Epididymal Cyst Lesions Are Not Associated With Impaired Semen Parameters Among Men Presenting for Fertility Evaluation.

PURPOSE: Epididymal cyst lesions (ECLs) include both spermatoceles and epididymal cysts and are often incidentally found on physical exam or scrotal US (SUS). We aimed to determine the association of ECLs and semen parameters among men presenting for fertility evaluation. MATERIALS AND METHODS: We reviewed men at our institution who had at least 1 semen analysis and SUS available for review between 2002 and 2022. SUS data included testicular measurements, presence or absence of subclinical varicocele, and size and laterality of ECL, if present. Demographic and clinical information including serum testosterone and follicle-stimulating hormone and semen parameters were compared between men with and without ECLs. RESULTS: Among 861 men, 164 (19%) had unilateral right ECL (median 4 mm, interquartile range 3-8 mm), 189 (22%) had unilateral left ECL (median 4 mm, interquartile range 3-9 mm), and 113 (13%) had bilateral ECL. Patients with ECLs were significantly older than men without ECLs at the time of evaluation but had no statistically significant difference in semen volume, sperm concentration, sperm motility, sperm morphology, total motile sperm count, or serum hormonal values. Analysis of men with unilateral and bilateral ECLs showed that ECL size and laterality did not significantly correlate with any semen parameter evaluated. CONCLUSIONS: We found no association between ECLs and semen parameters. Patients should be counseled toward conservative management with observation for asymptomatic ECLs in the setting of fertility evaluation.

Utility of zero echo time (ZTE) sequence for assessing bony lesions of skull base and calvarium.

BACKGROUND: The emergence of zero echo time (ZTE) imaging has transformed bone imaging, overcoming historical limitations in capturing detailed bone structures. By minimizing the time gap between radiofrequency excitation and data acquisition, ZTE generates CT-like images. While ZTE has shown promise in various applications, its potential in assessing skull base and calvarium lesions remains unexplored. Hence we aim to introduce a novel perspective by investigating the utility of inverted ZTE images (iZTE) and pseudoCT (pCT) images for studying lesions in the skull base and calvarium. MATERIALS AND METHODS: A total of 35 eligible patients, with an average age of 42 years and a male/female ratio of 1:4, underwent ZTE MRI and images are processed to generate iZTE and pCT images were generated through a series of steps including intensity equalization, thresholding, and deep learning-based pCT generation. These images were then compared to CT scans using a rating scale; inter-rater kappa coefficient evaluated observer consensus while statistical metrics like sensitivity and specificity assessed their performance in capturing bone-related characteristics. RESULTS: The study revealed excellent interobserver agreement for lesion assessment using both pCT and iZTE imaging modalities, with kappa coefficient of 0.91 (P < 0.0001) and 0.92 respectively (P < 0.0001). Also, pCT and iZTE accurately predicted various lesion characteristics with sensitivity ranging from 84.3% to 95.1% and 82.6%-94.2% (95% CI) with a diagnostic accuracy of 95.56% and 94.44% respectively. Although both of them encountered challenges with ground glassing, hyperostosis, and intralesional bony fragments, they showed good performance in other bony lesion assessments. CONCLUSIONS: The pilot study suggests strong potential for integrating the ZTE imaging into standard care for skull base and calvarial bony lesions assessment. Additionally, larger-scale studies are needed for comprehensive assessment of its efficacy.

Lyme Borreliosis, a public health concern in India: Findings of Borrelia burgdorferi serosurvey from two states.

