. Treatment was done by surgical excision of both the neck masses in-toto and ipsilateral selective neck dissection (Level I-IV). Conclusions: While MASC's histological pattern has been described in previous studies, its clinical picture is rarely documented. This report aims to shed light on the clinical presentation of this under-diagnosed entity and the aggressive management protocol required during preoperative workup, intraoperative disease clearance and post-operative follow up of such patients. MASC of the submandibular salivary gland is an uncommon cause of neck swelling in the adolescent age group, but due to its occasional aggressive nature, should be borne in mind as a possible differential diagnosis of salivary gland tumours.

Psychosocial determinants of adherence to public health and social measures (PHSMs) in 18 African Union Member States during the early phase of the COVID-19 pandemic: results of a cross-sectional survey.

OBJECTIVE: The objective of this study was to gain a better understanding of the psychosocial and sociodemographic factors that affected adherence to COVID-19 public health and social measures (PHSMs), and to identify the factors that most strongly related to whether citizens followed public health guidance. DESIGN: Cross-sectional study. SETTING AND PARTICIPANTS: Nationally representative telephone surveys were conducted from 4-17 August 2020 in 18 African Union Member States. A total of 21 600 adults (mean age=32.7 years, SD=11.4) were interviewed (1200 in each country). OUTCOME MEASURES: Information including sociodemographics, adherence to PHSMs and psychosocial variables was collected. Logistic regression models examined the association between PHSM adherence (eg, physical distancing, gathering restrictions) and sociodemographic and psychosocial characteristics (eg, risk perception, trust). Factors affecting adherence were ranked using the Shapley regression decomposition method. RESULTS: Adherence to PHSMs was high, with better adherence to personal than community PHSMs (65.5% vs 30.2%, p<0.05). Psychosocial measures were significantly associated with personal and community PHSMs (p<0.05). Women and older adults demonstrated better adherence to personal PHSMs (adjusted OR (aOR): women=1.43, age=1.01, p<0.05) and community PHSMs (aOR: women=1.57, age=1.01, p<0.05). Secondary education was associated with better adherence only to personal PHSMs (aOR=1.22, p<0.05). Rural residence and access to running water were associated with better adherence to community PHSMs (aOR=1.12 and 1.18, respectively, p<0.05). The factors that most affected adherence to personal PHSMs were: self-efficacy; trust in hospitals/health centres; knowledge about face masks; trust in the president; and gender. For community PHSMs they were: gender; trust in the president; access to running water; trust in hospitals/health centres; and risk perception. CONCLUSIONS: Psychosocial factors, particularly trust in authorities and institutions, played a critical role in PHSM adherence. Adherence to community PHSMs was lower than personal PHSMs since they can impose significant burdens, particularly on the socially vulnerable.

Gaucher's Disease in an Adult Female: A Rare Entity.

Gaucher's disease is a rare inborn error of metabolism with an autosomal recessive pattern of inheritance. With over 26 million births occurring per annum, extrapolation of this figure would give us an estimated burden of 17,000 babies born with lysosomal storage disorder (LSD). Given the large population of India and the high rates of consanguineous marriage that takes place in the subcontinent, LSD might not be as rare as we perceive it to be. We report a rare occurrence of type-1 Gaucher's disease in an adult female patient born of a non-consanguineous marriage, belonging to the tropical area of Chhattisgarh, India where there is a predominance of malaria, thalassemia, and sickling. The diagnosis was challenging in this case since we needed to work out all the differential diagnoses of pancytopenia with hepatomegaly and massive splenomegaly. The key part was her medical history where there was documentation of her elder brother's death due to some mental illness of undiagnosed etiology. Being a difficult time due to coronavirus disease 2019 ( COVID-19) , we were able to diagnose the patient with a bone marrow biopsy followed by glucocerebrosidase enzyme level suggestive of Gaucher's disease.

Evaluation of bowel wall thickening by computed tomography to differentiate benign from malignant lesions.

