Category: Nevin Manimala

J Neurosci Rural Pract. 2021 Apr;12(2):281-289. doi: 10.1055/s-0041-1722820. Epub 2021 Mar 24.

ABSTRACT

Objective Japanese encephalitis (JE) is an arthropod-borne flavivirus infection having high mortality and morbidity. This study was performed to evaluate the conventional magnetic resonance imaging (MRI) findings in JE and to find out any difference between pediatric and adult JE. Materials and Methods This retrospective study was performed on serologically positive 54 JE patients presented to a tertiary care hospital with acute encephalitic symptoms between April 2016 and October 2019. Relevant neurological examination, cerebrospinal fluid analysis, and MRI scan of the brain were performed. Results Fifty-four JE patients ( n = 31 males and n = 23 females) having 32 pediatric and 22 adult JE were included in the study sample. Group 1 JE ( n = 16) patients had encephalitic symptoms with duration less than 15 days up to the day of MRI scan and group 2 JE ( n = 38) had symptoms more than 15 days. Group 1 JE had mean apparent diffusion coefficient (ADC) value of 0.563 ± 0.109 (standard deviation [SD]) × 10 ^-3 mm ² /sec and group 2 JE had 1.095 ± 0.206 (SD) × 10 ^-3 mm ² /sec. The mean ADC value of pediatric JE was 0.907 ± 0.336 (SD) × 10 ^-3 mm ² /sec and adult JE was 0.982 ± 0.253 (SD) × 10 ^-3 mm ² /sec. Conclusion The majority of the JE patient shows abnormal signal alterations in bilateral thalami and substantia nigra. Diffusion-weighted imaging with ADC mapping helps in evaluating the stage of the JE. No statistical significance of the various conventional MRI findings was found between the pediatric JE and adult JE.

PMID:33935446 | PMC:PMC8079177 | DOI:10.1055/s-0041-1722820

J Neurosci Rural Pract. 2021 Apr;12(2):302-307. doi: 10.1055/s-0041-1722819. Epub 2021 Mar 15.

ABSTRACT

Background Cardiogenic brain abscess (CBA) is the commonest noncardiac cause of morbidity and mortality in cyanotic heart disease (CHD). The clinical diagnosis of a CBA is often delayed due to its nonspecific presentations and the scarce availability of computed tomography (CT) imaging in resource-restricted settings. We attempted to identify parameters that reliably point to the diagnosis of a CBA in patients with Tetralogy of Fallot (TOF). Methods From among 150 children with TOF treated at a tertiary care institute over a 15-year period from 2001 to 2016, 30 consecutive patients with CBAs and 85 age- and sex-matched controls without CBAs were included in this retrospective case-control study. Demographic and clinical features, laboratory investigations, and baseline echocardiographic findings were analyzed for possible correlations with the presence of a CBA. Statistical Analysis Variables demonstrating significant bivariate correlations with the presence of a CBA were further analyzed using multivariate logistic regression (LR) analysis. Various LR models were tested for their predictive value, and the best model was then validated on a hold-out dataset of 25 patients. Results Among the 26 variables tested for bivariate associations with the presence of a CBA, some of the clinical, echocardiographic, and laboratory variables demonstrated significant correlations ( p < 0.05). LR analysis revealed elevated neutrophil-lymphocyte ratio and erythrocyte sedimentation rate values and a lower age-adjusted resting heart rate percentile to be the strongest independent biomarkers of a CBA. The LR model was statistically significant, (χ ² = 23.72, p = <0.001), and it fitted the data well. It explained 53% (Nagelkerke R 2 ) of the variance in occurrence of a CBA, and correctly classified 83.93% of cases. The model demonstrated a good predictive value (area under the curve: 0.80) on validation analysis. Conclusions This study has identified simple clinical and laboratory parameters that can serve as reliable pointers of a CBA in patients with TOF. A scoring model-the ‘BA-TOF’ score-that predicts the occurrence of a CBA has been proposed. Patients with higher scores on the proposed model should be referred urgently for a CT confirmation of the diagnosis. Usage of such a diagnostic aid in resource-limited settings can optimize the pickup rates of a CBA and potentially improve outcomes.

PMID:33935447 | PMC:PMC8079174 | DOI:10.1055/s-0041-1722819

J Neurosci Rural Pract. 2021 Apr;12(2):335-342. doi: 10.1055/s-0041-1723071. Epub 2021 Apr 1.

