Complete heart block associated with hepatitis A infection in a female child with fatal outcome.

Hepatitis A virus (HAV) infection can cause extra-hepatic manifestations like myocarditis. An 8-year-old female with HAV infection presented with fever, abdominal pain, vomiting, and icterus. She developed viral myocarditis with complete AV dissociation on ECG and was treated with a temporary pacemaker, but her condition worsened, and she died. Hepatitis A viral infection can be associated with viral myocarditis and complete heart block that can lead to cardiogenic shock and death eventually.

Heavy metal toxicity arising from the industrial effluents repercussions on oxidative stress, liver enzymes and antioxidant activity in brain homogenates of Oreochromis niloticus.

Industrial effluents reaching to the aquatic ecosystem is one of the major causes of environmental pollution and exposure to industrial effluents containing harmful substances may be a serious threat to human health. Therefore, the present study aimed to determine the sub-lethal (1/5th of predetermined LC50) impact of industrial effluents from Sundar Industrial Estate on Oreochromis niloticus with proper negative control. The physicochemical analysis of industrial effluents showed enormous loads of inorganic pollutants and exhibited high mean levels of heavy metals, Mn, Fe, Pb, Ni, Cr, Hg, As, Zn and Fe with statistically significant differences at p < 0.05. Highest level of Mn and Fe was detected in effluent's samples as 147.36 ± 80.91 mg/L and 90.52 ± 32.08 mg/L, respectively. Exposure led to increase in serum biochemical parameters alanine aminotransferase + 25%, aspartate aminotransferase + 20% and alkaline phosphatase + 7% over control although superoxide dismutase, catalase, glutathione peroxidase and reduced glutathione significantly increased as 3.42, 2.44, 4.8 and 8 folds, respectively in metabolically active tissue brain which indicated stress caused by industrial effluents. The results concluded that industrial effluent has potent oxidative stress inducers on one hand whereas histoarchitectural and physiological toxicity causing contaminants on the other. This condition may adversely affect the health of aquatic organisms, the fish and ultimately the human beings.

Ultrasound-Guided Versus Conventional Fluoroscopy-Guided Epidural Injection for Radiculopathy. A Meta-Analysis of Randomized Controlled Trials.

BACKGROUND: Radiculopathy, a painful condition due to the irritation of a spinal nerve root, is a common neurosurgical presentation. Apart from its conventional treatment with pain killers and surgical management, it can also be managed with epidural steroid injections (ESIs). The objective of this study is to compare ultrasonography (USG) guidance with conventional fluoroscopy (FL) guidance for ESIs to treat radiculopathy. METHODS: PubMed, Embase, Clinicaltrials.gov, and Cochrane were systematically searched and randomized controlled trials comparing USG with conventional FL for ESIs in the case of radiculopathy were included. Web Revman was used for data analysis. RESULTS: The Literature search resulted in 640 studies, of which 7 studies were included in this meta-analysis after extensive screening. There was no statistically significant difference in pain reduction between USG and FL groups especially in the case of lumbosacral spinal level at 1 month [mean difference -0.12 (-0.47-0.23)] and at 3 months [mean difference 0.73 (-1.49, 2.96)]. Similarly, functional improvement after ESIs was comparable between the 2 groups. The Risk of inadvertent vascular puncture in USG-guided ESIs was lower as compared to conventional FL-guided ESIs [odds ratio 0.21 (0.07, 0.64)]. Furthermore, the procedure time in the USG group was also significantly lower as compared to FL group. CONCLUSION: USG-guided ESIs are not only comparable to conventional FL-guided ESIs in terms of pain control and functional improvement, particularly evident at the lumbosacral spinal level, but also have a lower risk of inadvertent vascular puncture.

Assessment of Dietary Supplementation of Lactobacillus rhamnosus Probiotic on Growth Performance and Disease Resistance in Oreochromis niloticus.

Probiotics play a significant role in aquaculture by improving the growth, health, and survival rate of fish against pathogenic organisms. In the present study, we have evaluated the effects of a Lactobacillus rhamnosus (L. rhamnosus) probiotic on growth performance and disease resistance in Oreochromis niloticus (O. niloticus) fingerlings. Four different concentrations of L. rhamnosus (T1: 0.5 × 1010, T2: 1 × 1010, T3: 1.5 × 1010, and T4: 2 × 1010 CFU/kg feed) were administered to fish over a period of three months. L. rhamnosus treated fish revealed a high growth increment as compared to the control, and the values of macromolecules (amino acids, fatty acids, and carbohydrates) varied significantly among the treated and control groups. Levels of thyroid hormones were noted to be high in the probiotic-treated groups. A challenge assay was performed with Aeromonas hydrophila (A. hydrophila). The optimum calculated concentration of probiotics from the growth assay (1.5 × 1010 CFU/kg feed) was used for the challenge assay. Fish were divided into four groups as follows: control (Con), probiotic-treated (PL), infected (I), and infected + probiotic-treated (I + PL) groups. Significant variations in hematological parameters were observed among control and treated groups. Histopathological changes were recorded in infected fish, while the infected + probiotic-treated group showed less deformations indicating the positive effect of the probiotic supplementation. The survival rate of fish was also better in the probiotic-treated group. Based on these findings, we conclude that probiotic supplementation enhances the growth and improves immunity of O. niloticus. Therefore, we propose that probiotics can be used as promising feed supplements for promoting fish production and disease resistance in aquaculture.

Fixed versus Adjustable differential pressure valves in case of idiopathic normal pressure hydrocephalus treated with ventriculoperitoneal shunt. A systematic review and meta-analysis of proportion.

