Establishing normal gallbladder volume: a comparative study of dual energy computed tomography and ultrasound measurements in a North Indian population

Background: The gallbladder, a critical component of the biliary system, plays a vital role in bile storage and digestion. Dysfunction in the gallbladder often results in gallstone formation, leading to significant healthcare burdens worldwide. Gallstone disease and gallbladder carcinoma are major health concerns, particularly in regions like India, where prevalence is high and poorly understood. Methods: This study aims to establish the normal baseline volume of the gallbladder using dual-energy computed tomography (DECT) and compare it with measurements obtained via ultrasound (USG). The cross-sectional study conducted at Era's Lucknow medical college and hospital involved 265 individuals aged 18-80 years with non-gallbladder-related abdominal conditions. Results: Final results showed the mean gallbladder volume to be 29.33�70 cm3 by DECT and 27.40�58 cm3 by USG, with DECT measurements being on average 1.93 cm3 higher. A significant association was found between gallbladder volume and obesity, but not gender. Conclusions: The findings suggest DECT provides slightly higher and potentially more accurate measurements of gallbladder volume compared to USG. These insights contribute to a better understanding of gallbladder physiology and the implications of its volume in various pathologies, emphasizing the need for further studies with larger sample sizes to validate these observations.

Tuberculous bronchoesophageal fistula presenting with miliary tuberculosis: a case report

A 35-year-old Asian woman with no pre-existing illnesses presented with a chronic cough during eating, mucoid sputum production, low-grade fever, and significant weight loss over the past few months. She had no history of high-risk behavior, foreign body aspiration, or ingestion of toxic substances. Physical examination revealed mild pallor without other significant findings. Vital signs were normal. Laboratory tests indicated mild anemia, leukocytosis, and elevated ESR. Sputum AFB and viral/autoimmune markers were negative. The tuberculin skin test was positive. Imaging studies, including fluoroscopy with contrast and a CT scan of the thorax, identified an esophagobronchial fistula and miliary tuberculosis, with multiple diffuse lung nodules and associated changes. The CT scan showed a thick-walled fistulous tract connecting the esophagus to the right main bronchus at three points, along with miliary nodules and bronchiectatic changes. AFB staining of bronchial secretions was negative, but PCR and cultures confirmed M. tuberculosis. The patient was initiated on weight-adjusted antituberculosis therapy and nasogastric feeding. The patient showed significant symptomatic improvement after two months of antituberculosis treatment. This case underscores the importance of thorough diagnostic evaluation in atypical presentations of tuberculosis and highlights the potential for esophagobronchial fistulas to complicate pulmonary tuberculosis.

The role of color Doppler and multidetector CT angiography in evaluation of peripheral arterial diseases of lower limb

Background: Characterized by atheromatous narrowing and hardening of arteries supplying blood to the legs and feet. Diabetes, along with other risk factors such as hypertension and smoking, exacerbates the prevalence and severity of PAD, leading to decreased blood flow and subsequent tissue injury. The prevalence of PAD in diabetics rises with age, underscoring the importance of early detection and management strategies. Methods: This study aims to evaluate the efficacy of color Doppler and MDCT Angiography in assessing lower limb peripheral arterial diseases. Conducted over twenty-four months, the cross-sectional study involved clinically suspected symptomatic cases aged 30 years and above, presenting at a tertiary care center. Patients underwent thorough clinical examination and demographic assessment before undergoing Color Doppler flowmetric studies and MDCT angiography. Results: Results revealed that color Doppler, with its ability to measure wall thickness and vascular flow, demonstrated promising diagnostic efficacy compared to MDCT angiography. Additionally, follow-up records of patients undergoing medical or surgical interventions provided valuable insights into the practical utility of these imaging modalities in guiding clinical management decisions. Conclusions: Overall, this study underscores the importance of non-invasive imaging techniques in diagnosing and evaluating the progression of peripheral arterial diseases. It suggests that Color Doppler Ultrasound, with its accessibility, low cost, and radiation-free nature, could serve as a suitable alternative to MDCT Angiography for assessing arterial characteristics in patients with PAD.

A comprehensive review on the documented characteristics of four Reticulitermes termites (Rhinotermitidae, Blattodea) of China / Uma revisão abrangente sobre as características documentadas de quatro cupins Reticulitermes da China

Termites are known as social insects worldwide. Presently in China 473 species, 44 genera and 4 families of termites have been reported. Of them, 111 Reticulitermes species are widely spread in different zones of China. The dispersion flight season of these Chinese Reticulitermes species are usually started from February to June, but in some regions different species are distributed, sharing their boundaries and having overlapping flight seasons. These reasons become important sources of hybridization between two different heterospecific populations of termites. It was confirmed that the fertilized eggs and unfertilized eggs of some Reticulitermes termites have the capacity of cleavage. While the unfertilized eggs of R. aculabialis, R. chinensis and R. labralis cleaved normally and the only R. aculabialis unfertilized eggs develop in embryos. While, the R. flaviceps and R. chinensis were observed with their abnormal embryonic development, and not hatching of eggs parthenogenetically. They were reported more threatening to Chinese resources as they propagate with parthenogenesis, hybridization and sexual reproduction. Eggshell and macrophiles of eggs play important roles in species identification and control. Although, they are severe pests and cause a wide range of damages to wooden structures and products in homes, buildings, building materials, trees, crops, and forests in China's Mainland.