ABSTRACT

Objective Mental health care needs of urban, rural, and tribal regions of India are varied and challenging, which require region-specific approaches. A significant treatment gap calls out for a state-wise introspection of existing service delivery models to cater to the specific mental health needs. In Madhya Pradesh, key findings were noted from a camp conducted in one of the tribal districts. To establish patient-centered services, it is important to understand their mental health care needs. Materials and Methods A cross-sectional study within a mental health camp was conducted in the east-central tribal district of Madhya Pradesh by using a semi-structured interview. Statistical Analysis Treatment deficit, pathways to care, and treatment barriers were assessed for correlation with demographic and clinical variables and analyzed by using the Chi-square test and logistic regression method using SPSS version 20. Results Among 113 patients who sought help, treatment deficit was 85% with patient factors contributing 76% predominantly affecting the unmarried group of patients. Common mental illnesses (CMIs) outnumbered severe mental illnesses (SMIs) of which anxiety spectrum disorder contributed the most. SMIs still appear to remain undiagnosed till late in the course of illness. Nicotine dependence was higher in males ( p < 0.001), and an increase in the dependence pattern was observed with increasing age ( p = 0.001). Conclusion Rising awareness and recognition of CMIs as a common mental health concern while under-recognition of SMIs among tribal communities needs further research. Considering attribution of symptoms to unknown factors, treatment barriers revolving around patient factors, and higher nicotine dependence in males, a timely evaluation of a multitargeted intervention to establish the balance in access to mental health care among the tribal population of Madhya Pradesh is warranted.

PMID:33935448 | PMC:PMC8079175 | DOI:10.1055/s-0041-1723071

Vet World. 2021 Mar;14(3):739-743. doi: 10.14202/vetworld.2021.739-743. Epub 2021 Mar 23.

ABSTRACT

BACKGROUND AND AIM: Mycotoxin contamination in animal feeds is of considerable concern because it can affect animal health systems. As a result of contamination in the food chain, humans can indirectly come into contact with mycotoxins. The present study aimed to present mycotoxin contamination patterns in animal feeds from 2015 to 2020 and elucidate associations between the type of feed and the type of ingredient.

MATERIALS AND METHODS: Data were summarized from the records of the Kamphaeng Saen Veterinary Diagnosis Center from 2015 to 2020, which comprised the analyses of aflatoxin (AFL), zearalenone (ZEA), T-2 toxin (T-2), fumonisin (FUM), and deoxynivalenol (DON) contamination in feed ingredients, complete feeds, and unclassified feeds. Descriptive statistics, Chi-squared tests, and Fisher’s exact tests were used for data analysis.

RESULTS: ZEA was prevalent in animal feeds. The prevalence of each mycotoxin was constant from 2015 to 2020. Approximately 20-30% of samples were positive for AFL and FUM. The highest contamination was ZEA, which was found in 50% of the samples, and the occurrence of T-2 and DON was <10%. AFL significantly contaminated complete feeds more than feed ingredients. Feed ingredients were related to mycotoxin contaminations. The highest levels of AFL, FUM, and DON contamination occurred in 2017. The data in this year consisted mostly of soybean, corn, and rice bran.

CONCLUSION: The number of positive samples of all five mycotoxins was constant from 2015 to 2020, but the occurrence of ZEA was the highest. Mycotoxins in feedstuffs are significantly related to the type of feed and the type of ingredient.

PMID:33935421 | PMC:PMC8076449 | DOI:10.14202/vetworld.2021.739-743

Vet World. 2021 Mar;14(3):769-776. doi: 10.14202/vetworld.2021.769-776. Epub 2021 Mar 26.

ABSTRACT

BACKGROUND AND AIM: Nowadays, toxic chemical contaminants in food are a major food safety problem in Bangladesh. Among toxic food contaminants, formalin is used to preserve fruit, vegetables, and fish, where urea is used for the whitening of rice and puffed rice. The purpose of this study was to determine the biochemical and histopathological effects on the liver of young and adult pigeons after exposure to formalin and urea contaminated feed.

MATERIALS AND METHODS: A total of 15 young and 15 adult pigeons were divided into control group, formaldehyde exposed group (2.5 mL formalin/kg feed), and urea exposed (1 g/kg feed) group. Each group consisted of five pigeons. After the experimentation procedures, the blood samples were collected for biochemical study, and the liver tissue was collected for histomorphological study. The statistical analysis was performed using the Student’s t-test, and p<0.05 was considered as statistically significant.