Background: Lyme borreliosis is a public health concern in India. The prevalence of the disease is still undetermined with major entomological and epidemiological gaps. The present study was conducted to determine the seropositivity of Borrelia burgdorferi in Sikkim and Arunachal Pradesh, India. Methods: A cross-sectional serosurvey was conducted in Sikkim and Arunachal Pradesh. Data collection tools were developed and standardized for the collection of clinico-socio-demographic data. Sample size for each site was calculated using the formula for the estimation of a single proportion. Qualitative detection of IgG antibodies in serum samples was done using NovaLisa™ Lyme Borrelia IgG ELISA kit. Results: A total of 793 participants were enrolled, 484 (61%) from Arunachal Pradesh and 309 (39%) from Sikkim. Out of 793 participants, 21 (2.7%), 22 (2.8%), 6 (0.8%), 29 (3.7%), 44 (5.5%), and 16 (2.1%) gave history of tick bite, rash, erythema migrans, migratory muscle pain, migratory joint pain, and numbness, respectively, in the past one year. The adjusted seroprevalence (for sensitivity and specificity of kit) for the study is 3.7 (2.4-5.2). No signs or symptoms were found to be associated with IgG ELISA positivity. The state-wise distribution of seropositivity for Arunachal Pradesh and Sikkim was 4.1 (95% CI: 2.5-6.3) and 2.3 (95% CI: 0.9-4.6), respectively. Conclusion: This study establishes the state of Sikkim as a new endemic area in India of Lyme disease besides its already reported endemicity in Arunachal Pradesh. No association was conclusively established between symptoms of Lyme and IgG seropositivity emphasizing the need for detailed history taking and clinical suspicion in endemic areas.

Manganese substitution induced magnetic transformation and magnetoelectricity in SrFe12O19.

In this study, manganese substituted strontium hexaferrite (SrFe12-xMnxO19; x = 0, 3, 5, and 7) prepared by the sol-gel auto-combustion method are studied. We observed that the substituted Mn preferentially goes to the 2a and 12k sites of Fe. Raman modes related to the 12k site suggest the stiffening of the lattice. The transformation of the grain's shape from hexagonal (x = 0 and 3) to rhombohedral (x = 7) was observed, as shown in the micrographs obtained from FESEM. The thermomagnetic curves show the shift of TC to lower temperatures with the increase in the Mn content. From x = 5 onwards, the growth of another magnetic phase (FiM2) of lower coercivity apart from the parent phase (FiM1) of higher coercivity is seen. The FiM2 phase was found to increase with the Mn content in the sample (16.4(3)% for x = 5 but 66.2(5)% for x = 7). Although the magnetization for both FiM1 and FiM2 decreases with the increase in temperature, both magnetic phases behave in contrast to each other for x = 5 and x = 7. The study suggests a transformation of the compound from high magnetic anisotropy (x = 0) to low magnetic anisotropy (x = 7). The x = 5 composition sample displays the highest value of the first-order ME coefficient (0.83(2) mV × cm-1 × Oe-1). The observed value for x = 5 composition is ∼2.5 times higher than that of the parent x = 0 composition sample (0.33(2) mV × cm-1 × Oe-1). The studies thus suggest that the x = 5 composition is one of the viable candidates for magnetoelectric applications.

Lunar lenses - Acquired lens colobomas.

Acquired lens colobomas secondary to ocular surgeries are scarcely described in the literature. We describe two cases of acquired lens coloboma in two infants with glaucoma who underwent ocular surgery. The coloboma in the first case was likely because of direct trauma to the lens zonules during an optical iridectomy with a vitrectomy cutter, resulting in localized loss of zonules and consequently localized lens coloboma. The coloboma in the second case was noticed during examination under anesthesia after scleral buckling and cryopexy for retinal detachment. The cause for coloboma development in this case could be disruption of the lens zonules because of stretching of the globe after scleral buckle surgery or because of injury to zonules during scleral buckling and the cryopexy procedure.

The role of transportation in developing the tourism sector at high altitude destination, Kinnaur.

As a supporting factor, transportation is an important element of destination image that provides a base for the successful tourism industry. It is like the blood vessels of an area and is considered a determinant in developing a tourist destination. The article aims to characterize the status or problem of transportation accessibility in Kinnaur. GARMIN hand GPS (Global Positioning System) has been used to identify the damaged roads from their start to endpoints. In addition, a simple random sample technique has been used to register the opinion of 280 tourists about the transport facilities. Study results suggest that the bad condition of National Highway-22 is one of the barriers to tourism development in Kinnaur. There were no significant differences found between the selected destinations. Overall, the district headquarters, Kalpa, has been perceived significantly higher agreements by tourists. The government should ensure that the Border Road Organization, the organization entrusted with the responsibility of construction and maintenance of roads in international border areas, has sufficient resources to invest in transport development and its maintenance.

Post-trabeculectomy early bleb localization mimicking a 'ring of steel'.

