Cecal volvulus following appendectomy in a teenage patient: A case report.

Patients mimicking appendicitis symptoms in a rural setting or those post-appendectomy, indicating cecal volvulus, should always be considered. Swift action can prevent catastrophic consequences. Abstract: We present a case of a 14-year-old female who initially underwent open appendectomy for acute appendicitis and subsequently experienced symptoms of abdominal distention, vomiting, and fever. Her condition deteriorated following the appendectomy, despite a prior appendectomy for similar symptoms at a different facility. A computed tomography (CT) scan identified cecal volvulus as the underlying issue. This led to the performance of a laparotomy, cecopexy, and decompressive ileostomy. After six weeks, ileostomy closure was successfully carried out, and the patient currently enjoys good health. This case highlights the significance of considering uncommon factors as potential contributors to postoperative complications in young patients.

EFFICACY OF AUTOLOGOUS STEM CELL TRANSPLANTATION IN ADULT BURKITT/BURKITT-LIKE LYMPHOMA: A SYSTEMATIC REVIEW.

BACKGROUND: Burkitt and Burkitt like lymphoma (BL/BLL) are highly proliferative germinal or post-germinal B cell tumors. Few studies have evaluated the impact of autologous stem cell transplantation (ASCT) on disease outcomes. AIM: We performed a systematic review to analyze the efficacy of ASCT as frontline consolidation and for treatment of relapsed/refractory cases in adult BL/BLL. MATERIALS AND METHODS: Eligible studies with clear outcome measures on the efficacy of ASCT in adult patients with BL/BLL were identified through systematic search. The overall survival (OS), progression-free survival (PFS), complete response (CR), partial response (PR), and progression/relapse were used to assess the efficacy. RESULTS: For patients who underwent ASCT in first CR, 5-year PFS and OS ranged between 70-78% and 70-83% respectively. For relapsed/refractory disease, 5-year PFS and OS were 27% and 31%, respectively. Patients undergoing ASCT for chemoresistant disease fared poorly with 3-year OS of 7% vs 37% for chemosensitive disease (p ≤ 0.00001). The overall response rate to ASCT for patients transplanted in first CR ranged between 71% and 93% and was 37% for patients who were transplanted in disease status other than first CR. Disease progression/relapse was observed in 16-29% of the patients transplanted in first CR, and 55% to 60% in relapsed disease. CONCLUSION: We found insufficient evidence to support ASCT over chemotherapy alone in the first remission for adult BL/BLL. Evidence supports guidelines recommending ASCT for chemosensitive disease but suggests there is no benefit to ASCT for chemoresistant disease.

Genomic analyses reveal two distinct lineages of Corynebacterium ulcerans strains.

Corynebacteriumulcerans is an important zoonotic pathogen which is causing diphtheria-like disease in humans globally. In this study, the genomes of three recently isolated C. ulcerans strains, 4940, 2590 and BR-AD 2649, respectively from an asymptomatic carrier, a patient with pharyngitis and a canine host, were sequenced to investigate their virulence potential. A comparative analysis was performed including the published genome sequences of 16 other C. ulcerans isolates. C. ulcerans strains belong to two lineages; 13 strains are grouped together in lineage 1, and six strains comprise lineage 2. Consistent with the zoonotic nature of C. ulcerans infections, isolates from both the human and canine hosts clustered in both the lineages. Most of the strains possessed spaDEF and spaBC gene clusters along with the virulence genes cpp, pld, cwlH, nanH, rpfI, tspA and vsp1. The gene encoding Shiga-like toxin was only present in one strain, and 11 strains carried the tox gene encoding the diphtheria-like toxin. However, none of strains 4940, 2590 and BR-AD 2649 carried any toxin genes. These strains varied in the number of prophages in their genomes, which suggests that they play an important role in introducing diversity in C. ulcerans. The pan-genomic analyses revealed a variation in the number of membrane-associated and secreted proteins that may contribute to the variation in pathogenicity among different strains.

Menopausal Health Status of Nepalese Women.