Os cupins são conhecidos como insetos sociais em todo o mundo. Atualmente na China foram relatadas 473 espécies, 44 gêneros e 4 famílias de cupins. Destas, 111 espécies de Reticulitermes estão amplamente distribuídas em diferentes zonas da China. A temporada de voo de dispersão dessas espécies chinesas de Reticulitermes geralmente começa de fevereiro a junho, mas em algumas regiões diferentes espécies são distribuídas, compartilhando seus limites e tendo temporadas de voo sobrepostas. Essas razões tornam-se importantes fontes de hibridização entre duas populações heteroespecíficas de cupins. Foi confirmado que os ovos fertilizados e não fertilizados de alguns cupins Reticulitermes possuem capacidade de clivagem. Já os ovos não fertilizados de R. aculabialis, R. chinensis e R. labralis clivaram normalmente, e os únicos ovos não fertilizados de R. aculabialis se desenvolvem em embriões. R. flaviceps e R. chinensis foram observados com desenvolvimento embrionário anormal, e não eclosão de ovos por partenogênese. Eles foram relatados como mais ameaçadores para os recursos chineses à medida que se propagam com partenogênese, hibridização e reprodução sexual. Casca de ovo e macrófilos de ovos desempenham papéis importantes na identificação e controle de espécies, embora sejam pragas graves e causem uma ampla gama de danos a estruturas e produtos de madeira em residências, edifícios, materiais de construção, árvores, plantações e florestas na China continental.

Prevalence of needle stick injury and its associated factors among nursing staff working at a tertiary care hospital of North India

Background: Needle stick injury is a serious concern for healthcare workers as it poses a major risk for HIV, Hepatitis and other diseases transmission. The study aimed to determine the prevalence of NSI and its associated factors among nursing staff working at SKIMS, a tertiary care hospital of Kashmir, India. Methods: A descriptive cross-sectional study was conducted among 200 nurses working in different departments of SKIMS. Data regarding socio-demographic, various organizational and behavioral factors that may contribute to NSI, was collected using self-structured questionnaire and analysed using IBM statistical package for social sciences (SPSS), version 23. Results: The overall prevalence of NSI among nurses of SKIMS was 61% and it was 43.5% in the last 1 year. The nurses working for >40 hrs per week were found more at risk of NSI and it was more prevalent in young nurses with ?5 years of experience. The nurses working in emergency unit were found more prone to NSI than the other units and recapping was found as the most common practice responsible for NSI. Post exposure to NSI, only 21.5% were found to wash the injury site with soap, water and applied antiseptics and most of them (75%) had not reported NSI to the concerned body. Conclusions: The magnitude of needlestick injury among nurses was high. Awareness generation regarding occupational health hazards of NSI, protective measures, the importance of reporting of incident and sharp management is the need of hour.

Genetic diversity and molecular characterization of Cucumber mosaic cucumovirus (CMV) subgroup II infecting Spinach (Spinacia oleracea) and Pea (Pisum sativum) in Pothwar region of Pakistan / Diversidade genética e caracterização molecular do Cucumber mosaic cucumovirus (CMV) subgrupo II infectando espinafre (Spinacia oleracea) e ervilha (Pisum sativum) na região de Pothwar, Paquistão

Abstract Cucumber mosaic virus (CMV) is a tremendous threat to vegetables across the globe, including in Pakistan. The present work was conducted to investigate the genetic variability of CMV isolates infecting pea and spinach vegetables in the Pothwar region of Pakistan. Serological-based surveys during 2016-2017 revealed 31.70% overall CMV disease incidence from pea and spinach crops. Triple-antibody sandwich enzyme-linked immunosorbent assay (TAS-ELISA) revealed that all the positive isolates belong to CMV subgroup II. Two selected cDNA from ELISA-positive samples representing each pea and spinach crops were PCR-amplified (ca.1100 bp) and sequenced corresponding to the CMV CP gene which shared 93.7% nucleotide identity with each other. Both the sequences of CMV pea (AAHAP) and spinach (AARS) isolates from Pakistan were submitted to GenBank as accession nos. MH119071 and MH119073, respectively. BLAST analysis revealed 93.4% sequence identity of AAHAP isolate with SpK (KC763473) from Iran while AARS isolate shared maximum identity (94.5%) with the strain 241 (AJ585519) from Australia and clustered with some reference isolates of CMV subgroup II from UK (Z12818) and USA (AF127976) in a Neighbour-joining phylogenetic reconstruction. A total of 59 polymorphic (segregating) sites (S) with nucleotide diversity (π) of 0.06218 was evident while no INDEL event was observed in Pakistani isolates. The evolutionary distance of Pakistani CMV isolates was recorded as 0.0657 with each other and 0.0574-0.2964 with other CMV isolates reported elsewhere in the world. A frequent gene flow (Fst = 0.30478 <0.33) was observed between Pakistani and earlier reported CMV isolates. In genetic differentiation analysis, the value of three permutation-based statistical tests viz; Z (84.3011), Snn (0.82456), and Ks* (4.04042) were non-significant. The statistical analysis revealed the values 2.02535, 0.01468, and 0.71862 of Tajima's D, Fu, & Li's F* and D* respectively, demonstrating that the CMV population is under balancing selection.