A 54-year-old-man underwent trabeculectomy with mitomycin-C (0.02%). At 4-week follow-up, there was an elevated, well-circumscribed bleb with raised intra-ocular pressure (IOP) of 32-mmHg, with a classic "ring of steel" appearance, typically seen in a tenon's cyst. A sub-tenon needle revision re-established aqueous flow. Two weeks later, the IOP was 8-mmHg without any anti-glaucoma medications. A diffuse well formed bleb was noted. Careful ocular examination helps to identify early post-operative localized bleb that may appear like a "ring of steel" but can be managed by needling, unlike a tenon's cyst, which would require more extensive intervention.

Epidemiological analysis of SARS-COV-2 B.1.617.2 (delta variant) transmission in an educational institute.

Background: Despite having an effective COVID-19 vaccine, the COVID-19 pandemic is far from over and the delta variant continues to cause havoc across several continents. The present study was conducted to analyze and describe the occurrence of COVID-19 cases among completely vaccinated individuals. Methods: In an educational institute in Western Maharashtra, we analyzed a cluster of RTPCR positive COVID-19 cases among fully vaccinated students which occurred in 12 days. The cases were linked to a series of curricular and co-curricular events in the institute. A detailed epidemiological investigation and genome sequencing of cases were conducted. IgG antibodies against S1 protein of novel SARS-CoV-2 were estimated for cases and age, sex, and vaccination status matched controls. Results: All 37 identified cases were mild COVID. 188 high risk (HR) contacts of the cases were identified. The overall secondary attack was 9.5%. Out of 31 cases and 50 controls, 09 (29%) cases and 08 (16%) controls were found to have IgG antibodies against S1 protein of novel SARS-CoV-2 titer of more than 60 U/ml. Whole-genome sequencing of 15 samples of the cluster showed the presence of the Delta variant of SARS-CoV-2. No correlation was observed between Ct value and IgG S1 antibody titers. Conclusion: The study provides significant evidence that only vaccination alone does not completely protect against SARS-CoV-2 B.1.617.2 (Delta) variant infection. An all-encompassing multicomponent strategy involving implementation of NPIs, robust contact tracing, early identification and isolation of cases, and high vaccination coverage is the way forward for the prevention of COVID-19.

Findings of second multicentric follow-up serosurvey among Health Care Workers in government hospitals.

Background: The change in serological status of community may be used as input for guiding the public health policy. Hence, the present study was conducted to determine change in seroprevalence of COVID-19 among healthcare workers (HCWs). Methods: From the baseline multicentric study sample, a subsample was followed up, and a seroepidemiological study was conducted among them between 6 and 22 weeks after the second dose of the vaccination. Multistage population proportion to size sampling was performed for the selection of subsample of HCWs. The serosurvey was conducted using the enzyme-linked immunosorbent assay-based IgG antibody test (COVID KAVACH). Results: Follow-up serological testing was done in subsample of 1122 participants of original 3253 participants. The mean age of the participants was 34.6 (8.13) years. A total of 300 (26.7%) participants were females. The seroprevalence was 78.52, (95%CI:76-80.1). Among those who were seronegative at initial test, 708 (77.04%) were seroconverted. Those who were not seroconverted (241 (21.5%)) have longer duration from the second dose of the vaccination (93 (31.4) vs. 56 (38.4); p value < 0.001). The COVID-19 infection was significantly associated with seropositive status and being a medical staff was associated with remaining seronegative on follow-up. The higher age (≥50 years) was found to be significantly associated with seroreversion. Conclusion: Four in five HCWs had detectable antibodies. Seroepidemiological studies carry vital information to control the public health response in the course of the pandemic. The study can also further help as a platform to study the seroconversion and effect of vaccination among HCWs for newer variants of SARS-CoV-2.

An analysis of mortality and survival of COVID 19 patients admitted to a tertiary care hospital in Maharashtra, India.