INTRODUCTION: Menopause is an unavoidable and sometimes problematic condition in which women may suffer from a number of health problems. Knowledge of the major symptoms associated with menopause helps reduce the burden and stress associated with the condition. In this context, a study was conducted to establish baseline data regarding menopausal health problems among Nepalese women. METHODS: A descriptive cross-sectional study was conducted among 2000 women aged over 40 years to identify their knowledge, attitude and practice related to menopausal health problems. Data was collected by interviewing the women and doing physical examination. Analysis was done using descriptive statistics and SPSS software was used for data analysis. RESULTS: A cohort of 2073 women (ages 40-60 years) participated in the research, among them 2000 yielded complete response. The study revealed that 820 (41%) women had reached menopause. The average age of menopause was 48.7 years. Majority of the women 1183 (59.2%) in the study did not know about menopausal health problems. Abnormal bleeding 353 (17.65%), sweating 315 (15.75%), hot flushes 299 (14.95%), joint/muscle pain 285 (14.25%) were the most common menopausal symptoms known by the women. Joint pain 736 (36.8%), hot flushes 584 (29.2%), irregular bleeding 582 (29.1%) were the most common experienced symptoms of menopause and only 586 (29.3%) consulted the health workers to alleviate menopausal symptoms. Moreover, most of the women 926 (46.3%) accepted menopause as a part of life. CONCLUSIONS: The research has tried to establish the baseline of menopausal health problems in the Nepalese women. The average age of menopause was 48.7 years. Majority did not know about menopausal health problems. Further researches with nationally representative sample are recommended to further explore the menopausal health problems of Nepalese women.

Assessing Health Status of Khanigaun Village Development Committee in Nuwakot District of Nepal.

BACKGROUND: Assessing health status is crucial to understand the level of health in the community. Maternal health, child health and behavioral practice on diseases are key issues to assess health status of a community in Nepal. Nationwide surveys and literature suggest that there is improvement in health status of Nepalese community. Thus, the aim of this study was to assess general health status of Khanigaun VDC of Nepal and compare it with regional and national status. METHODS: A descriptive cross-sectional study was undertaken using semi-structured questionnaire, interview and observation methods. Simple random sampling was done to conduct household survey among 346 (30%) households. Ethical approval was taken from Nepal Health Research Council, Ethical Review Board Results: General Fertility Rate (GFR) of the VDC was found 69.15 per 1000 Women. Literacy rate of the VDC was 71.14% and 74.92% of households depended on agriculture for income. The major health problem of the community was diarrhea followed by unknown fever and respiratory problems. More than 50% of women breastfed their children only up to the age of one year. Contraceptive prevalence rate was 72% and more than two third of women were found to be have delivered their most recent baby at home. It was found that 31% of newborn were born underweight and measles immunization coverage was 89%. After need identification and prioritization, Micro Health Project (MHP) was conducted to create health related awareness among the people through demonstration and exhibition. CONCLUSIONS: Regular health status assessment of a community people that ultimately helps to plan the health programs and services accordingly.

Chemically and biologically-mediated fertilizing value of manure-derived biochar.

This study evaluates the potential of manure-derived biochars in promoting plant growth and enhancing soil chemical and biological properties during a 150day pot experiment. Biochars from pyrolysis of poultry litter (PL) and swine manure (SM) at 400 and 600°C, and a commonly available wood chip (WC) biochar produced at high temperature (1000°C) were incorporated to silt-loam (SL) and sandy (SY) soils on a 2% dry soil weight basis. Ryegrass was sown and moisture was adjusted to 60% water filled pore space (WFPS). The PL400 and SM400 biochars significantly increased (p<0.05) shoot dry matter (DM) yields (SL soil) and enhanced nitrogen (N), phosphorus (P) and potassium (K) uptake by the plants in both soils, compared to the Control. All biochars significantly increased the soil carbon (C) contents compared to the Control. Total N contents were significantly greater for PL400 and PL600 treatments in both soils. The dehydrogenase activity (DA) significantly increased for PL400 and SM400 treatments and was positively correlated with the volatile matter (VM) contents of the biochars, while ß-glucosidase activity (GA) decreased for the same treatments in both soils. All biochars significantly shifted (p≤0.05) the bacterial community structure compared to the Control. This study suggests that pyrolysis of animal manures can produce a biochar that acts as both soil amendment and an organic fertilizer as proven by increased NPK uptake, positive liming effect and high soil nutrient availability, while WC biochar could work only in combination with fertilizers (organic as well as mineral).

