Acute Psychosis and Mania: An Uncommon Complication of Dengue Fever.

Dengue fever is primarily known as a mosquito-borne viral infection that causes a range of physical symptoms, ranging from myalgia to bleeding tendencies. However, there is growing recognition of its potential to trigger psychiatric manifestations, although such cases remain relatively rare. We report a case of acute dengue fever in a 25-year-old male who developed mania and psychotic symptoms after one week of infection. A comprehensive diagnostic workup, including laboratory tests, including cerebrospinal fluid analysis, and neuroimaging, confirmed the absence of organic causes for his psychiatric symptoms, except for his prior exposure to the dengue virus. The patient was initiated on mood stabilizers and antipsychotic medications, leading to a gradual improvement in his mental health.

Intussusception in an elderly female and its management: A case report and literature review.

Intussusception is the telescoping or invagination of the proximal part of the gastrointestinal tract into an adjacent section. It is rare in adults, accounting for 1% of adult bowel obstruction. Adult presentation of intussusception is variable, with nonspecific, vague symptoms like abdominal pain, nausea, vomiting, and rectal bleeding. Abdominal computed tomography (CT) scans have the highest sensitivity in the diagnosis of intussusception. The classical findings of intussusception are the target sign and mesenteric vessels lined within the bowel lumen. An abdominal CT scan can reveal a cloverleaf figuration, fluid-filled ileal loops, superior mesenteric venous (SMV) occlusion, and concerns about ongoing sealed perforation or fistulization. Our patient is an 86-year-old female who was diagnosed with a jejunal-jejunal long-segment intussusception, gastro-enteric fistula, and SMV occlusion with distal reconstitution. The patient responded well to conservative treatment and was discharged for follow-up.

Neurological, Psychiatric, and Multisystemic Involvement of Fragile X Syndrome Along With Its Pathophysiology, Methods of Screening, and Current Treatment Modalities.

Fragile X syndrome (FXS) is a hereditary disease that predominantly leads to intellectual disability (ID) in boys. It is the second prominent cause of ID, which manifests as a result of the atypical development of the cytosine-guanine-guanine (CGG) region. This irregular extension of the CGG region gives rise to methylation and silencing of the fragile X mental retardation 1 (FMR1) gene, causing a loss of the fragile X mental retardation 1 protein (FMRP). This reduction or loss of FMRP is the main cause of ID. It has a multisystemic involvement showing neuropsychiatric features such as ID, speech and language delay, autism spectrum disorder, sensory hyperarousal, social anxiety, abnormal eye contact, shyness, and aggressive behaviour. It is also known to cause musculoskeletal symptoms, ocular symptoms, cardiac abnormalities, and gastrointestinal symptoms. The management is challenging, and there is no known cure for the disease; hence an early diagnosis of the condition is needed through prenatal screening offered to couples with familial history of ID before conception. The management rests on non-pharmacological modalities, including applied behaviour analysis, physical therapy, occupational therapy, speech-language therapy, and pharmacologic management through symptomatic treatment of comorbid behaviours and psychiatric problems and some forms of targeted therapy.

Flea infestation on small wild mammals in Gharyan, Northwest Libya.

Background: Fleas play a major role as vectors for many pathogens that affect humans and livestock. Wild animals, especially wild rodents, are the most important hosts, acting as reservoir hosts for many flea species and pathogens. Aim: This study aimed to identify seasonality and hosts of fleas that parasitize small wild mammals in Gharyan, north-western Libya. Methods: Fleas were collected from seasonally infested hosts from summer 2017 to winter 2018. Results: This survey identified three flea species: Pulex irritans, Xenopsylla cheopis, and Leptopsylla segnis. Pulex irritans was collected from porcupines, X. cheopis from hedgehogs and jerboas, whereas L. segnis from gundis. The highest flea prevalence was in porcupines (35.00%) and the lowest was in gundis (11.11%). The highest intensity was in porcupines (10.43 ± 4.37), and the lowest was in jerboas (1.28 ± 0.24). The highest mean flea abundance was among porcupines of 3.65, whereas in hedgehogs, jerboas and gundis were less than 0.50 flea/host. Pulex irritans was collected during all seasons, while X. cheopis was collected during all seasons except winter, whereas L. segnis was collected only in spring. Conclusion: The finding in this study has increased our awareness that small wild mammals can act as hosts for medically important flea species. All collected flea species have a great specialty in choosing their hosts. Flea intensity is affected by seasonal variations.