BACKGROUND: After nine months of responding to the coronavirus disease-19 (COVID-19) pandemic, the scientific fraternity is yet to unravel the mystery of those who are at most risk from mortality. Despite resistance to wear masks, the global public health response has beaten the grimmer projections of millions of deaths. The present study seeks to analyze the survival of COVID-19 patients at a tertiary care hospital and identify the risk factors of mortality. METHODS: Medical records of 1233 RT PCR confirmed COVID-19 patients admitted in a tertiary care hospital between 01 April and 30 September 2020 were retrospectively analyzed for calculating overall survival and to investigate the independent predictors of survival of COVID-19 patients. RESULTS: There were 72 (5.8%) deaths; which occurred in 24.9% of the elderly (age > 60yrs) people (P < 0.001), 76.0% in people with multiple comorbidities (having more than one comorbidity) (P < 0.001), 75.6% in people with diabetes (P < 0.001), and 75.5% in people with hypertension (P < 0.001). A significantly higher risk of mortality was observed in elderly patients, patients with comorbidities, and patients requiring oxygen while admitted in the hospital. CONCLUSION: Survival reflects the cure rates and is used by health professionals and policymakers to plan and implement disease control measures. The insights provided by the study would help facilitate the identification of patients at risk and timely provision of specialized care for the prevention of adverse outcomes in the hospital setting.

Effectiveness of ChAdOx1 nCOV-19 Vaccine: Experience of a tertiary care institute.

BACKGROUND: The first dose of the ChAdOx1 nCoV- 19 Corona Virus Vaccine (Covishield) was administered to the eligible beneficiaries of tertiary care institute of Western Maharashtra on 16 Jan 21 and in the past three months almost 97% of the staff has been vaccinated. The present study analyses the incidence of COVID cases in the unvaccinated and vaccinated population of the institute. METHODS: All Covid 19 infections (RT-PCR positive) from 01 February 21 to 25 April 21 were included in the study and analyzed as per their vaccination status. To assess the COVID 19 transmission in contacts, Secondary Attack Rates (SAR) of the pre-vaccination period (Jun-Oct 20) was compared with the present SAR. RESULTS: A total of 113 cases occurred in the study period (01 Feb to 25 Apr 21). Lower number of infections were observed among the fully vaccinated as compared to partially vaccinated and non-vaccinated. The overall vaccine effectiveness was found to be 88.6% (81.55-92.37) and 44.1% (4.55-67.3) in completely and partially vaccinated individuals respectively. Hazard Ratios for getting infected dropped significantly after 28 days of the second dose. The SAR in high risk contacts (HRCs) was found to be 4.25%, which was lower than SAR (20.6%) of pre-vaccination period. CONCLUSION: This is one of the earliest studies in India to report the impact of COVID-19 vaccination. The results indicate that the vaccine provides effective protection against COVID-19 infection. However, given the complex dynamics of vaccination, the role of NPIs and implementation of COVID appropriate behavior cannot be undermined.

Estimating the proportion and IgG antibody response to SARS-CoV-2 in individuals joining a central educational institute from different parts of India by Enzyme-linked immunosorbent assay (ELISA) based serology.

BACKGROUND: Antibody response to SARS-CoV may be estimated to give trends and patterns emerging in a population during an evolving epidemic. The novel coronavirus has opened a new chapter in the history of pandemics and understanding the disease epidemiology. METHODS: The study was a cross-sectional descriptive study. Institutional Ethical clearance and informed consent were taken for participation in the study. The study population included all personnel reporting to the institute for training courses, permanent posting or joining back from leave during the study period of 2 months (16 June to 16 August 2020). The sample size was calculated assuming the prevalence of COVID-19 to be 1% with the absolute precision of 0.5% and 5% level of significance, and finite correction for population size of 500, and the calculated sample size was 377. Inclusion criteria were all personnel reporting to the institute from different states and districts. Exclusion criteria-Any personnel reported for a short visit of lesser than 14 days. Demographic details and details of any likely exposure to a confirmed COVID-19 case were noted. A blood sample was collected, and serological tests were done using ErbaLisa COVID-19 IgG kit by Calbiotech, as per the manufacturer's instructions. RESULTS: Overall seropositivity of IgG COVID-19 antibodies was 7.5% (31/413) (95% CI: 5.3-10.4%). Study population (n = 413) comprised of an adult population in the age range of 21 years-53 years, and the mean age was 31.4 years (SD = 6.2 years). CONCLUSION: As the personnel joining the institute have come from various parts of the country the study provides an estimation of antibodies against COVID-19.

Seroconversion among COVID-19 patients admitted in a dedicated COVID hospital: A longitudinal prospective study of 1000 patients.

