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Abstract Background Fish with vertebral monstrosities are very rare in the wild, as those individuals in the natural populations tend to perform poorly to survive in any ecosystem. Species of the fish genus Hypselobarbus as reported (Bleeker in De visschen van den Indischen Archipel, Lange, 1860) are freshwater endemic barbs of Western Ghats and peninsular India. Four species of the genus, namely Hypselobarbus dobsoni (Krishna carp), H. jerdoni (Jerdon’s Carp), H. lithopidos (Canara barb) and H. thomassi (Red Canarese barb), were collected from three different river systems of the Western Ghats biodiversity hotspot of India. Some individuals were found to be different from normal specimens, with extremely large body depth compared to normal specimens. The study was initiated with the aim of bringing an understanding on monstrosities of these four species along with identifying the normal and abnormal individuals in an integrated approach; employing traditional morphometry, X-ray imaging and barcoding mtDNA COI X-ray imaging could elucidate the vertebral monstrosities, which are discussed in detail. The mtDNA COI gene sequences generated were used to draw conclusions on identity of both normal and deformed individuals. Results The phenotypic deformities have led to deepening of the body with a more robust and reduced length which is evident from the morphometric comparison of normal specimens with deformed ones. The radiographic images revealed reduced intra-vertebral space in comparison with the normal vertebrae, deformed vertebrae were between 25 and 32, showing significantly altered intra-vertebral space. Slight genetic divergence of 1.1% between normal and deformed specimens in mitochondrial DNA COI gene of H. lithopidos and H. thomassi and no divergence in H. dobsoni and H. jerdoni were also observed. Conclusion The specimens were collected from areas with high anthropogenic stresses, abate water quality, and habitat, which could be possible reasons of appearance of individuals with deformed vertebrae. Several environmental and genetic factors might have influenced the development of these robust short-bodied phenotypes in these rivers and possess slight genetic divergence from normal specimens. However, these deformities may also be the result of the stress during embryonic and early life stages in the wild.

Context. Mealtime insulin bolus is traditionally administered before meals in children with type 1 diabetes (T1D). Controlled studies on the use of pre-and postprandial insulin bolus have shown variable results. There are no realworld studies on postprandial bolusing of insulin in young children with T1D. Methods. Children with T1D aged <7 years were grouped into preprandial (Group 1) or postprandial (Group 2) groups according to the practice of prandial insulin use. Their retrospective data on mean glycosylated hemoglobin (HbA1c), hypoglycemic events, and diabetic ketoacidosis (DKA) episodes were compared. Results. Forty-four children (mean age 4.1±1.3 years, range 2-7 years) with mean diabetes duration of 2.0±0.7 years (range, 1-4 years) were identified; 23 (52.3%) belonged to Group 1 and 21 (47.7%) to Group 2. There were no differences in the mean HbA1c levels, mean hypoglycemic events, and DKA episodes between the two groups during a mean follow-up duration of two years. Conclusion. Young children with T1D administered insulin bolus during or immediately after meals showed similar long-term glycemic control and diabetesrelated adverse event profile compared to the premeal timing of insulin bolus. Larger real-world studies are needed on flexible insulin bolus timing in young children with T1D. [ABSTRACT FROM AUTHOR]

Aim: This study was designed to enumerate regulatory T‑cells (Tregs) and estimate transforming growth factor‑β1 (TGF‑β1) levels in type 1 diabetic (T1D) patients with respect to disease duration and associated autoimmune diseases. Methods: One hundred and fifty patients and twenty healthy controls were recruited in the study. The patients were subcategorized into eight categories on the basis of disease duration (new onset [NO] and long standing [LS]) and associated diseases, i.e., celiac disease (CD) and autoimmune thyroid disease (AiTD). Treg cells were assessed as CD4+ CD25hi+, FOXP3+ cells and serum TGF‑β1 levels were assessed by ELISA. Results: The frequency of Tregs and levels of TGF‑β1 were significantly increased in the patients compared to the healthy controls. Among the different categories of the patients, no significant differences were seen for TGF- β1 levels, but for Tregs in patients with T1D and AiTD (P = 0.035). A significant correlation was also found between percentage count of Tregs and TGF‑β1 levels in NO cases in all disease subcategories, but not in LS patients. Conclusion: Thus, there was an increased percentage of Tregs and serum levels of TGF‑β1 in T1D patients, irrespective of the disease duration and associated autoimmune diseases. The significant correlation in these two parameters at the onset of the disease, but not in LS disease, indicates that the immunological milieu in LS autoimmune diseases is more complicated with disease‑associated conditions such as prolonged hyperglycemia, insulin therapy, and/or continued gluten in diet. Treatment and modulation of these long‑term complications for improving immunological parameters require further research. [ABSTRACT FROM AUTHOR]

We assessed prevalence and factors associated with hepatitis B in a cross section of HIV-infected primary care and antinatal clinic patients in South Africa and evaluated a rapid hepatitis B surface antigen (HBsAg) assay. We enrolled 998 patients; 88% were women, median age was 29 years and median CD4 count was 354 cells/mm3. HBsAg enzyme-linked immunosorbent assay (ELISA), anti-hepatitis B core (HBc) antibodies and hepatitis C virus antibody were positive among 4.2%, 37% and 0.1% of subjects, respectively. Univariate and multivariate associations were assessed using logistic regression. Anti-HBc antibodies were associated with alcohol use, traditional medicines and higher CD4 counts; HBsAg positivity was associated with lower CD4. Compared with the HBsAg ELISA, a rapid HBsAg test had a sensitivity of 75.0% and specificity of 99.6%. In conclusion, we identified a moderate prevalence of both HBsAg and anti-HBc. Importantly, we found that subjects with HBsAg positivity had lower CD4 counts. [ABSTRACT FROM AUTHOR]

Zygomycosis is a frequently fatal infection in the immunocompromised and diabetic host. A 12 year old girl with type 1 diabetes presented in diabetic ketoacidosis and consolidation of right lung along with thymic abscess causing persistent respiratory symptoms. A diagnosis of mucormycosis was made on smear examination of the thymic aspirate. Intravenous amphotericin along with surgical excision of the abscess resulted in clinical cure. Thymic involvement as seen in this case is an extremely rare occurrence in a diabetic patient which has not been reported in literature so far . [ABSTRACT FROM AUTHOR]

The article explains that infantile cortical hyperostosis or Caffey's disease classically presents in infants less than 5 months of age, though has also been reported to occur in utero. Mandibular involvement is seen in 75-80%. Radiological findings are diagnostic; however, other conditions with similar clinicoradiological features such as scurvy, osteomyleitis, syphilitic osteochondritis, hypervitaminosis A, metastatic neuroblastoma, and battered baby syndrome need to be excluded. Treatment is palliative with NSAIDs, and sometimes steroids.