Utilization Trends and Predictors of Non-invasive and Invasive Ventilation During Hospitalization Due to Community-Acquired Pneumonia.

BACKGROUND: Community-acquired pneumonia (CAP) is associated with significant morbidity and mortality. Non-invasive ventilation (NIV) and invasive mechanical ventilation (IMV) are most important interventions for patients with severe CAP associated with respiratory failure. We analysed utilization trends and predictors of non-invasive and invasive ventilation in patients hospitalized with CAP. METHODS:  Nationwide Inpatient Sample and Healthcare Cost and Utilization Project data for years 2008-2017 were analysed. Adult hospitalizations due to CAP were identified by previously validated International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) and International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM) codes. We then utilized the Cochran-Armitage trend test and multivariate survey logistic regression models to analyse temporal incidence trends, predictors, and outcomes. We used SAS 9.4 software (SAS Institute Inc., Cary, NC, USA) for analysing data. RESULTS: Out of a total of 8,385,861 hospitalizations due to CAP, ventilation assistance was required in 552,395 (6.6%). The overall ventilation use increased slightly; however, IMV utilization decreased, while NIV utilization increased. In multivariable regression analysis, males, Asian/others and weekend admissions were associated with higher odds of any ventilation utilization. Concurrent diagnoses of septicemia, congestive heart failure, alcoholism, chronic lung diseases, pulmonary circulatory diseases, diabetes mellitus, obesity and cancer were associated with increased odds of requiring ventilation assistance. Ventilation requirement was associated with high odds of in-hospital mortality and discharge to facility. CONCLUSION: The use of NIV among CAP patients has increased while IMV use has decreased over the years. We observed numerous factors linked with a higher use of ventilation support. The requirement of ventilation support is also associated with very high chances of mortality and morbidity.

Mortality and Attrition Rates within the First Year of Antiretroviral Therapy Initiation among People Living with HIV in Guangxi, China: An Observational Cohort Study.

OBJECTIVE: To assess the mortality and attrition rates within the first year of antiretroviral therapy (ART) initiation among people living with human immunodeficiency virus (PLHIV) in rural Guangxi, China. DESIGN: Observational cohort study. Setting. The core treatment indicators and data were collected with standard and essential procedures as per the Free ART Manual guidelines across all the rural health care centers of Guangxi. Participants. 58,115 PLHIV who were under ART were included in the study. Interventions. The data collected included sociodemographic characteristics that consist of age, sex, marital status, route of HIV transmission, CD4 cell count before ART, initial ART regimen, level of ART site, and year of ART initiation. Primary and Secondary Outcome Measures. Mortality and attrition rate following ART initiation. RESULTS: The average mortality rate was 5.94 deaths, and 17.52 attritions per 100 person-years within the first year of ART initiation among PLHIV. The mortality rate was higher among intravenous drug users (Adjusted Hazard Ratio (AHR) 1.27, 95% Confidence Interval (CI) 1.14-1.43), prefecture as a level of ART site (AHR 1.14, 95% CI 1.02-1.28), and county as the level of ART site (AHR 2.12, 95% CI 1.90-2.37). Attrition was higher among intravenous drug users (AHR 1.87, 95% CI 1.75-2.00), the first-line ART containing AZT (AHR 1.09, 95% CI 1.03-1.16), and first-line ART containing LVP/r (AHR 1.34, 95% CI 1.23-1.46). CONCLUSION: The mortality and attrition rates were both at the highest level in the first year of post-ART; continued improvement in the quality of HIV treatment and care is needed.

Nanostructures Formed by Custom-Made Peptides Based on Amyloid Peptide Sequences and Their Inhibition by 2-Hydroxynaphthoquinone.