PURPOSE: Computed tomography(CT) is an excellent non-invasive modality to evaluate bowel wall thickening.The aim of our study was to evaluate CT appearance of bowel wall thickening due to various benign and malignant conditions taking into consideration pattern of attenuation, bowel wall thickness, extent of lesion, symmetry of lesion and other associated CT findings. MATERIALS AND METHODS: The prospective study was carried out on 50 patients who underwent computed tomographic evaluation of abdomen for suspicion of bowel pathology based on ultrasonography, barium studies and/or clinical grounds. The studies were conducted on Siemens ART and GE High speed CT scanners. The examination was performed as is done routinely for an abdominal scan with imaging done from diaphragm to pubic symphysis in supine position with the right lateral decubitus scans in selected cases for better characterization of gastric antral and duodenal lesions. Oral, rectal and intravenous (IV) contrast agents were administered. The diagnosis was confirmed by cytology or histopathology of any biopsy or surgical specimen. However, in cases where surgery was not done, diagnosis was confirmed by clinical response to medical treatment. RESULTS: Based on the various CT characteristics of abnormal bowel wall thickening, sensitivity and specificity of classifying a lesion as benign or malignant were calculated. Majority of the malignant bowel lesions were showing the following characteristics i.e. heterogeneous pattern of enhancement, marked bowel wall thickening, asymmetry of the lesion and focal/segmental bowel involvement. Overall, CT showed a sensitivity of 97% and specificity of 93% in differentiating between benign and malignant etiology of abnormal bowel wall thickening. CONCLUSION: Due to its high sensitivity and specificity, CT is an ideal imaging modality for differentiating between benign and malignant etiology of abnormal bowel wall thickening. Radiologists should be aware of the usefulness of specific CT criteria of bowel wall thickening to better differentiate benign lesions from malignant or potentially malignant lesions that warrant further diagnostic evaluation.

Antagonist molecules in the treatment of angina.

INTRODUCTION: Management of chronic angina has evolved dramatically in the last few decades with several options for pharmacotherapy outlined in various evidence-based guidelines. AREAS COVERED: There is a growing list of drugs that are currently being investigated for treatment of chronic angina. These also include several herbal medications, which are now being scientifically evaluated as potential alternative or even adjunctive therapy for angina. Gene- and cell-based therapies have opened yet another avenue for management of chronic refractory angina in 'no-option' patients who are not candidates for either percutaneous or surgical revascularization and are on optimal medical therapy. An extensive review of literature using PUBMED, Cochrane database, clinical trial databases of the USA and European Union was done and summarized in this review. This review will attempt to discuss the traditional as well as novel therapeutic agents for angina. EXPERT OPINION: Several pharmacological and non-pharmacological therapeutic options are now available for treatment and management of chronic refractory angina. Renewed interest in traditional therapies and cell- and gene-based modalities with targeted drug delivery systems will open the doors for personalized therapy for patients with chronic refractory angina.

Diverse manifestations and management options in Klippel-Trenaunay syndrome: a single centre 10-year experience.

Klippel-Trenaunay syndrome is a well-known conglomeration of capillary malformations, bony or soft tissue hypertrophy, and abnormal deep or superficial veins. Although it generally presents with grossly enlarged limbs, it can present with more serious features like haematuria, haematochezia, and seizures. This retrospective study included patients admitted with the diagnosis of Klippel-Trenaunay syndrome in this institute from 2001-2010. The patients' demographic data, clinical features, associated findings, and treatments given were tabulated. A total of 19 patients were included in the study. Two patients presented with haematocezia and had to undergo bowel resection. Five presented with bleeding and ulceration. Debulking surgery was done in three of them. Patients also presented with abdominal distension, jaundice, seizures, and haematuria. Although the common presentation of varicose veins was treated with sclerotherapy, the treatment was tailored to each patient. Klippel-Trenaunay syndrome is a multifaceted disorder which can manifest in a number of different ways. These features may be missed by an unwary plastic surgeon treating them only for the limb hypertrophy.

Application of smooth exterior scaling method to calculate the high harmonic generation spectra.

We have calculated the high harmonic generation spectra from Xe atom by imposing different kinds of absorbing potentials. Owing to the center of inversion of the model system, one should get odd harmonics only. However, using negative imaginary potentials as an absorbing boundary condition, we have also got even order harmonics along with the odd order harmonics. These non-odd order harmonics are generated due to the spurious reflections occurring at the grid boundary. On the contrary, when smooth exterior scaling methods are used as an absorbing boundary condition, only odd order harmonics are obtained. Hence, smooth exterior scaling methods impose proper absorbing boundary condition.

Arteriovenous malformation of the scrotum: Is preoperative angioembolization a necessity?