RESULTS: The aspartate transaminase serum hepatic enzyme was significantly increased in both formalin and urea exposed young and adult pigeons than the control pigeons. In control pigeons, parenchymal hepatocytes and non-parenchymal cells are regularly arranged. However, histological observation of the liver of formalin and urea exposed young, and adult pigeons showed coagulation necrosis with infiltration of many inflammatory cells around the central and portal veins. The necrotic areas are more extensive with massive infiltration of inflammatory cells in the liver of formalin-treated pigeons than the urea treated pigeons.

CONCLUSION: The present study results show that low concentrations of formalin and urea in feed induced liver lesions in pigeons in different extents and indicate that exposure to toxic chemicals may affect homeostasis of the liver and cause liver injury or act as a co-factor for liver disease.

PMID:33935426 | PMC:PMC8076463 | DOI:10.14202/vetworld.2021.769-776

J Orthop. 2021 Apr 15;25:75-81. doi: 10.1016/j.jor.2021.03.024. eCollection 2021 May-Jun.

ABSTRACT

PURPOSE: To compare the in vitro elution characteristics of CMW1 and Palacos R bone cement loaded with gentamicin, teicoplanin, or in combination.

METHODS: Four bone cement discs were prepared for each cement type. Disc 1 contained no antibiotics; disc 2 contained 0.5 g gentamicin; disc 3 contained 2 g teicoplanin; disc 4 contained 0.5 g gentamicin and 2 g teicoplanin. Elution studies were conducted using a fluorescence polarisation immunoassay technique and performed at intervals of 6 weeks.

RESULTS: For CMW1, gentamicin and teicoplanin elution levels in combination discs were higher than those in the single antibiotic discs (p < 0.001 & p < 0.06). For Palacos R, gentamicin elution levels in combination discs were higher than those in the single antibiotic discs (p < 0.001), but teicoplanin elution levels in combination discs were lesser than that from the single antibiotic discs (p < 0.02). In single and combination discs, gentamicin elution levels in Palacos R were higher than those in CMW1 (p < 0.001 & p < 0.001). Palacos R eluted more teicoplanin than CMW1, except in combined disc with gentamicin, when less teicoplanin was eluted.

CONCLUSION: Antibiotic elution is higher in Palacos R than CMW1. Antibiotic combination in both cement types has the synergistic effect of increasing antibiotic elution, except for teicoplanin from Palacos R. When high elution of gentamicin is required, Palacos R is preferable. When high elution of teicoplanin is required, Palacos R with only teicoplanin is superior to CMW1.

PMID:33935435 | PMC:PMC8079329 | DOI:10.1016/j.jor.2021.03.024

J Phys Ther Sci. 2021 Apr;33(4):369-374. doi: 10.1589/jpts.33.369. Epub 2021 Apr 6.

ABSTRACT

[Purpose] The present study aimed to examine the existence and degree of possible asymmetries of functional test performance and their intercorrelations in the lower extremities of young basketball players. [Participants and Methods] Twenty-seven healthy male basketball players (age: 15.52 ± 1.37 years) were examined for the symmetric function of their lower extremities using triple hop for distance tests in the sagittal and frontal plane (medial-lateral), the Y-balance test and a vertical jump test. [Results] Participants exhibited statistically significant side-to-side differences in only the medial triple hop test, as they jumped further on their non-dominant for stability lower limb. No other asymmetries were observed in the rest of the functional tests. Significant correlations were also indicated between the vertical jumptest and the three directions of the triple hop test for both lower limbs. [Conclusion] Our findings proved that young basketball players present a symmetrical picture of functional performance, as revealed by the evaluation of various functional tests. The only significant asymmetric adaptation observed in the medial triple hop test will have to be strengthened by future studies to be implemented in injury prevention programs.

PMID:33935363 | PMC:PMC8079892 | DOI:10.1589/jpts.33.369

J Cytol. 2021 Jan-Mar;38(1):21-30. doi: 10.4103/JOC.JOC_70_20. Epub 2021 Feb 17.

ABSTRACT

CONTEXT: Radiology and pathology are pivotal tools in the investigational artillery for management of wide spectrum of hepatic lesions and early detection is of a paramount importance.

AIMS: The study aimed at analyzing the efficacy, comparative yield and validity of image-guided aspiration cytology (FNA)/core biopsy (CB) in focal hepatic lesions.

SETTINGS AND DESIGN: A retrospective hospital-based study was conducted in departments of Pathology and Radiology and Imaging of a tertiary care center.

MATERIALS AND METHODS: Cases of focal hepatic lesions that underwent percutaneous image guided-FNA reported (2011-2018) were analyzed. Cytological-histopathological correlation was performed where available. FNA diagnoses were divided into four categories-positive for malignancy (group 1), atypical (group 2), negative for malignancy (group 3), and non-diagnostic (group 4).