Extensive research on amyloid fibril formations shows that certain core sequences within Aß peptide play an important role in their formation. It is impossible to track these events in vivo. Many proteins and peptides with such core sequences form amyloid fibrils and such Aß sheet mimics have become excellent tools to study amyloid fibril formation and develop therapeutic strategies. A group of peptides based on amyloid peptide sequences obtained from PDB searches, where glycine residues are substituted with alanine and isoleucine, are tested for aggregation by SEM and ThT binding assay. SEM of different peptide sequences showed morphologically different structures such as nanorods, crystalline needles and nanofibrils. The peptides were co-incubated with HNQ (a quinone) to study its effect on the process of aggregation and/or fibrillation. In conclusion, this group of peptides seem to be Aß sheet mimics and can be very useful in understanding the different morphologies of amyloid fibrils arising from different peptide sequences and the effective strategies to inhibit or anneal them.

Investigation of Biochemical Alterations in Ischemic Stroke Using Fourier Transform Infrared Imaging Spectroscopy-A Preliminary Study.

OBJECTIVE: Brain damage, long-term disability and death are the dreadful consequences of ischemic stroke. It causes imbalance in the biochemical constituents that distorts the brain dynamics. Understanding the sub-cellular alterations associated with the stroke will contribute to deeper molecular understanding of brain plasticity and recovery. Current routine approaches examining lipid and protein biochemical changes post stoke can be difficult. Fourier Transform Infrared (FTIR) imaging spectroscopy can play a vital role in detecting these molecular alterations on a sub-cellular level due to its high spatial resolution, accuracy and sensitivity. This study investigates the biochemical and molecular changes in peri-infract zone (PIZ) (contiguous area not completely damaged by stroke) and ipsi-lesional white matter (WM) (right below the stroke and PIZ regions) nine weeks post photothrombotic ischemic stroke in rats. MATERIALS AND METHODS: FTIR imaging spectroscopy and transmission electron microscopy (TEM) techniques were applied to investigate brain tissue samples while hematoxylin and eosin (H&E) stained images of adjacent sections were prepared for comparison and examination the morphological changes post stroke. RESULTS: TEM results revealed shearing of myelin sheaths and loss of cell membrane, structure and integrity after ischemic stroke. FTIR results showed that ipsi-lesional PIZ and WM experienced reduction in total protein and total lipid content compared to contra-lesional hemisphere. The lipid/protein ratio reduced in PIZ and adjacent WM indicated lipid peroxidation, which results in lipid chain fragmentation and an increase in olefinic content. Protein structural change is observed in PIZ due to the shift from random coli and α-helical structures to ß-sheet conformation. CONCLUSION: FTIR imaging bio-spectroscopy provide novel biochemical information at sub-cellular levels that be difficult to be obtained by routine approaches. The results suggest that successful therapeutic strategy that is based on administration of anti-oxidant therapy, which could reduce and prevent neurotoxicity by scavenging the lipid peroxidation products. This approach will mitigate tissue damage in chronic ischemic period. FTIR imaging bio-spectroscopy can be used as a powerful tool and offer new approach in stroke and neurodegenerative diseases research.

Vision-based Mobile Indoor Assistive Navigation Aid for Blind People.

This paper presents a new holistic vision-based mobile assistive navigation system to help blind and visually impaired people with indoor independent travel. The system detects dynamic obstacles and adjusts path planning in real-time to improve navigation safety. First, we develop an indoor map editor to parse geometric information from architectural models and generate a semantic map consisting of a global 2D traversable grid map layer and context-aware layers. By leveraging the visual positioning service (VPS) within the Google Tango device, we design a map alignment algorithm to bridge the visual area description file (ADF) and semantic map to achieve semantic localization. Using the on-board RGB-D camera, we develop an efficient obstacle detection and avoidance approach based on a time-stamped map Kalman filter (TSM-KF) algorithm. A multi-modal human-machine interface (HMI) is designed with speech-audio interaction and robust haptic interaction through an electronic SmartCane. Finally, field experiments by blindfolded and blind subjects demonstrate that the proposed system provides an effective tool to help blind individuals with indoor navigation and wayfinding.