Resumo Cucumber mosaic cucumovirus (CMV) é uma tremenda ameaça aos vegetais em todo o mundo, inclusive no Paquistão. O presente trabalho foi conduzido para investigar a variabilidade genética de isolados de CMV infectando vegetais de ervilha e espinafre na região de Pothwar, Paquistão. Pesquisas com base em sorologia durante 2016-2017 revelaram 31,70% da incidência geral da doença por CMV em safras de ervilha e espinafre. O ensaio de imunoabsorção enzimática em sanduíche de anticorpo triplo (TAS-ELISA) revelou que todos os isolados positivos pertencem ao subgrupo II do CMV. Dois cDNA selecionados de amostras positivas para ELISA representando cada safra de ervilha e espinafre foram amplificados por PCR (ca.1100 pb) e sequenciados correspondendo ao gene CMV CP que compartilhou 93,7% de identidade de nucleotídeo um com o outro. Ambas as sequências de isolados de ervilha CMV (AAHAP) e espinafre (AARS) do Paquistão foram submetidas ao GenBank como nos de acesso. MH119071 e MH119073, respectivamente. A análise BLAST revelou 93,4% de identidade de sequência do isolado AAHAP com SpK (KC763473) do Irã, enquanto o isolado AARS compartilhou a identidade máxima (94,5%) com a cepa 241 (AJ585519) da Austrália e agrupada com alguns isolados de referência do subgrupo II de CMV do Reino Unido (Z12818) e EUA (AF127976) em uma reconstrução filogenética vizinha. Um total de 59 sítios polimórficos (segregantes) (S) com diversidade de nucleotídeos (π) de 0,06218 foi evidente, enquanto nenhum evento INDEL foi observado em isolados do Paquistão. A distância evolutiva de isolados de CMV do Paquistão foi registrada como 0,0657 entre si e 0,0574-0,2964 com outros isolados de CMV relatados em outras partes do mundo. Um fluxo gênico frequente (Fst = 0,30478 < 0,33) foi observado entre os isolados de CMV do Paquistão e relatados anteriormente. Na análise de diferenciação genética, os valores de três testes estatísticos baseados em permutação viz, Z (84,3011), Snn (0,82456) e Ks * (4,04042) não foram significativos. A análise estatística revelou os valores 2,02535, 0,01468 e 0,71862 de Tajima's D, Fu, & Li's F * e D * respectivamente, demonstrando que a população de CMV está sob seleção de balanceamento.

Genetic diversity and molecular characterization of Cucumber mosaic cucumovirus (CMV) subgroup II infecting Spinach (Spinacia oleracea) and Pea (Pisum sativum) in Pothwar region of Pakistan / Diversidade genética e caracterização molecular do Cucumber mosaic cucumovirus (CMV) subgrupo II infectando espinafre (Spinacia oleracea) e ervilha (Pisum sativum) na região de Pothwar, Paquistão

Cucumber mosaic virus (CMV) is a tremendous threat to vegetables across the globe, including in Pakistan. The present work was conducted to investigate the genetic variability of CMV isolates infecting pea and spinach vegetables in the Pothwar region of Pakistan. Serological-based surveys during 2016-2017 revealed 31.70% overall CMV disease incidence from pea and spinach crops. Triple-antibody sandwich enzyme-linked immunosorbent assay (TAS-ELISA) revealed that all the positive isolates belong to CMV subgroup II. Two selected cDNA from ELISA-positive samples representing each pea and spinach crops were PCR-amplified (ca.1100 bp) and sequenced corresponding to the CMV CP gene which shared 93.7% nucleotide identity with each other. Both the sequences of CMV pea (AAHAP) and spinach (AARS) isolates from Pakistan were submitted to GenBank as accession nos. MH119071 and MH119073, respectively. BLAST analysis revealed 93.4% sequence identity of AAHAP isolate with SpK (KC763473) from Iran while AARS isolate shared maximum identity (94.5%) with the strain 241 (AJ585519) from Australia and clustered with some reference isolates of CMV subgroup II from UK (Z12818) and USA (AF127976) in a Neighbour joining phylogenetic reconstruction. A total of 59 polymorphic (segregating) sites (S) with nucleotide diversity (π) of 0.06218 was evident while no INDEL event was observed in Pakistani isolates. The evolutionary distance of Pakistani CMV isolates was recorded as 0.0657 with each other and 0.0574-0.2964 with other CMV isolates reported elsewhere in the world. A frequent gene flow (Fst = 0.30478 <0.33) was observed between Pakistani and earlier reported CMV isolates. In genetic differentiation analysis, the value of three permutation-based statistical tests viz; Z (84.3011), Snn (0.82456), and Ks* (4.04042) were non-significant. The statistical analysis revealed the [...].

