Evaluation of Insect Growth Regulators (IGRs) as biological pesticides for control of Aedes aegypti mosquitoes.

BACKGROUND OBJECTIVES: Insect growth regulators (IGRs) are biological hormone analogue or mimics used as pesticides to inhibit the growth of larva during their molting and skin shedding. This study aimed to test the effect of IGRs on the eggs hatching and post-hatching inhibition of Aedes mosquitoes and understanding its effect in the mosquito breeding habitats for reduction in adult emergence. METHODS: Experiments on the evaluation of three insect growth regulators (IGRs) for the control of different stages of Aedes aegypti was carried out during 2020-21. Each experiment consisted of four treatments viz., Pyriproxyfen, Novaluron, and Larvicol at 1.0 ppm and distilled water as a control. All experiments were carried out in completely randomized design (CRD) except eggs which were carried out in factorial design each with three replications. RESULTS: All tested IGRs performed better in affecting eggs, larval and pupal stages of Ae. aegypti. Highest eggs hatching inhibition (80%) of fresh eggs occurred in Pyriproxyfen followed by Novaluron (66%) and lowest in Larvicol (62%). Eggs hatch inhibition of embryonated eggs was lower than fresh eggs. Pyriproxyfen caused 69%, Novaluron 59% and Larvicol 39% eggs hatch inhibition of embryonated eggs. Both Pyriproxyfen and Novaluron performed better in causing 98-100% larval mortality followed by Larvicol (39%). Larval development to pupal stage was completely prevented by both Pyriproxyfen and Novaluron. Although Larvicol resulted in lowest eggs hatch and larval inhibition but prevented pupae to emerge as adults. Results further showed 70-89% mortality of 3rd instar larvae of Ae. aegypti when exposed to Pyriproxyfen and Novaluron solutions after 30 days storage at lab. temperature (27±2°C), RH 70±5. INTERPRETATION CONCLUSION: None of the IGRs was more effective at the pupal stage but showed carry-on activity of growth inhibition and mortality of the successive stages of development when used against eggs stages. Therefore, we recommend early application of IGRs at mosquito habitats during the beginning and onset of the season when very early stages of mosquitoes are available in the field.

Beyond standard echocardiography: Strain imaging as the AI-powered key to comprehensive cardiac function evaluation.

Application of left ventricular and left atrial strain to distinguish cardiac from non-cardiac dyspnea.

Covid-induced thyroiditis.

Thyroiditis is one of the manifestations of novel Covid-19 virus. Thyroid function test (TFTs) shows typical features of hyperthyroidism. Inflammatory markers and thyroid scan give clue to the diagnosis. This report is about a 39-year-old female who presented with signs and symptoms of thyrotoxicosis along with pain in the neck, odynophagia, and intermittent fever after recovering from Covid-19 a few weeks back. She had no significant history of past medical or endocrine disease. TFTs revealed high T3 and T4 and low TSH. Thyroid scan revealed decrease uptake and ESR was 115. She was started on NSAID, steroids, and beta blocker. Four weeks later, she reverted with the resolution of symptoms and normal TFTs.

Unique case of abdominal aortic aneurysm causing obstructive jaundice and duodenal obstruction.

Obstruction of the duodenum by an abdominal aortic aneurysm (AAA) (aortoduodenal syndrome) has rarely been reported. It presents with symptoms of upper gastrointestinal (GI) tract obstruction. Obstructive jaundice caused by an AAA is also extremely rare and requires high clinical suspicion. We present a unique case with informed consent of an elderly gentleman who presented with both rare presentations over a course of few months. After extensive literature search, we have found case reports of patients showing either of the two unusual presentations, but none were found to show them together.

The Efficacy of Fenofibrate in Addition to Atorvastatin in Patients of Type II Diabetes Mellitus.

Background The objective was to study the efficacy of atorvastatin in combination with fenofibrate as compared to atorvastatin in combination with saroglitazar in patients of diabetes mellitus type II with dyslipidemia.  Methodology A quasi-experimental study was done at the Diabetes and Endocrinology Ward, Hayatabad Medical Complex Peshawar, between January 2021 to June 2021. All patients aged 25 years and above with newly diagnosed diabetes mellitus (less than six months ago) with dyslipidemia, i.e., deranged lipid range, were eligible to participate. Patients with secondary hypertension, pregnancy, or any pulmonary disease were excluded from the study. Patients already taking anti-glycemic drugs were also ineligible to participate. Patients were divided into two groups. Group I patients received Atorvastatin 10mg plus Fenofibrate 145 mg, while Group II received the combination of the tab. Atorvastatin 10mg in addition to Saroglitazar 4g. Lipid profiles were studied at baseline and 24-month follow-up. All data were documented in a preformed proforma.  Results A total of 80 patients were enrolled in the study, with 40 patients in each group. In Group I (atorvastatin + fenofibrate), the mean cholesterol at 24-week follow-up was 254.51 ± 47.41 as compared to 230.45 ± 47.21 in Group II (p<0.0001). Similarly, total triglycerides, low-density lipoprotein (LDL), and very-low-density lipoprotein (VLDL) were significantly higher in Group I patients by 24-week follow-up as compared to Group II. The mean HDL levels in Group I changed from 40.21 ± 3.54 at baseline to 46.28 ± 6.25 at follow-up, while in Group II, the mean HDL levels altered from 39.54 ± 4.52 to 52.34 ± 7.54 (p<0.0001).  Conclusion Overall, both groups showed significant improvements in lipid profiles; however, when atorvastatin in addition to fenofibrate was compared with saroglitazar, it was found that the latter combination was more effective in improving the overall patient outcome.

Retroperitoneal Fibrosis as a Cause of Chylous Ascites.

Retroperitoneal fibrosis is a rare condition characterized by chronic inflammation and marked fibrosis of the retroperitoneal tissue, often leading to entrapment of abdominal organs. We report a 69-year-old white man who presented with a 5-week history of gradual onset of progressive abdominal distension. He had no history or risk factors for an underlying liver condition. Ascites and a retroperitoneal mass encasing the major abdominal vessels were revealed on imaging. Biopsies of the mass confirmed the presence of retroperitoneal fibrosis, and the ascitic fluid was milky, consistent with chylous ascites. We discuss this rare presentation and the challenges of treatment for chylous ascites caused by RPF, including the role for supportive treatment.

Rickettsioses in Swedish travellers, 1997-2001.

From laboratory records, information was collected on all 77 cases of rickettsioses diagnosed in Sweden during 1997-2001, 14 of which were diagnosed as belonging to the typhus group and 63 to the spotted fever group. Signs of hepatic involvement occurred more frequently in the typhus group. Denominators for the number of journeys to different parts of the world were retrieved from a commercial Swedish tourist database. The estimated risk of rickettsioses in destinations outside Europe varied from 1 case in 140,000 travellers to south-east Asia to 1 in 1600 travellers to southern Africa. The risk of infection in southern Africa increased over the 5 y period and is now 4-5 times higher than the risk of acquiring malaria in the same region. Rickettsiosis is an important differential diagnosis to consider in the febrile traveller, especially from South Africa. It should be remembered that the serological response may be considerably delayed and in patients with a negative first serology, serological testing should be repeated. Where there is a strong suspicion of rickettsiosis treatment may have to be started without a confirmed diagnosis.