BACKGROUND: The immune response after SARS-CoV-2 is complex and may be affected by severity of the disease, race, etc. The present study was conducted to assess the serial antibody response among the COVID-19 patients admitted in the hospital. METHODS: The study was conducted between July and October 2020 in a dedicated COVID-19 hospital. All consented patients underwent serial testing of antibodies using a rapid chromatographic immunoassay-based qualitative IgG/IgM kit every third day until their discharge or death. The data about age, sex, severity of disease, length of stay, onset of symptoms, date of molecular testing were also collected. Appropriate statistical tests were used. RESULTS: The mean age of 1000 COVID-19 patients was 47.5 ± 17.9 years. Out of the total, 687 (68.7%) were males. With respect to severity, 682 (68.2%) were asymptomatic/mild, 200 (20%) were moderate and 118 (11.8%) were severe cases. The seroconversion percentage increased from 12.8% to 97.9% and 16.3% to 80.9% for IgG and IgM respectively in 21 days. The median time for seroconversion was 10 days (IQR:6-12 days) for IgG and eight days (IQR: 6-11 days) for IgM. At the time of discharge (median nine days), detectable IgG and IgM antibodies were present in 502 (52.46%) and 414 (43.26%) participants respectively. Seroconversion was associated with days after the symptoms, increasing severity of the disease and the presence of co-morbidity. CONCLUSION: Seroconversion increased during the period of observation. The severe/moderate cases of COVID-19 tend to have an early seroconversion as compared to the asymptomatic/mild cases. Only half of the patients were seroconverted at discharge.

Multispectral diffusion-weighted MRI of the instrumented cervical spinal cord: a preliminary study of 5 cases.

PURPOSE: Diffusion-weighted imaging has undergone substantial investigation as a potential tool for advanced assessment of spinal cord health. Unfortunately, commonly encountered surgically implanted spinal hardware has historically disrupted these studies. This preliminary investigation applies the recently developed multispectral diffusion-weighted PROPELLER technique to quantitative assessment of the spinal cord immediately adjacent to metallic spinal fusion instrumentation. METHODS: Morphological and diffusion-weighted MRI of the spinal cord was collected from 5 subjects with implanted cervical spinal fusion hardware. Conventional and multispectral diffusion-weighted images were also collected on a normative non-instrumented control cohort and utilized for methodological stability analysis. Variance of the ADC values derived from the normative control group was then analyzed on a subject-by-subject basis and qualitatively correlated with clinical morphological interpretations. RESULTS: Normative control ADC values within the spinal cord were stable across DWI methods for a b value of 600 s/mm2, though this stability degraded at lower b value levels. Susceptibility artifacts precluded conventional DWI analysis of the cord in subjects with spinal fusion hardware in 4 of the 5 test cases. On the contrary, multispectral PROPELLER DWI produced viable ADC measurements within the cord of all 5 instrumented subjects. Instrumented cord regions without obvious pathology (N = 4) showed ADC values that were lower than expected, whereas one subject with diagnosed myelomalacia showed abnormally elevated ADC. CONCLUSIONS: In the absence of instrumentation, multispectral DWI provides quantitative capabilities that match with those of conventional DWI approaches. In a preliminary instrumented subject analysis, cord ADC values showed both expected and unexpected variations from the normative cohort. These slides can be retrieved under Electronic Supplementary Material.

3D-multi-spectral T2 mapping near metal implants.

PURPOSE: Due to host-mediated adverse reaction to metallic debris, there is an increasing need for noninvasive assessment of the soft tissue surrounding large joint arthroplasties. Quantitative T2 mapping can be beneficial for tissue characterization and early diagnosis of tissue pathology but current T2 mapping techniques lack the capability to image near metal hardware. A novel multi-spectral T2 mapping technique is proposed to address this unmet need. METHODS: A T2 mapping pulse sequence based on routinely implemented 3D multi-spectral imaging (3D-MSI) pulse sequences is described and demonstrated. The 3D-MSI pulse sequence is altered to acquire images at 2 echo times. Phantom and knee experiments were performed to assess the quantitative capabilities of the sequence in comparison to a commercially available T2 mapping sequence. The technique was demonstrated for use within a clinical protocol in 2 total hip arthroplasty (THA) cases to assess T2 variations within the periprosthetic joint space. RESULTS: The proposed multi-spectral T2 mapping technique agreed, within experimental errors, with T2 values derived from a commercially available clinical standard of care T2 mapping sequence. The same level of agreement was observed in quantitative phantoms and in vivo experiments. In THA cases, the method was able to assess variations of T2 within the synovial envelope immediately adjacent to implant interfaces. CONCLUSIONS: The proposed 3D-MSI T2 mapping sequence was successfully demonstrated in assessing tissue T2 variations near metal implants.