Cucumber mosaic cucumovirus (CMV) é uma tremenda ameaça aos vegetais em todo o mundo, inclusive no Paquistão. O presente trabalho foi conduzido para investigar a variabilidade genética de isolados de CMV infectando vegetais de ervilha e espinafre na região de Pothwar, Paquistão. Pesquisas com base em sorologia durante 2016-2017 revelaram 31,70% da incidência geral da doença por CMV em safras de ervilha e espinafre. O ensaio de imunoabsorção enzimática em sanduíche de anticorpo triplo (TAS-ELISA) revelou que todos os isolados positivos pertencem ao subgrupo II do CMV. Dois cDNA selecionados de amostras positivas para ELISA representando cada safra de ervilha e espinafre foram amplificados por PCR (ca.1100 pb) e sequenciados correspondendo ao gene CMV CP que compartilhou 93,7% de identidade de nucleotídeo um com o outro. Ambas as sequências de isolados de ervilha CMV (AAHAP) e espinafre (AARS) do Paquistão foram submetidas ao GenBank como nos de acesso. MH119071 e MH119073, respectivamente. A análise BLAST revelou 93,4% de identidade de sequência do isolado AAHAP com SpK (KC763473) do Irã, enquanto o isolado AARS compartilhou a identidade máxima (94,5%) com a cepa 241 (AJ585519) da Austrália e agrupada com alguns isolados de referência do subgrupo II de CMV do Reino Unido (Z12818) e EUA (AF127976) em uma reconstrução filogenética vizinha. Um total de 59 sítios polimórficos (segregantes) (S) com diversidade de nucleotídeos (π) de 0,06218 foi evidente, enquanto nenhum evento INDEL foi observado em isolados do Paquistão. A distância evolutiva de isolados de CMV do Paquistão foi registrada como 0,0657 entre si e 0,0574-0,2964 com outros isolados de CMV relatados em outras partes do mundo. Um fluxo gênico frequente (Fst = 0,30478 < 0,33) foi observado entre os isolados de CMV do Paquistão e relatados anteriormente. Na análise de diferenciação genética, os valores de três testes estatísticos baseados em [...].

Genetic diversity and molecular characterization of Cucumber mosaic cucumovirus (CMV) subgroup II infecting Spinach (Spinacia oleracea) and Pea (Pisum sativum) in Pothwar region of Pakistan

Abstract Cucumber mosaic virus (CMV) is a tremendous threat to vegetables across the globe, including in Pakistan. The present work was conducted to investigate the genetic variability of CMV isolates infecting pea and spinach vegetables in the Pothwar region of Pakistan. Serological-based surveys during 2016-2017 revealed 31.70% overall CMV disease incidence from pea and spinach crops. Triple-antibody sandwich enzyme-linked immunosorbent assay (TAS-ELISA) revealed that all the positive isolates belong to CMV subgroup II. Two selected cDNA from ELISA-positive samples representing each pea and spinach crops were PCR-amplified (ca.1100 bp) and sequenced corresponding to the CMV CP gene which shared 93.7% nucleotide identity with each other. Both the sequences of CMV pea (AAHAP) and spinach (AARS) isolates from Pakistan were submitted to GenBank as accession nos. MH119071 and MH119073, respectively. BLAST analysis revealed 93.4% sequence identity of AAHAP isolate with SpK (KC763473) from Iran while AARS isolate shared maximum identity (94.5%) with the strain 241 (AJ585519) from Australia and clustered with some reference isolates of CMV subgroup II from UK (Z12818) and USA (AF127976) in a Neighbour-joining phylogenetic reconstruction. A total of 59 polymorphic (segregating) sites (S) with nucleotide diversity () of 0.06218 was evident while no INDEL event was observed in Pakistani isolates. The evolutionary distance of Pakistani CMV isolates was recorded as 0.0657 with each other and 0.0574-0.2964 with other CMV isolates reported elsewhere in the world. A frequent gene flow (Fst = 0.30478 0.33) was observed between Pakistani and earlier reported CMV isolates. In genetic differentiation analysis, the value of three permutation-based statistical tests viz; Z (84.3011), Snn (0.82456), and Ks* (4.04042) were non-significant. The statistical analysis revealed the values 2.02535, 0.01468, and 0.71862 of Tajima's D, Fu, & Lis F* and D* respectively, demonstrating that the CMV population is under balancing selection.

Resumo Cucumber mosaic cucumovirus (CMV) é uma tremenda ameaça aos vegetais em todo o mundo, inclusive no Paquistão. O presente trabalho foi conduzido para investigar a variabilidade genética de isolados de CMV infectando vegetais de ervilha e espinafre na região de Pothwar, Paquistão. Pesquisas com base em sorologia durante 2016-2017 revelaram 31,70% da incidência geral da doença por CMV em safras de ervilha e espinafre. O ensaio de imunoabsorção enzimática em sanduíche de anticorpo triplo (TAS-ELISA) revelou que todos os isolados positivos pertencem ao subgrupo II do CMV. Dois cDNA selecionados de amostras positivas para ELISA representando cada safra de ervilha e espinafre foram amplificados por PCR (ca.1100 pb) e sequenciados correspondendo ao gene CMV CP que compartilhou 93,7% de identidade de nucleotídeo um com o outro. Ambas as sequências de isolados de ervilha CMV (AAHAP) e espinafre (AARS) do Paquistão foram submetidas ao GenBank como nos de acesso. MH119071 e MH119073, respectivamente. A análise BLAST revelou 93,4% de identidade de sequência do isolado AAHAP com SpK (KC763473) do Irã, enquanto o isolado AARS compartilhou a identidade máxima (94,5%) com a cepa 241 (AJ585519) da Austrália e agrupada com alguns isolados de referência do subgrupo II de CMV do Reino Unido (Z12818) e EUA (AF127976) em uma reconstrução filogenética vizinha. Um total de 59 sítios polimórficos (segregantes) (S) com diversidade de nucleotídeos () de 0,06218 foi evidente, enquanto nenhum evento INDEL foi observado em isolados do Paquistão. A distância evolutiva de isolados de CMV do Paquistão foi registrada como 0,0657 entre si e 0,0574-0,2964 com outros isolados de CMV relatados em outras partes do mundo. Um fluxo gênico frequente (Fst = 0,30478 0,33) foi observado entre os isolados de CMV do Paquistão e relatados anteriormente. Na análise de diferenciação genética, os valores de três testes estatísticos baseados em permutação viz, Z (84,3011), Snn (0,82456) e Ks * (4,04042) não foram significativos. A análise estatística revelou os valores 2,02535, 0,01468 e 0,71862 de Tajimas D, Fu, & Lis F * e D * respectivamente, demonstrando que a população de CMV está sob seleção de balanceamento.

