Diagnostic evaluation of nested PCR and microscopy for Cryptosporidiosis in goats: can COWP gene based qRT-PCR be useful in assessment of active Cryptosporidial infections?

The present research delved into the transmission patterns, diagnostic methods, molecular traits, and phylogenetic analysis of Cryptosporidium species. The research was undertaken to enhance comprehension of the epidemiology and the potential for zoonotic transmission. A total of 80 goat-kid samples were tested, 7 were confirmed positive by mZN microscopy and 12 by nested-PCR. By PCR, 18SSUrRNA, HSP70, and GP60 amplicons were tested for Cryptosporidium. The restriction enzymes viz., SspI, VspI and MboII were used to genotype 12 Cryptosporidium positive samples by which C. parvum and C. bovis mixed infections were detected. Quantitative reverse transcription real-time PCR was used to transcriptionally screen the COWP-subunit genes to assess the severity of the infection in goat-kids, which showed upregulation of COWP6 and COWP4, while COWP9 and COWP3 genes were downregulated. A silent mutation was found at the codon CCA→CCC, which is being reported for the first time in goat field isolates. Phylogenetic and sequencing analyses confirmed the presence of the anthropozoonotic IIe subtype.

Identification of a Novel Intronic Mutation in VMA21 Associated with a Classical Form of X-Linked Myopathy with Autophagy.

Introduction VMA21 -related myopathy is one of the rare forms of slowly progressive myopathy observed in males. Till now, there have been only a handful of reports, mainly from Europe and America, and two reports from India. Method Here, we describe a case of genetically confirmed VMA21 -associated myopathy with clinical, histopathological, and imaging features with a list of known VMA21 mutations. Results A 29-year-old man had the onset of symptoms at 18 years of age with features of proximal lower limb weakness. Muscle magnetic resonance imaging showed the preferential involvement of vasti and adductor magnus. A biopsy of the left quadriceps femoris showed features of autophagic vacuolar myopathy with vacuoles containing granular eosinophilic materials. In targeted next-generation sequencing, hemizygous mutation in the 3' splice site of intron 2 of the VMA21 gene (c.164-7 T > A) was identified and confirmed the diagnosis of X-linked myopathy with excessive autophagy. Conclusion This report expands the phenotypic and genotypic profile of VMA21 -related myopathy, with a yet unreported mutation in India.

Giant Pleomorphic Adenoma of Infratemporal Fossa: A Rare Case Report.

Of all the head and neck tumors, salivary gland tumors account to 3%. Pleomorphic adenomas are one of the most common benign tumors arising from major salivary glands, although it could also develop from minor salivary glands situated at accessory sites like nasal cavity, pharynx, parapharyngeal space, lacrimal glands etc. Tumors of infratemporal fossa are quite unusual, mainly because of its hidden location in retromaxillary region. We report an unusual case of 65 years old male presenting with complaint of progressive left cheek swelling for 4 years. FNAC revealed pleomorphic adenoma of minor salivary gland tumor. Intraoperatively a giant lobulated tumor was seen occupying almost whole space of infratemporal fossa, which was removed in-toto via open approach. Patient was kept on regular follow up with no evidence of recurrence reported till date.

British Society of Gastroenterology guidelines for the management of hepatocellular carcinoma in adults.

Deaths from the majority of cancers are falling globally, but the incidence and mortality from hepatocellular carcinoma (HCC) is increasing in the United Kingdom and in other Western countries. HCC is a highly fatal cancer, often diagnosed late, with an incidence to mortality ratio that approaches 1. Despite there being a number of treatment options, including those associated with good medium to long-term survival, 5-year survival from HCC in the UK remains below 20%. Sex, ethnicity and deprivation are important demographics for the incidence of, and/or survival from, HCC. These clinical practice guidelines will provide evidence-based advice for the assessment and management of patients with HCC. The clinical and scientific data underpinning the recommendations we make are summarised in detail. Much of the content will have broad relevance, but the treatment algorithms are based on therapies that are available in the UK and have regulatory approval for use in the National Health Service.

A computational strategy for estimation of mean using optimal imputation in presence of missing observation.

In this study, we suggest an optimal imputation strategy for the elevated estimation of the population mean of the primary variable utilizing the known auxiliary parameters for the missing observations. Under this strategy, we suggest a new modified Searls type estimator, and we study its sampling properties, mainly bias and mean squared error (MSE), for an approximation of order one. The introduced estimator is compared theoretically with the estimators of population mean in competition under the imputation method. The efficiency conditions for the introduced estimator to be more efficient than the estimators in the competition are derived. To be sure about the efficiencies, these efficiency conditions are verified through the three natural populations. We have also conducted a simulation study and generated an artificial population with the same parameters as a natural population. The estimator with minimum MSE and the highest Percentage Relative Efficiency (PRE) is recommended for practical use in different areas of applications.