Arteriovenous malformations (AVMs) of the scrotum are uncommon lesions, usually picked up incidentally during the evaluation of scrotal masses or infertility. They have also been reported to present with acute bleeding. We present a case who presented with acute pain following an abandoned surgical attempt at excision, elsewhere. Diagnosis was confirmed by duplex ultrasound and magnetic resonance imaging. Angioembolization was deferred quoting concerns with radiation exposure. The patient underwent a near total excision of the scrotal mass. This is the first reported case, in the English literature, of a surgical resection of a scrotal AVM without a preceding angioembolization. Patients should be counselled about radiation exposure risks before angioembolization, and allowed to make an informed decision.

Application of parametric equations of motion to study the resonance coalescence in H2(+).

Recently, occurrence of coalescence point was reported in H(2)(+) undergoing multiphoton dissociation in strong laser field. We have applied parametric equations of motion and smooth exterior scaling method to study the coalescence phenomenon of H(2)(+). The advantage of this method is that one can easily trace the different states that are changing as the field parameters change. It was reported earlier that in the parameter space, only two bound states coalesce [R. Lefebvre, O. Atabek, M. Sindelka, and N. Moiseyev, Phys. Rev. Lett. 103, 123003 (2009)]. However, it is found that increasing the accuracy of the calculation leads to the coalescence between resonance states originating from the bound and the continuum states. We have also reported many other coalescence points.

Tensor fascia lata flap reconstruction following groin dissection: is it worthwhile?

OBJECTIVE: To compare the morbidity of primary skin closure with elective Tensor Fascia Lata (TFL) flap cover in groin dissections. MATERIALS AND METHODS: This was a retrospective study between January 2007 and December 2009. All patients undergoing groin dissections without skin involvement were included. RESULTS: Of the twenty-five patients, who underwent groin dissections, 14 had primary skin closure (28 groin dissections)-group I. Eleven had TFL flap cover as a means of primary reconstruction (20 groin dissections)-group II. In group I, there were 16 (57%) inguinal dissections and 12 (43%) ilioinguinal block dissections, whereas 82% in group II underwent ilioinguinal dissections (p = 0.09). Wound infection requiring treatment with a culture specific antibiotic was required in 4 (14%) in group I (n = 28) and only 1 (5%) in group II (n = 20) (p = 0.38). In group I, 7 (25%) had major flap necrosis and minor necrosis was seen in another 7 (25%). Only three (15%) in group II developed minor flap necrosis (p = 0.01). Following an ilioinguinal dissection, flap necrosis occurred in 75% of groins that underwent primary closure and in 17% of those which were reconstructed with TFL (p = 0.001). Seroma formation was seen in 5 (18%) in group I and 3 (15%) in group II (p = 1.0). Lymphoedema occurred in equal numbers in both groups. The duration of hospital stay was 20 ± 14 days in the primary closure group and 16 ± 3 days in the TFL group. CONCLUSION: The TFL flap can reduce postoperative morbidity and decrease hospital stay. Prophylactic TFL flap reconstruction following ilioinguinal dissections is advisable.

Application of parametric equations of motion to study the laser induced multiphoton dissociation of H2+ in intense laser field.

We have applied parametric equations of motion (PEM) to study photodissociation dynamics of H(2)(+). The resonances are extracted using smooth exterior scaling method. This is the first application of PEM to non-Hermitian Hamiltonian that includes resonances and the continuum. Here, we have studied how the different resonance states behave with respect to the change in field amplitude. The advantage of this method is that one can easily trace the different states that are changing as the field parameter changes.

Use of modified smooth exterior scaling method as an absorbing potential and its application.

Here, we propose a new complex path to achieve better absorption during the propagation of a wavepacket. In the proposed modified smooth exterior scaling (SES) method, scaling function, θ(x), has been chosen as a real function rather than complex (as used in a conventional smooth exterior scaling method). It greatly reduces the artificial reflections from the boundary edges. This modified SES method is applied to study the multiphoton dissociation of H(2)(+) in intense laser field. The resonance states are calculated accurately.

Application of smooth exterior scaling method to study the time dependent dynamics of H2(+) in intense laser field.

A study of the multiphoton dissociation of H(2)(+) in intense laser field using the smooth exterior scaling method to calculate resonance states is presented. This method is very attractive as it does not disturb the interaction region. The wave functions calculated with this method provide indisputable proof in support of the mechanisms of the different phenomena happening during photodissociation. Wave functions corresponding to the "vibrationally trapped" (bond-hardening) states are found. A unequivocal mechanism for "bond-softening" is provided. It is observed that with an increase in intensity, the lifetime of low vibrational level increases. The mechanism for this novel phenomenon is also explained.