TWO INTERESTING CASES OF FILARIASIS AT UNCOMMON SITES

Filariasis is a condition resulting from filarial parasites that affects both humans and animals.There are several hundreds of filarial parasites which have been mentioned in medical literature, out of which only eight species are known to cause natural infections in humans. Repeated episodes of inflammation and lymphedema cause lymphatic damage, persistent edema, and elephantiasis of the legs, arms, scrotum, vulva, and breasts. We have reported two cases of filariasis at unusual sites

Evaluation of the Chilli veinal mottle virus CP gene expressing transgenic Nicotiana benthamiana plants for disease resistance against the virus / Avaliação do gene CP do vírus Chilli veinal mottle que expressa plantas transgênicas Nicotiana benthamiana quanto à resistência a doenças contra o vírus

Vegetables are an important source of income and high-value crops for small farmers. Chilli (Capsicum spp.) is one of the most economically important vegetables of Pakistan and it is grown throughout the country. It is a rich source of nutrition especially vitamins A, B, C and E along with minerals as folic acid, manganese (Mn), potassium (K) and molybdenum (Mo). Chilli possesses seven times more amount of vitamin C than an orange. Vitamin A, C and beta carotenoids are strong antioxidants to scavenge the free radicals. Chilli production is restricted due to various biotic factors. Among these viruses, Chilli veinal mottle virus (ChiVMV) is one of the most destructive and menacing agents that inflicts heavy and colossal losses that accounted for 50% yield loss both in quality and quantity. Pathogen-Derived Resistance (PDR) approach is considered one of the effective approaches to manage plant viruses. In this study, ChiVMV was characterized on a molecular level, the coat protein (CP) gene of the virus was stably transformed into Nicotiana benthamiana plants using Agrobacterium tumefaciens. The transgenic plants were challenged with the virus to evaluate the level of resistance of plants against the virus. It was observed that the plants expressing CP gene have partial resistance against the virus in terms of symptoms' development and virus accumulation. Translation of this technique into elite chilli varieties will be resulted to mitigate the ChiVMV in the crop as well as an economic benefit to the farmers.

Vegetais são uma importante fonte de renda e culturas de alto valor para os pequenos agricultores. A pimenta-malagueta (Capsicum spp.) é uma das hortaliças mais importantes economicamente do Paquistão e é cultivada em todo o país. É uma rica fonte de nutrição, especialmente vitaminas A, B, C e E com minerais como ácido fólico, manganês (Mn), potássio (K) e molibdênio (Mo). O pimentão possui sete vezes mais vitamina C do que a laranja. Vitaminas A e C e betacarotenoides são antioxidantes fortes para eliminar os radicais livres. A produção de pimenta é restrita devido a vários fatores bióticos. Entre esses vírus, o ChiVMV é o agente mais destrutivo e ameaçador que inflige perdas pesadas e colossais que representam 50% da perda de rendimento, tanto em qualidade quanto em quantidade. A abordagem de resistência derivada de patógenos (PDR) é considerada uma das abordagens eficazes para gerenciar os vírus de plantas. Neste estudo, ChiVMV foi caracterizado em nível molecular e o gene CP do vírus foi transformado de forma estável em plantas Nicotiana benthamiana usando Agrobacterium tumefaciens. As plantas transgênicas foram desafiadas com o vírus para avaliar seu nível de resistência contra o vírus. Observou-se que as plantas que expressam o gene CP apresentam resistência parcial ao vírus em termos de desenvolvimento de sintomas e acúmulo de vírus. A tradução dessa técnica em variedades de pimenta de elite resultará na mitigação do ChiVMV na safra, bem como em benefícios econômicos para os agricultores em termos de melhor rendimento e baixo custo de produção.

Evaluation of the Chilli veinal mottle virus CP gene expressing transgenic Nicotiana benthamiana plants for disease resistance against the virus

Abstract Vegetables are an important source of income and high-value crops for small farmers. Chilli (Capsicum spp.) is one of the most economically important vegetables of Pakistan and it is grown throughout the country. It is a rich source of nutrition especially vitamins A, B, C and E along with minerals as folic acid, manganese (Mn), potassium (K) and molybdenum (Mo). Chilli possesses seven times more amount of vitamin C than an orange. Vitamin A, C and beta-carotenoids are strong antioxidants to scavenge the free radicals. Chilli production is restricted due to various biotic factors. Among these viruses, Chilli veinal mottle virus (ChiVMV) is one of the most destructive and menacing agents that inflicts heavy and colossal losses that accounted for 50% yield loss both in quality and quantity. Pathogen-Derived Resistance (PDR) approach is considered one of the effective approaches to manage plant viruses. In this study, ChiVMV was characterized on a molecular level, the coat protein (CP) gene of the virus was stably transformed into Nicotiana benthamiana plants using Agrobacterium tumefaciens. The transgenic plants were challenged with the virus to evaluate the level of resistance of plants against the virus. It was observed that the plants expressing CP gene have partial resistance against the virus in terms of symptoms development and virus accumulation. Translation of this technique into elite chilli varieties will be resulted to mitigate the ChiVMV in the crop as well as an economic benefit to the farmers.