MRI of Hip Arthroplasties: Comparison of Isotropic Multiacquisition Variable-Resonance Image Combination Selective (MAVRIC SL) Acquisitions With a Conventional MAVRIC SL Acquisition.

OBJECTIVE. The objective of our study was to compare the quality and diagnostic utility of the following three metal artifact reduction sequences in evaluating hip arthroplasties: conventional multiacquisition variable-resonance image combination selective (MAVRIC SL), isotropic MAVRIC SL, and reduced-TR isotropic MAVRIC SL. SUBJECTS AND METHODS. Ninety-three hip arthroplasties (85 total hip replacements and eight hip resurfacings [nine bilateral hips]) in 84 patients (38 men and 46 women; mean age ± SD, 69.1 ± 9.7 years old) were imaged and evaluated. A calibration scan determined the number of spectral bins needed for each implant, and isotropic and conventional MAVRIC SL images were acquired. Reduced-TR isotropic MAVRIC SL scans were acquired for 40 arthroplasties. Two board-certified radiologists blinded to MRI acquisition evaluated images for clinical and image quality features and compared images using a mixed-effects ordinal logistic regression model and odds ratios. Rater agreement was assessed with Gwet agreement coefficients. Scanning times were compared using mixed-effects linear regression. Significance was set at p < 0.05. RESULTS. Calibration scans decreased the number of bins needed (median, 12 bins; interquartile range, 10-16 bins). Isotropic MAVRIC SL (mean scanning time, 7 minutes 16 seconds; 95% CI, 7 minutes 7 seconds-7 minutes 25 seconds) acquisitions had the longest scanning time, and conventional (mean, 5 minutes 46 seconds; 95% CI, 5 minutes 37 seconds-5 minutes 55 seconds) and reduced-TR isotropic (5 minutes 28 seconds; 95% CI, 5 minutes 15 seconds-5 minutes 41 seconds) MAVRIC SL acquisitions had scanning times that were similar. Both isotropic and reduced-TR isotropic MAVRIC SL images showed decreased blurring and improved visualization of the synovium and periprosthetic bone compared with conventional MAVRIC SL images (p < 0.001). Isotropic MAVRIC SL acquisitions more effectively improved signal-to-noise ratio (SNR), visualization of the synovium and periprosthetic bone, and lesion conspicuity and decreased blurring compared with reduced-TR isotropic MAVRIC SL acquisitions (p < 0.032). CONCLUSION. Isotropic MAVRIC SL acquisitions improve SNR, conspicuity of lesions, and visualization of synovium and periprosthetic bone and decrease blurring compared with conventional MAVRIC SL acquisitions.

Nitrosative stress and cytokines are linked with the severity of sepsis and organ dysfunction.

OBJECTIVE: An imbalance in oxidant-antioxidant status may impact the severity of sepsis. We hypothesised links between nitrosative stress and pro-inflammatory cytokines and their correlation with the severity of sepsis and associated organ dysfunction. METHODS: The hypothesis was tested in 110 patients with sepsis (in whom a disease severity score (APACHE II) and assessment of organ failure score (SOFA) were determined) and 55 healthy volunteers. Neutrophil inducible nitric oxide synthase (iNOS) expressions at mRNA and protein levels were estimated by real-time PCR and immuno-precipitation followed by Western blotting, respectively. Nitric oxide (NO) content was assessed in neutrophils by confocal microscopy, plasma nitrite by the Griess reaction and inflammatory cytokines (TNF-α, IFN-γ and IL-8) by ELISA (in plasma) and real-time PCR (in neutrophils). Serum bilirubin and creatinine were determined by routine methods and lung function by the PaO2/FiO2 ratio. RESULTS: Increased neutrophil iNOS expression and NO content, plasma total nitrite content and pro-inflammatory cytokines were present in sepsis patients (all P < 0.001). Plasma nitrite correlated with cytokines, APACHE II, SOFA, PaO2/FiO2 ratio, serum bilirubin and creatinine clearance (all r2 0.63-0.85, P < 0.001). Cytokines correlated with nitrite, APACHE II, SOFA, PaO2/FiO2 ratio, serum bilirubin and creatinine clearance (all r2 0.35-0.85, P < 0.001). CONCLUSION: Neutrophils iNOS expression, NO content, plasma nitrite and cytokines have a role in the assessment of the severity of sepsis and organ toxicity.