Measurements of parity-violating asymmetries in electron-deuteron scattering in the nucleon resonance region.

We report on parity-violating asymmetries in the nucleon resonance region measured using inclusive inelastic scattering of 5-6 GeV longitudinally polarized electrons off an unpolarized deuterium target. These results are the first parity-violating asymmetry data in the resonance region beyond the Δ(1232). They provide a verification of quark-hadron duality-the equivalence of the quark- and hadron-based pictures of the nucleon-at the (10-15)% level in this electroweak observable, which is dominated by contributions from the nucleon electroweak γZ interference structure functions. In addition, the results provide constraints on nucleon resonance models relevant for calculating background corrections to elastic parity-violating electron scattering measurements.

Precise extraction of the induced polarization in the 4He(e,e'p)3H reaction.

We measured with unprecedented precision the induced polarization P(y) in (4)He(e,e'p)(3)H at Q(2)=0.8 and 1.3 (GeV/c)(2). The induced polarization is indicative of reaction-mechanism effects beyond the impulse approximation. Our results are in agreement with a relativistic distorted-wave impulse approximation calculation but are overestimated by a calculation with strong charge-exchange effects. Our data are used to constrain the strength of the spin-independent charge-exchange term in the latter calculation.

Polarization transfer in the 4He(e,e'p)3H reaction at Q2=0.8 and 1.3 (GeV/c)2.

Proton recoil polarization was measured in the quasielastic 4He(e,e'p)3H reaction at Q{2}=0.8 and 1.3 (GeV/c){2} with unprecedented precision. The polarization-transfer coefficients are found to differ from those of the 1H(e,e'p) reaction, contradicting a relativistic distorted-wave approximation and favoring either the inclusion of medium-modified proton form factors predicted by the quark-meson coupling model or a spin-dependent charge-exchange final-state interaction. For the first time, the polarization-transfer ratio is studied as a function of the virtuality of the proton.

Probing cold dense nuclear matter.

The protons and neutrons in a nucleus can form strongly correlated nucleon pairs. Scattering experiments, in which a proton is knocked out of the nucleus with high-momentum transfer and high missing momentum, show that in carbon-12 the neutron-proton pairs are nearly 20 times as prevalent as proton-proton pairs and, by inference, neutron-neutron pairs. This difference between the types of pairs is due to the nature of the strong force and has implications for understanding cold dense nuclear systems such as neutron stars.

Investigation of proton-proton short-range correlations via the 12C(e,e'pp) reaction.

We investigated simultaneously the 12C(e,e'p) and 12C(e,e'pp) reactions at Q2=2 (GeV/c)2, xB=1.2, and in an (e, e'p) missing-momentum range from 300 to 600 MeV/c. At these kinematics, with a missing momentum greater than the Fermi momentum of nucleons in a nucleus and far from the delta excitation, short-range nucleon-nucleon correlations are predicted to dominate the reaction. For (9.5+/-2)% of the 12C(e,e'p) events, a recoiling partner proton was observed back-to-back to the 12C(e,e'p) missing-momentum vector, an experimental signature of correlations.

Preparation of alpha-(2,2-diphenylhydrazino)lactones and related compounds by radical cyclization: use of glyoxylic acid hydrazone derivatives.

Glyoxylic acid diphenylhydrazone (2a) and the corresponding O-benzyloxime (2b) are easily esterified in high yield by beta-bromo alcohols. The resulting esters undergo radical cyclization to alpha-(2,2-diphenylhydrazino)- or alpha-[(phenylmethoxy)amino]lactones on treatment with tributyltin hydride. Esters for radical cyclization were also made using a beta-(phenylseleno) alcohol and an enol ether. Several derivatives of glyoxylic acid were evaluated, but none was as effective as 2a or 2b. The imine 28 was prepared by an indirect route; it undergoes radical cyclization with displacement of the nitrogen substituent (28 --> 30) so that an alpha-amino lactone can be generated by acid hydrolysis of the cyclization product.