Outcomes of Palisade Cartilage Tympanoplasty in Chronic Otitis Media: Our Experience at a Tertiary Care Centre.

To evaluate the anatomical and functional success rates of palisade cartilage tympanoplasty in chronic otitis media. Thirty patients with chronic otitis media with subtotal perforation underwent palisade cartilage tympanoplasty and were assessed prospectively. The outcomes evaluated were graft uptake and hearing gain. Overall graft uptake was 90% with failure in 3 cases. The preoperative mean air conduction threshold was 22.087 ± 6.120 dB which was improved to 13.387 ± 5.253 dB postoperatively at 12 weeks which was statistically significant. The mean postoperative ABG closure was 8.700 dB with a p value of 0.001 which was statistically significant. Palisade cartilage tympanoplasty demonstrates that subtotal perforations, which are at high risk for graft failure, can be treated efficiently and a durable and resistant reconstruction of the tympanic membrane with reasonable hearing can be achieved.

Evaluation of Pre and Post-operative Pulmonary Artery Pressures in Children with Adenotonsillar Hypertrophy and Correlation with Chronicity: A Prospective Study on 50 Children.

Children with grade III or IV of adenotonsillar hypertrophy especially of a longer duration, may show cardiovascular changes due to mouth breathing. These changes can be detected on doppler echocardiocardiography which can be used as a screening tool. Fifty paediatric patients of grade 3 and 4 adenotonsillar hypertrophy underwent adenotonsillar resection after a pre-operative work up which included doppler echocardiography to measure pulmonary artery pressures. A post-operative doppler echocardiography was done after three months. 11 children (22%) showed deranged pulmonary artery pressure values with increased mean pulmonary artery pressure (MPAP) and pulmonary artery systolic pressure (PSAP) on preoperative doppler echocardiography, and 2 out of these 11 children had Pulmonary Artery Hypertension. A significant (p < 0.001) improvement was noted in pulmonary artery pressure values (MPAP and PSAP returned to normal) after adenotonsillectomy in 3-month postoperative echocardiography. Also, a statistically significant correlation was obtained between chronicity of symptoms and raised pulmonary artery pressures. Our study concluded that these children with chronic untreated upper airway obstructive symptoms get predisposed to potential cardiac complications. And these grave consequences can be easily prevented by a timely intervention.

Prevalence of Ear Disease and Associated Hearing Loss Among Government Rural Primary School Students in Patiala, Punjab: A Cross Sectional Survey.

Ear disease in children are a major public health problem in developing countries and if left untreated, it may result in various social and psychological problems for affected children. Among all ear diseases, ear infections are a common but treatable cause of morbidity in children. Long term consequences of persistent severe ear infection can result in speech development disorders, poor academic and educational development and overall lower quality of life. Most of ear diseases leading to hearing loss are preventable if diagnosed and treated early. A cross sectional study was conducted in Government Rural Primary School students, 2160 students in Patiala district of Punjab state in India with aim to study the prevalence of ear disease and associated hearing loss in students and their relationship with socioeconomic status. The data was collected, compiled and analysed statistically.

Robert Alan LeVine (1932-2023).

Article memorializes Robert Alan LeVine (1932-2023). Robert Alan LeVine was a leading psychological anthropologist, who was instrumental in the rise of cultural psychology. LeVine taught at Northwestern University (1958-1960), the University of Chicago (1960-1976), and Harvard University (1976-1998), where he was Emeritus Professor of Education and Human Development. He wrote 15 books and published over 125 peer-reviewed articles and book chapters. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Surgical Outcomes of Type 1 Tympanoplasty in Chronic Otitis Media in Paediatric Patients: A Prospective Study.

Objectives: To observe the surgical outcome of type 1 tympanoplasty in paediatric patients in the form of graft uptake and audiological improvement. Materials and methods: A prospective study was done in which 40 paediatric patients in age group 6-16 years, diagnosed of chronic otitis media, were taken up for tympanoplasty under general anaesthesia. Patients were followed in post operative period at 4, 6 and 12 weeks for assessment of graft status and audiological evaluation. Results: In this study, we found surgical success rate in the form of graft uptake in 80% of the cases and audiological improvement in 75% of the cases. Conclusion: Tympanoplasty is safe and effective in children with adequate graft uptake and audiological outcome. Supplementary Information: The online version contains supplementary material available at 10.1007/s12070-023-03965-1.

A Case Report of Chondromyxoid Fibroma of the Nasal Cavity.