Resumo Vegetais são uma importante fonte de renda e culturas de alto valor para os pequenos agricultores. A pimenta-malagueta (Capsicum spp.) é uma das hortaliças mais importantes economicamente do Paquistão e é cultivada em todo o país. É uma rica fonte de nutrição, especialmente vitaminas A, B, C e E com minerais como ácido fólico, manganês (Mn), potássio (K) e molibdênio (Mo). O pimentão possui sete vezes mais vitamina C do que a laranja. Vitaminas A e C e betacarotenoides são antioxidantes fortes para eliminar os radicais livres. A produção de pimenta é restrita devido a vários fatores bióticos. Entre esses vírus, o ChiVMV é o agente mais destrutivo e ameaçador que inflige perdas pesadas e colossais que representam 50% da perda de rendimento, tanto em qualidade quanto em quantidade. A abordagem de resistência derivada de patógenos (PDR) é considerada uma das abordagens eficazes para gerenciar os vírus de plantas. Neste estudo, ChiVMV foi caracterizado em nível molecular e o gene CP do vírus foi transformado de forma estável em plantas Nicotiana benthamiana usando Agrobacterium tumefaciens. As plantas transgênicas foram desafiadas com o vírus para avaliar seu nível de resistência contra o vírus. Observou-se que as plantas que expressam o gene CP apresentam resistência parcial ao vírus em termos de desenvolvimento de sintomas e acúmulo de vírus. A tradução dessa técnica em variedades de pimenta de elite resultará na mitigação do ChiVMV na safra, bem como em benefícios econômicos para os agricultores em termos de melhor rendimento e baixo custo de produção.

Evaluation of the Chilli veinal mottle virus CP gene expressing transgenic Nicotiana benthamiana plants for disease resistance against the virus / Avaliação do gene CP do vírus Chilli veinal mottle que expressa plantas transgênicas Nicotiana benthamiana quanto à resistência a doenças contra o vírus

Vegetables are an important source of income and high-value crops for small farmers. Chilli (Capsicum spp.) is one of the most economically important vegetables of Pakistan and it is grown throughout the country. It is a rich source of nutrition especially vitamins A, B, C and E along with minerals as folic acid, manganese (Mn), potassium (K) and molybdenum (Mo). Chilli possesses seven times more amount of vitamin C than an orange. Vitamin A, C and betacarotenoids are strong antioxidants to scavenge the free radicals. Chilli production is restricted due to various biotic factors. Among these viruses, Chilli veinal mottle virus (ChiVMV) is one of the most destructive and menacing agents that inflicts heavy and colossal losses that accounted for 50% yield loss both in quality and quantity. Pathogen-Derived Resistance (PDR) approach is considered one of the effective approaches to manage plant viruses. In this study, ChiVMV was characterized on a molecular level, the coat protein (CP) gene of the virus was stably transformed into Nicotiana benthamiana plants using Agrobacterium tumefaciens. The transgenic plants were challenged with the virus to evaluate the level of resistance of plants against the virus. It was observed that the plants expressing CP gene have partial resistance against the virus in terms of symptoms' development and virus accumulation. Translation of this technique into elite chilli varieties will be resulted to mitigate the ChiVMV in the crop as well as an economic benefit to the farmers.

Vegetais são uma importante fonte de renda e culturas de alto valor para os pequenos agricultores. A pimenta-malagueta (Capsicum spp.) é uma das hortaliças mais importantes economicamente do Paquistão e é cultivada em todo o país. É uma rica fonte de nutrição, especialmente vitaminas A, B, C e E com minerais como ácido fólico, manganês (Mn), potássio (K) e molibdênio (Mo). O pimentão possui sete vezes mais vitamina C do que a laranja. Vitaminas A e C e betacarotenoides são antioxidantes fortes para eliminar os radicais livres. A produção de pimenta é restrita devido a vários fatores bióticos. Entre esses vírus, o ChiVMV é o agente mais destrutivo e ameaçador que inflige perdas pesadas e colossais que representam 50% da perda de rendimento, tanto em qualidade quanto em quantidade. A abordagem de resistência derivada de patógenos (PDR) é considerada uma das abordagens eficazes para gerenciar os vírus de plantas. Neste estudo, ChiVMV foi caracterizado em nível molecular e o gene CP do vírus foi transformado de forma estável em plantas Nicotiana benthamiana usando Agrobacterium tumefaciens. As plantas transgênicas foram desafiadas com o vírus para avaliar seu nível de resistência contra o vírus. Observou-se que as plantas que expressam o gene CP apresentam resistência parcial ao vírus em termos de desenvolvimento de sintomas e acúmulo de vírus. A tradução dessa técnica em variedades de pimenta de elite resultará na mitigação do ChiVMV na safra, bem como em benefícios econômicos para os agricultores em termos de melhor rendimento e baixo custo de produção.