HIV, syphilis and behavioral risk factors among men who have sex with men in a drug-using area of southwestern China: Results of 3 cross-sectional surveys from 2013 to 2015.

To assess human immunodeficiency virus (HIV), syphilis, and behavioral risk factors among men who have sex with men (MSM) in southwestern China, where HIV started as a drug-driven epidemic, and shifted to mainly heterosexual transmission.These cross-sectional studies were conducted yearly in 2013, 2014, and 2015 in Guangxi, China. A total of 1,996, 1,965, and 1,697 participants were recruited in 2013, 2014, and 2015, respectively. The data included demographic and sexual behavioral variables. Other variables included individuals who used illegal drugs, and who received HIV counseling, testing, and free condoms, and peer education. Participants were tested for HIV, syphilis, and hepatitis C virus (HCV) with whole blood specimens. Questionnaires and laboratory testing data were double entered, and validated with EpiData software. The data were then transferred into SPSS software (SPSS Inc, Chicago, IL) and Chi-square test performed.The prevalence of HIV was 6.6% in 2013, 8.4% in 2014, and 11.2% in 2015. The prevalence of syphilis was 9.3% in 2013, 9.8% in 2014, and 6.1% in 2015. And HCV prevalence was 0.5% in 2013 and remained stable at 0.4% in 2014, and 2015. HIV infection, and associated factors among MSM in these 3 annual cross-sectional survey showed that HIV-infected MSM were significantly, more likely, to perform unprotected anal intercourse with any commercial male partners in the past 6 months (adjusted odds ratio [AOR] = 1.81, 95% CI: 1.50-2.20), had sex with any female partners in the past 6 months (AOR = 1.31, 95% CI: 1.01-1.71), used drugs in the past (AOR = 2.73, 95% CI: 1.30-5.71), and are syphilis infected (AOR = 3.53, 95% CI: 2.77-4.49).There is an urgent need for intervention strategies like condom distribution, HIV counseling, free testing, and education regarding safe sex, HIV, and other sex-related diseases in Guangxi to curb, and prevent HIV among MSM.

Cationic folate-mediated liposomal delivery of bis-arylidene oxindole induces efficient melanoma tumor regression.

The folate receptor (FR) is a well-validated and common target for cancer due to its high over-expression in many different cancer cells. Herein, we developed a new FR-targeting ligand (FA8) by conjugating folic acid and a cationic lipid. Owing to its favorable structural property FA8 as a ligand could be accommodated at an unusually higher molar ratio for a ligand-targeted liposome. We then encapsulated a drug-like molecule, bis-arylidene oxindole (NME2), in the targeted liposome. The resulting formulation induced potent caspase-8 up-regulation even in FR-moderately expressing melanoma cells. The NME2-associated non-targeted liposome (i.e., without FA8) or pristine NME2 could not up-regulate caspase-8. Caspase-8, an important apoptotic protein involved in the extrinsic pathway of apoptosis-signalling and inhibition of acquired drug resistance, was induced in cancer cells due to the combination treatment of liposomally associated FA8 and NME2 through the activation and subsequent cleavage of RIP-1. Consistently, in a melanoma tumor model too wherein FR is moderately expressed, significant tumour regression was obtained with this liposomal combination of FA8 and NME2. In conclusion, we demonstrate the development of a new FR-targeting ligand molecule whose higher level of inclusion (>10 mol%) in the liposomal formulation altered the mode of anticancer action of the encapsulated drug, thereby indicating a new therapeutic possibility involving FR targeted cancer treatment.

Alcohol drinking and HIV-related risk among men who have sex with men in Chongqing, China.