STATISTICAL ANALYSIS USED: Categorical data was depicted in the form of frequencies and proportions. Validity of percutaneous image-guided FNA diagnosis was collated with the final diagnosis and results were analyzed.

RESULTS: A total of 338 FNA of focal hepatic lesions were reported in which 217 (68.2%) cases in group 1; 21 (6.2%) in group 2; 58 (17.2%) in group 3 and 42 (12.4%) in group 4. CB correlation was available in 123 cases. Based on clinical, radiological and pathological findings, conclusive final diagnoses were obtained and the cases were regrouped [malignant cases-245, benign lesions-57 and uncertain lesions-36]. Metastasis was the most common malignancy (175/245; 71.4%). Sensitivity, specificity, and overall diagnostic accuracy of FNA to categorize the lesion as benign or malignant were 96.94%, 100% and 97.51%, respectively. However, the cytology-histopathology correlation revealed discordance of subtyping the lesion in 20% of cases and sensitivity and specificity reduced to 80% and 50% respectively in rendering the specific diagnosis.

CONCLUSIONS: Percutaneous image-guided FNA is a sensitive and specific tool with high diagnostic accuracy in evaluating focal hepatic lesions. The study highlights the pre-eminence of interventional radiology and cytology in the care of patients with liver lesions.

PMID:33935388 | PMC:PMC8078618 | DOI:10.4103/JOC.JOC_70_20

Vet World. 2021 Mar;14(3):585-588. doi: 10.14202/vetworld.2021.585-588. Epub 2021 Mar 8.

ABSTRACT

BACKGROUND AND AIM: The concentration of serum progesterone is commonly used to determine the optimal mating time in bitches, and to diagnose reproductive-related abnormalities. This study aims to compare the serum progesterone results obtained by rapid fluorescence immunochromatography assay (RFICA) with those obtained by chemiluminescent microparticle immunoassay (CMIA) from the same serum samples to develop a standard guideline for optimal breeding time.

MATERIALS AND METHODS: Serum progesterone levels were measured in 124 bitches using RFICA and CMIA. Simple linear regression and correlation analyses were performed to analyze the data. The percentage difference between the maximum and minimum progesterone values in the same serum sample in the same assay was compared using Wilcoxon’s rank-sum test.

RESULTS: The present study showed a strong linear dependence of the results obtained by RFICA on those obtained by CMIA as R²=0.8976, with regression coefficient of 0.9474 and p<0.05, including the regression model was CMIA = (0.9483 × RFICA) – 0.761. Moreover, five critical measurement times during estrous in bitches showed statistically significant differences (p<0.05), except at the fertilizable period, which showed a non-significant difference (p>0.05).

CONCLUSION: This study demonstrated that it is presumably acceptable to use the RFICA and CMIA methods interchangeably for quality progesterone measurements in serum samples from bitches. However, when considering the use of the RFICA method, it is advisable to carefully interpret the results and follow the interpretation guidelines. Finally, RFICA in the present study provides a reliable and convenient option for veterinarian practitioners to measure canine progesterone levels in-house.

PMID:33935401 | PMC:PMC8076448 | DOI:10.14202/vetworld.2021.585-588

Contemp Jew. 2021 Apr 23:1-22. doi: 10.1007/s12397-021-09366-2. Online ahead of print.

ABSTRACT

In June 2020, the Office for National Statistics (ONS) in England and Wales published the results of an investigation into mortality from COVID-19 by religious group. The analysis revealed a significant “Jewish penalty”: coronavirus mortality of Jews was shown to be relatively high compared to the British Christian majority. This paper considers these findings in the light of the literature on Jewish mortality and undertakes a re-analysis of the results alongside the additional data on Jewish deaths provided by the British Jewish communal statistics. It asks two questions: (1) To what extent is elevated British Jewish mortality from COVID-19 a result of the presence of long-standing vulnerability and ill health among Jews? (2) What role do strictly Orthodox Jews play in elevating coronavirus mortality levels among British Jews? The primary contribution of the paper is to explore, via analyses of alternative data sources, the ONS finding of elevated Jewish mortality from coronavirus, to explain why it is surprising, to test whether it is real and to eliminate certain explanations. Such process of elimination in itself will highlight other alternative explanations, but the paper falls short of decisively explaining the phenomenon of the elevated British Jewish mortality from coronavirus. It ends with an outline of future directions of research in this area.

PMID:33935336 | PMC:PMC8064418 | DOI:10.1007/s12397-021-09366-2