INTRODUCTION: Idiopathic normal pressure hydrocephalus is a common cause of communicating hydrocephalus in adult age, presenting with classic Hakim-Adam's triad. Ventriculoperitoneal shunting is the treatment of choice in these cases. The main objective of this study is to compare the complication rate of Adjustable differential pressure valves with fixed differential pressure valves in these cases. LITERATURE SEARCH: We systematically searched PubMed/Medline, Embase, LILACS, and ClinicalTrials.gov from their date of inception to 30th Jan 2023. We included observational studies, Randomized Controlled Trials (RCTs), and comparative and noncomparative studies in the search. The literature search resulted in 1394 studies, and only 22 studies were eligible to be included in the meta-analysis. We performed the meta-analysis of proportion to compare incidence rates by performing a Freeman-turkey double arcsine transformation. RESULTS: The summary of the proportions of the incidence rate of complications was less for Adjustable Differential Pressure Valves (ADPV) as compared to Fixed Differential Pressure Valves (FDVP) but the confidence intervals overlapped. The summary proportion of surgical revision of shunt in the case of ADPV was 0.081 (95% CI (0.047, 0.115)), and in the case of FDPV was 0.173 (95% CI (0.047, 0.299)). Similarly, the summary proportion of subdural fluid collection in the case of ADPV was 0.090 (0.058, 0.122), and in the case of FDPV was 0.204 (0.132, 0.277). The incidence of complication was low in population implanted with DPV along with gravitational or anti-siphon unit (GASU). CONCLUSION: Complication rates in the case of ADPV plus GASU were the lowest. Though the summary proportion of complication rate in the case of ADPV was low as compared to FDPV, the statistical significance of this difference is doubted due to overlapping confidence intervals.

Investigation on Immune-Related Protein (Heat Shock Proteins and Metallothionein) Gene Expression Changes and Liver Histopathology in Cadmium-Stressed Fish.

Heat shock proteins (HSP) are highly conserved in their structure and released in case of stress. Increased metallothionein (MT) synthesis is associated with increased capacity for binding heavy metals. Healthy juveniles of grass carp were exposed to sublethal dose (1.495 mg L-1) of cadmium for 28 days. Simultaneously, a control group was also run to compare difference of total RNA expression levels in cadmium-treated and control groups. The cadmium levels in the tissues of treated fish recorded were 1.78 ± 0.10 mg L-1, 1.60 ± 0.04 mg L-1, and 2.00 ± 0.05 mg L-1, respectively. Several histological alterations including edema, hemorrhage, dilated sinusoids, hypertrophy, hyperplasia, congestion of central vein, and nuclear alterations were observed in cadmium-exposed fish. Stress gene (metallothionein and heat shock proteins) mRNA transcription levels were studied by mRNA extraction and cDNA preparation by using PCR. The expression level of heat shock protein gene was higher as compared to metallothionein and beta-2-microglobulin gene after cadmium exposure. This study reports various stress-related immune-responsive changes of immune proteins, heat shock proteins, metallothionein, and histopathological changes in fish due to cadmium toxicity that make the fish immunocompromised which may be considered as the biomarkers of cadmium toxicity in other experimental species.

Monkeypox in 2022: A new threat in developing.

Monkeypox that started spreading from central and western Africa has recently been detected in various countries including Spain, Canada, Australia, and UAE. Though it has a very low incidence rate, it is still a significant threat that must be dealt with as quickly as possible and the probability of it spreading to many other countries is still very high. It is caused the by Monkeypox virus that belongs to the genus Orthopox that also include smallpox virus, which has quite similar clinical presentation as that of Monkeypox. With fading immunity against Smallpox, it is important to counter this threat with newly developed vaccines.

Assessment of abnormalities in lipid profiles of patients with chronic kidney disease from different hospitals of Lahore, Pakistan: A case control study.

The current study aimed to evaluate lipid profile parameters in patients with chronic kidney disease (CKD). This case-control study was conducted at the Zoology Department of Lahore College for Women University, Lahore, Pakistan, from September 2016 to June 2017 and analysed lipid profiles of patients with CKD attending different hospitals of Lahore. Of the randomly collected 100 blood samples, 50 were healthy, while the remaining 50 were patients with CKD. Lipid profile parameters were analysed using Hitachi 704 Analyser. For data analysis Chi-square test was used by means of SSPS 17. Results showed that all the parameters, including high density lipoprotein, triglycerides and low density lipoprotein were considerably altered in patients with CKD as compared to the control group. The values of triglycerides and LDL parameters were higher, while HDL cholesterol was lower in patients with CKD as compared to controls.

Evaluation of Fish Health Status and Histopathology in Gills and Liver Due to Metal Contaminated Sediments Exposure.

Health status of freshwater fish, Cirrhina mrigala was studied by qualitative and quantitative histopathological analysis, alterations in frequency/prevalence percentages (%) and histological alteration indices (HAI) in response to metal contaminated sediments of the River Ravi aquatic ecosystem. Histo-structures of gill and liver samples of fish were analyzed and comparison between the degree of damage of the alterations in fish organs was performed after exposure to metal contaminated sediments for 7, 14 and 28 days under semi-static water renewal bioassays. Histopathological studies revealed marked histological alterations in the gills and liver of exposed fish as compared to normal tissue structure observed in control fish. The frequency and prevalence percentages observed in 28-day exposed fish were significantly higher as compared to 7- and 14-day exposed fish. The order of frequency and prevalence percentage for gills and liver of exposed fish was as: 28-day > 14-day > 7-day. The highest prevalence percentages recorded were 83 and 80% as focal area of necrosis in gill and liver, respectively, after 28-day exposure. The lowest prevalence percentage observed in 7-day exposed Cirrhina mrigala was dilation of sinusoids (17%).