To estimate the prevalence of any alcohol use and heavy alcohol drinking using the Alcohol Use Disorders Identification Test (AUDIT) and its correlates among men who have sex with men (MSM), a cross-sectional study was conducted among 391 MSM in Chongqing, China to collect data about sociodemographic characteristics, alcohol use, sexual behaviors, and other related factors through a computer-assisted self-administered questionnaire. Heavy alcohol drinking in the past 12 months was defined as an AUDIT-C score ≥ 4. Blood was collected from each potential participant to test for HIV and syphilis status. Twenty three percent of MSM had consumed a drink containing alcohol in the previous year. 7.2% had an AUDIT-C score ≥ 4, defined as heavy alcohol drinkers. 23.5% were unmarried, but planning to marry, who were more likely to report any alcohol drinking (adjusted odds ratio [AOR], 2.38; 95% confidence interval [CI], 1.40-4.06) and to have AUDIT-C scores ≥ 4 (AOR, 3.58; 95% CI, 1.60-8.00). MSM who had used any alcohol in the previous year, and MSM who were heavy alcohol drinkers, were more likely to have had anal sex with male casual partners in the previous 6 months, to have been tested for HIV, and to have decreased scores on the scales of general self-efficacy, increased scores on the scales of stigma and discrimination. Our findings provided further evidence of the associations of any alcohol use and heavy alcohol consumption with HIV-risky behaviors, lowered sense of general self-efficacy, and higher sense of HIV/AIDS-related stigma and discrimination among MSM in the city with the highest HIV epidemic among MSM in China.

Protective activity of gallic acid against glyoxal -induced renal fibrosis in experimental rats.

This study was designed to evaluate the protective activity of gallic acid (GA) against glyoxal (GO) an advanced glycation intermediate-induced renal fibrosis in experimental rats. Glyoxal (i.p) at a dose of 15 mg/Kg body weight/day for 4 weeks induces renal fibrosis. GA was administered orally (100 mg/Kg body weight/day) along with GO for 4 weeks. The anti-fibrotic activity of GA was analyzed by measuring the collagen synthesis and deposition in renal tissues using mRNA expression analysis and Masson trichrome staining (MTS), respectively. The nephroprotective potential of GA was assessed by quantifying the markers of kidney damage such as serum blood-urea-nitrogen (BUN), creatinine (CR) and alkaline phosphatase (AP). Moreover, basement membrane damage in renal tissues was analysed by periodic acid Schiff's (PAS) staining. GA co-treatment markedly suppressed the GO-induced elevation in mRNA expression of collagenIand III, MMP-2, MMP-9 and NOX (p < 0.05, respectively) genes as compared with GO alone infused rats. In addition, GA co-treatment significantly attenuated the GO -induced elevation in serum markers such as BUN, CR and AP levels (p < 0.05, respectively). Furthermore, GA co-treatment restored back the decreased renal super oxide dismutase (SOD) activity (p < 0.05) thereby assuage the reactive oxygen species (ROS) generation, and maintained the normal architecture of glomerulus. The present study clearly indicates that GO -induces renal fibrosis by enhancing GO/receptor of advanced glycation end product (RAGE) induced ROS generation and GA effectively counteracted GO-induced renal fibrosis by its ROS quenching and anti-glycation activity.

Alignment of carbon nanotubes and reinforcing effects in nylon-6 polymer composite fibers.

Alignment of pristine carbon nanotubes (P-CNTs) and fluorinated carbon nanotubes (F-CNTs) in nylon-6 polymer composite fibers (PCFs) has been achieved using a single-screw extrusion method. CNTs have been used as filler reinforcements to enhance the mechanical and thermal properties of nylon-6 composite fibers. The composites were fabricated by dry mixing nylon-6 polymer powder with the CNTs as the first step, then followed by the melt extrusion process of fiber materials in a single-screw extruder. The extruded fibers were stretched to their maxima and stabilized using a godet set-up. Finally, fibers were wound on a Wayne filament winder machine and tested for their tensile and thermal properties. The tests have shown a remarkable change in mechanical and thermal properties of nylon-6 polymer fibers with the addition of 0.5 wt% F-CNTs and 1.0 wt% of P-CNTs. To draw a comparison between the improvements achieved, the same process has been repeated with neat nylon-6 polymer. As a result, tensile strength has been increased by 230% for PCFs made with 0.5% F-CNTs and 1% P-CNTs as additives. These fibers have been further characterized by DSC, Raman spectroscopy and SEM which confirm the alignment of CNTs and interfacial bonding to nylon-6 polymer matrix.