Bio-eco-social determinants of Aedes breeding in field practice area of a medical college in Pune, Maharashtra.

BACKGROUND: Major determinant of dengue incidence is interaction between ecology, vector bionomics, and social factors. OBJECTIVES: The objective of the study is to find out bio-eco-social determinants of Aedes breeding. METHODS: Background, household, entomological, and knowledge, attitude, and practice (KAP) surveys were undertaken post- and premonsoon showers from May to June 2016 in urban and rural practice area of medical college. RESULTS: A total of 181 and 204 households, 131 and 137 individuals, and 1250 and 1268 water-holding containers were included in household survey, KAP survey, and larval survey in urban slum and rural area, respectively. In both locations, maximum water-holding containers were indoors (41.4% and 61.8%, respectively); however, maximum positivity was peridomestic (63.6% and 83.1%, respectively). Pupae per container were 0.9 and 1.9 in respective locations and pupae per person were 1.2 and 2.3, respectively. Container positivity was seen in containers with rain as water source (8.8%) as well as among those who were never used (10.7%). Irregular water supply was significantly more in rural area (P < 0.05). KAP survey revealed that majority (90.1% and 71.5%, respectively) had heard about dengue, with significantly higher knowledge in urban slum, and television was the main source of information. Majority (89% and 83%, respectively) were unaware that peak biting time of Aedes is daytime. Use of mosquito repellent coils was the predominant preventive practice (46.6% and 61.2%, respectively). Pupae were reared; all were found to be Aedes aegypti. CONCLUSIONS: Despite enhanced awareness campaigns, an integrated vector management approach is required for prevention of dengue.

Detection of Wolbachia Phage (WO) in Indian Lac Insect [Kerria lacca (Kerr.)] and Its Implications.

Wolbachia, a maternally inherited bacterium induces reproductive alterations in its hosts such as feminization of males, male killing and parthenogenesis. It is the most diverse endosymbiont infecting more than 70% of the insects ranging from pests to pollinators. Kerria lacca-a hemipteran is a sedentary, oriental insect known to produce lac-the only resin of animal origin. The present study was conducted to screen the presence of Wolbachia and its associated phages in the two infrasubspecific forms (four insect lines) of K. lacca viz. kusmi and rengeeni differing from each other on the basis of host preference. Wolbachia and its associated phage were found to be prevalent in all the insect lines analyzed. We, hereby, report the presence of WO-phage (Wolbachia phage) for the first time in K. lacca. Further, phylogenetic data differentiated the kusmi and rengeeni infrasubspecific forms into two different groups on the basis of WO-phage sequences.

Off-resonance based assessment of metallic wear debris near total hip arthroplasty.

PURPOSE: The presence of metallic debris near total hip arthroplasty can have a significant impact on longitudinal patient management. Methods for magnetic resonance imaging-based quantification of metallic debris near painful total hip replacements are described and applied to cohorts of symptomatic and control subject cases. METHODS: A combination of metal artifact reduction, off-resonance mapping, off-resonance background removal, and spatial clustering methods are utilized to quantify off-resonance signatures in cases of suspected metallosis. These methods are applied to a cohort of symptomatic hip arthroplasties composed of cobalt-chromium alloys. Magnetostatic simulations and theoretical principles are used to illuminate the potential sources of the measured off-resonance effects. Reported metrics from histological tissue assays extracted during surgical revision procedures are also correlated with the proposed magnetic resonance imaging-based quantification results. RESULTS: The presented methods identified quantifiable metallosis signatures in more than 70% of the symptomatic and none of the control cases. Preliminary correlations of the MR data with direct histological evaluation of retrieved tissue samples indicate that the observed off-resonance effect may be related to tissue necrosis. CONCLUSIONS: Magnetostatic simulations, theoretical principles, and preliminary histological trends suggest that disassociated cobalt is the source of the observed off-resonance signature. Magn Reson Med 79:1628-1637, 2018. © 2017 International Society for Magnetic Resonance in Medicine.