Effect Of TXA On Intraoperative Blood Loss In Mandibular Fracture Surgeries A Prospective, Double Blinded Randomized Clinical Trial

Background:The aim of this doubleblind prospective study was to determine whether administering 1 gm Tranexamic Acid (TXA) would the intraoperative blood loss during the Open Reduction and Internal Fixation (ORIF) surgery of mandibular fracture via the intraoral approach operated under local anesthesia (LA).Material And Methods:20 patients who underwent ORIF surgery ofmandibular fractures under LA were randomly allocated to two groups. Study group was administered 1 gm TXA diluted in a 500 ml Ringer Lactate solution one hour before thesurgery. Control group did not receive any such IV infusion. All the surgeries were performed by the same surgeon.Result:Mean difference in Intraoperative blood loss between the two groups was found out to be statistically insignificant. Effect of age, gender or site of fracture was also found out to be insignificant. Conclusion:There is not much effect of TXA on intraoperative blood loss during ORIF of a mandibular fracture via the intraoral approach. Even without tranexamic, if area is infiltrated with adrenaline, proper flap reflection and tissue handling technique is used, and vital structures avoided; blood loss will be minimal.

Documenting catastrophic spending on health by migrant slum population

Background: India ranks among the bottom five countries in public health spending. Out of pocket spending of households on healthcare is almost 70% of income and reimbursement in any form availed by households whose members are employed in the formal sector is negligible. Objectives: To determine the usual source of medical care opted for by the study population. To find out the illness pattern and its age/sex distribution in the study population. To find out the expenditure incurred on illness and its source of procurement by the study population. Methodology: 52.42% urban Aligarh resides in slums. A cross sectional study was done to study the newer slum pockets. 3409 households with a population of 16,978 were studied with the help of pretested questionnaire; SPSS 20 was used for statistical analysis. Results: In our study, we found that almost all the households suffered from catastrophic health expenditure. The study population, which was already vulnerable owing to their low socio-economic and migrant status was further forced into poverty and indebtedness on account of expenditure on illness. Conclusions: National health financing systems should be designed to protect households from financial catastrophe, by reducing out-of-pocket spending.

Knowledge and awareness regarding eye donation among medical and para medical students in a tertiary care hospital in Odisha: a comparative study

Background: India needs around 2,77,000 donations annually to perform 1,00,000 corneal transplants. To enhance the procurement of corneal donations further, raising the level of public education on eye donation was the most important first step. The Govt. of India under the 11th 5-year plan envisages eliminating avoidable blindness completely by 2020. The aim and objective of the study was to compare the awareness of eye donation and willingness to donate eyes among medical and paramedical students.Methods: A cross sectional study was carried out among 400 final year MBBS students and interns and also among the final year B.Sc. nursing students and at Hi-Tech Medical College and Hospital, Bhubaneswar from August 2018 to September 2018.Results: The study participants were in the age group of 18-25 years. While 100% medical students had heard about organ donation, 85.5% of paramedical students heard about organ donation. Positive opinion regarding donation of eye post death was got from all the medical students as against 85% of paramedical students. More than 1/3rd of the study participants in both the groups were willing to donate eyes and know more regarding the same and also had a fair idea regarding shortage of donors in India.Conclusions: Awareness of eye donation is better in medical students compared to paramedical students, preferably due to the exposure and study curriculum. Most of the students in both groups were inclined to pledge for eye donation. Awareness regarding eye donation will form the prime base for the elimination of avoidable blindness in India.

Awareness of patients towards eye diseases in middle aged population in rural Odisha

Background: One of the most important public health issue for developing nations in the world with special reference to India is preventive blindness. In the world, 36 million people are blind and 217 million people are with moderate or severe distance vision impairment. The aim and objectives of the study were a qualitative survey to get an initial picture of rural residents knowledge of the prevalent eye disease; serve as an initial assessment of patient’s baseline knowledge of eye conditions and possible treatment methods to aid in the future development of educational outreach initiatives and studies.Methods: A cross sectional study was carried out in the rural areas of Jajpur, Nayagarh, Puri and Cuttack district of Odisha during preventive eye screening camps. The study was carried over 6 months from Jan to July 2018. The sample size was calculated to be 914 and the study subjects were all aged 40 years and above comprising of 64.7% male and 35.3% female.Results: In this study we found out that 60.18% reported previous eye doctor visits, 24.08% reported using eye drops prescribed by a non-doctor, while 60.18% of the non-doctor visitors reported not knowing that a doctor should prescribe eye drops. While 76.69% had little or no awareness regarding glaucoma, 51.87% had a fair idea regarding cataract surgery.Conclusions: The increase in patient awareness of prevalent eye diseases and treatments could lead to an increase in patient acceptance regarding the importance of routine eye examinations for proper identification and treatment of various eye conditions.

An unusual case of corneal lipoma

A 24-year-old male presented with a painless yellowish lesion on the nasal part of his cornea that extended to the paracentral area. Without a confirmed clinical diagnosis, the patient was advised surgical removal of the lesion. The lesion showed a smooth, elevated anterior surface without any signs of inflammation. On making a small incision over the lesion, we found yellowish material being extruded from the lesion. Cytological evaluation of the material revealed clear vacuolated cells suggestive of lipocytes, based on which we diagnosed it a rare case of corneal lipoma.