The chondromyxoid fibroma is a benign osseocartilaginous tumor histopathologically characterized by chondroid, fibrous, and myxoid tissues (Nazeer et al. in Skeltal Radiol 25:779-78, 1996). Its occurrence is quite rare, accounting for less than 0.5% of all bone tumors, with 1-5% of cases reported in the head and neck region. We report an unusual case of 25 years old male who presented with progressive swelling over dorsum of nose with bilateral nasal obstruction over 1 year. The histopathological examination was suggestive of chondromyxoid fibroma. The tumor was completely excised via open approach. We report this case owing to the rarity of the disease, sometimes masquerading as invasive/malignant pathology.

Long-Term Outcome of the First Completely Leadless Cardiac Resynchronization Therapy in the United States.

Completely leadless cardiac resynchronization therapy is feasible with the combination of Micra AV pacemaker (Medtronic Inc) and WiSE-CRT (EBR Inc) systems. Several reports have highlighted this combination in Europe. This case report presents a 1- year follow-up the first reported concomitant use of the leadless systems in the United States. (Level of Difficulty: Advanced.).

Recent developments in nanoparticles for the treatment of diabetes.

Changes in the homeostasis of blood sugar levels are a hallmark of diabetes mellitus, an incurable metabolic condition, for which the first-line treatment is the subcutaneous injection of insulin. However, this method of administration is linked to low patient compliance because of the possibility of local infection, discomfort and pain. To enable the administration of the peptide through more palatable paths without requiring an injection, like by oral routes, the use of nanoparticles as insulin carriers has been suggested. The use of nanoparticles usually improves the bioavailability and physicochemical stability of the loaded medicine. The utilisation of several forms of nanoparticles (like lipid and polymeric nanoparticles, micelles, dendrimers, liposomes, niosomes, nanoemulsions and drug nanosuspensions) is discussed in this article as a way to improve the administration of various oral hypoglycaemic medications when compared to conventional treatments.

Management of patients at the hepatopancreatobiliary unit of a London teaching hospital during the COVID-19 pandemic.

To mitigate COVID-19-related shortage of treatment capacity, the hepatopancreatobiliary (HPB) unit of the Royal Free Hospital London (RFHL) transferred its practice to independent hospitals in Central London through the North Central London Cancer Alliance. The aim of this study was to critically assess this strategy and evaluate perioperative outcomes. Prospectively collected data were reviewed on all patients who were treated under the RFHL HPB unit in six hospitals between November 2020 and October 2021. A total of 1541 patients were included, as follows: 1246 (81%) at the RFHL, 41 (3%) at the Chase Farm Hospital, 23 (2%) at the Whittington Hospital, 207 (13%) at the Princess Grace Hospital, 12 (1%) at the Wellington Hospital and 12 (1%) at the Lister Hospital, Chelsea. Across all institutions, overall complication rate were 40%, major complication (Clavien-Dindo grade ≥ 3a) rate were 11% and mortality rates were 1.4%, respectively. In COVID-19-positive patients (n = 28), compared with negative patients, complication rate and mortality rates were increased tenfold. Outsourcing HPB patients, including their specialist care, to surrounding institutions was safe and ensured ongoing treatment with comparable outcomes among the institutions during the COVID-19 pandemic. Due to the lack of direct comparison with a non-pandemic cohort, these results can strictly only be applied within a pandemic setting.

Effect of Chronic Suppurative Otitis Media on Gustatory Function of chorda Tympani Nerve : A Prospective Study.

Introduction the ability to taste is among the life's finest pleasures and perception of taste can be altered by various disorders or therapeutic regimens as colds or dental procedures. Head trauma patients, patients on certain drugs such as phenylbutanone, carbamazepine and baclofen and patients with inflammatory diseases of the middle ear frequently complain about alterations in their ability to taste. So, assessment of gustatory sensitivity is the prerequisite for the correct diagnosis of taste dysfunction which uses taste strips impregnated with taste stimulants. Material and method in this prospective study, 40 patients were enrolled after assessment of history, general and local examination of ear and finally assessment of gustatory function was done according to Muller technique using taste strips. Results in present study out of 40 patients, 16 (40%) patients had COM squamous, 24 patients (60%) had COM mucosal. In the ipsilateral diseased ear (both COM squamous & mucosal) the mean taste score for various taste sensation was 11.65 ± 2.59. In the contralateral normal ear, the mean taste score was 15.42 ± 0.78. The difference between the two was found to be statistically significant (p < 0.0001). Conclusion a significant difference was obtained in taste scores between diseased (ipsilateral) and normal (contralateral) ears both overall and also when subtypes were compared. Thus, the present prospective study indicates that COM squamous as well as mucosal can induce taste dysfunction. Supplementary Information: The online version contains supplementary material available at 10.1007/s12070-023-03703-7.