Invasive Candida auris infections in Kuwait hospitals:epidemiology, antifungal treatment and outcome

Purpose: Candida auris is a recently recognized yeast pathogen, which has attracted worldwide attention due to its multidrug-resistant nature and associated high mortality rates. Its persistence in hospital environment and propensity of nosocomial transmission underscores the need of continuous monitoring to prevent outbreaks. Since the first case of C. auris candidemia in May, 2014, we have identified 17 additional invasive cases, which are described here

Methods: Identity of 17 isolates originating from proven or possible cases of invasive C. auris infection and identified as Candida haemulonii by Vitek 2 yeast identification system was confirmed by PCR-sequencing of rDNA. Information about risk factors, treatment and outcomes were retrospectively retrieved from case files. Antifungal susceptibility testing was performed by Etest

Results: Thirteen cases of candidemia and 4 cases of other invasive infections were detected in 6 hospitals across Kuwait. Major risk factors included adult patients with cancer, diabetes, gastrointestinal/ liver diseases and extended [> 25 days] hospital stay. All isolates were resistant to fluconazole. Additionally, 5 and 4 isolates were also resistant to voriconazole and amphotericin B, respectively. Despite antifungal treatment, 9 of 15 patients died. Most patients [n = 12] were hospitalized in 2 hospitals that are in close proximity, whereas 5 other patients were from 3 hospitals that are situated > 10 km apart

Conclussion: Occurrence of successive cases of invasive C. auris infections with resulting mortality in nine patients suggests persistence of this multidrug-resistant yeast in major hospitals in Kuwait. Early detection by continuous surveillance and enforcement of infection control measures are recommended

Extracellular phospholipase production of oral Candida albicans isolates from smokers, diabetics, asthmatics, denture wearers and healthy individuals following brief exposure to polyene, echinocandin and azole antimycotics

Abstract Objective Candida albicans is the primary causative agent of oral candidosis, and one of its key virulent attributes is considered to be its ability to produce extracellular phospholipases that facilitate cellular invasion. Oral candidosis can be treated with polyenes, and azoles, and the more recently introduced echinocandins. However, once administered, the intraoral concentration of these drugs tend to be sub-therapeutic and rather transient due to factors such as the diluent effect of saliva and cleansing effect of the oral musculature. Hence, intra-orally, the pathogenic yeasts may undergo a brief exposure to antifungal drugs. We, therefore, evaluated the phospholipase production of oral C. albicans isolates following brief exposure to sub-therapeutic concentrations of the foregoing antifungals. Materials and methods Fifty C. albicans oral isolates obtained from smokers, diabetics, asthmatics using steroid inhalers, partial denture wearers and healthy individuals were exposed to sub-therapeutic concentrations of nystatin, amphotericin B, caspofungin, ketoconazole and fluconazole for one hour. Thereafter the drugs were removed and the phospholipase production was determined by a plate assay using an egg yolk-agar medium. Results The phospholipase production of these isolates was significantly suppressed with a percentage reduction of 10.65, 12.14, 11.45 and 6.40% following exposure to nystatin, amphotericin B, caspofungin and ketoconazole, respectively. This suppression was not significant following exposure to fluconazole. Conclusions Despite the sub-therapeutic, intra oral, bioavailability of polyenes, echinocandins and ketoconazole, they are likely to produce a persistent antifungal effect by suppressing phospholipase production, which is a key virulent attribute of this common pathogenic yeast.

Clinical Profile of Hypertrophic Cardiomyopathy in a Tertiary Level Hospital.

Background- Hypertrophic cardiomyopathy (HCM) is a genetically transmitted disease with diverse natural history for which the potential to produce adverse consequences has been emphasized. However, the possibility of this disease remaining clinically dormant for many years has not been as widely appreciated. Certainly, the clinical recognition of previously undiagnosed patients with HCM may be advantageous by permitting risk stratification for sudden cardiac death or for timely pharmacologic therapy when symptoms intervene. The purpose of this study was to assess the disease pattern and the extent to which hypertrophic cardiomyopathy (HCM) exists undetected in a suspected group of population never diagnosed to have any cardiovascular disease, referred from the primary care facilities to one of the largest tertiary level hospital of Bangladesh. Methods-We prospectively conducted an echocardiographic survey in 3648 cases between 19-03-2009 to 03-08-2010 (18 months) in the cardiac centre of Combined Military Hospital, Dhaka, Bangladesh. Results- A total of 3648 cases referred by primary care physicians underwent echocardiogram either to confirm a new diagnosis or to exclude obvious cardiovascular abnormalities. Hypertrophic cardiomyopathy was identified in 148 patients (4.06%) who was not known have any cardiac disease before. At diagnosis, age ranged from 20 to 83 years (mean 52.19) with male gender preponderance (85.81%). Ninety eight patients (67%) had no functional limitation and the remaining fifty patients reported with symptoms mostly giving multiple responses like chest pain (39.2%), palpitation (18.9%), dyspnoea (22.3%), unusual fatigability (16.9%) and syncope (6.8%). Twelve patients had strong suspicion of familial predisposition depending on the symptomatology of the familial tree but were confirmed only in 03 cases by echocardiography. Basal left ventricular outflow obstruction (gradients 20 to 76 mm Hg) was evident in 14 patients (9.45%). Relatively variable phenotypic expression of the disease was substantiated by diffuse thickening of left ventricular wall occurring more commonly than localized distributed hypertrophy (56.08% vs. 43.94%, respectively). Electrocardiogram was abnormal in almost 95% of cases and typical pattern of left ventricular hypertrophy was observed in 25.68% cases. Conclusion -This prospectively assembled data show that HCM cases may remain asymptomatic, clinically dormant and undetectable for many years (often to advance ages) in our community. The actual prevalence of the disease in our community needs to be ascertained which might exceed the prevalence mentioned in the text books.