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Introduction: Chest injury resulting from thoracic trauma experienced by an individual is presented in this study. The results obtained from this analysis conducted retrospectively are anticipated to contribute to raising awareness of early diagnosis of embolism in the context of trauma. Objective: Pulmonary embolism remains a disease that needs clinical suspicion to prevent mortality and morbidity. More so in young individuals, suspicion is very low as compared to old age individuals with multiple co-morbid conditions. There is a high risk of mortality associated with Pulmonary embolism in case of not detected and treated in the early stage. Methods: This document outlines a case study involving a young male patient who exhibited sudden breathlessness after experiencing blunt chest trauma. The patient was diagnosed with pulmonary thromboembolism later on. Results: The patient was discharged on the novel oral anticoagulant Rivaroxaban. It is one of the first available direct factor Xa inhibitors, recommended for use in venous thromboembolism. It allows predictable anticoagulation, and routine coagulation monitoring is not required, unlike warfarin. Conclusion: The authors concluded that the development of a hypercoagulable state leads to the occurrence of pulmonary embolism triggered by epithelial injury following a traumatic event. In the case of submissive pulmonary embolism, catheter-directed thrombolysis is considered useful when systemic thrombolysis poses a potential risk of hemorrhage.

Abstract Objective: Despite the literature on dydrogesterone, studies on dydrogesterone utilization patterns are largely lacking in Indian patients. Methods: This was a multi-center, retrospective, observational, cross-sectional, and descriptive study across 817 centers in India. Data of patients who received dydrogesterone in past and provided consent for future use of their medical record for research purpose was were retrieved and analyzed. Results: Data of 7287 subjects (aged 29.55±4.84 years) was analyzed. Threatened abortion was the most common indication for which the subjects received dydrogesterone (46.9%) followed by recurrent pregnancy loss. Polycystic ovary syndrome (PCOS), thyroid disorders and anemia were the most common comorbid conditions and prior pregnancy loss, advanced maternal age and obesity were the most common risk factors seen in subjects who received dydrogesterone. Total 27.5% of subjects received a loading dose of dydrogesterone, and majority (64%) received 40 mg as loading dose. 10 mg dose was used as maintenance or regular dose in 81.4% of the subjects. Twice daily (BID) was the most common dosing frequency (66.6%). The most common concomitant medications being taken by the subjects on dydrogesterone included folic acid (45.1%), iron supplements (30.3%) and calcium and vitamin D3 supplements (25.5%). Another progesterone preparation (oral, injection, vaginal, tubal) other than dydrogesterone was used concurrently in 7.8% of subjects. Conclusion: The study helped to identify the patient population that is benefitted by dydrogesterone and the preferred indications, risk factors, comorbid conditions and concomitant medication used in this patient population at real-life scenario.

We define and study a new parametrization of a Bertrand partner D-curve \{$\alpha$,$\alpha^{*}$\} in Euclidean 3-space by not taking Darboux frame element $g^{*}$ of Bertrand partner D-curve $\alpha^{*}$ parallel to $\overrightarrow{\alpha \alpha^{*}}$. We obtain a necessary and sufficient condition for a curve to be such type of Bertrand D-curves. Also, we obtain a characterization of a new parametrization of asymptotic Bertrand D-curves and provide an example.

This purpose of this paper is to introduce a new class of open sets namely semi-delta-open sets . Further, some basic topological concepts such as neighbourhood axioms, border point, exterior point, frontier point of a set are defined and their properties have been investigated. In addition, in terms of these open sets, semi-delta-closed functions and semi-delta-continuous functions are also defined and their properties have been discussed

Introduction: Sexually transmitted infections (STIs) present significant global and national health challenges, particularly in India. Objective: This study investigates the prevalence and characteristics of STIs among attendees at the Suraksha clinic in the Apex Regional STD Centre, Safdarjung Hospital. Methods: Retrospective data from January 2018 to December 2022 were statistically analyzed using Excel and SPSS. The study includes the examination for diagnosis of various STIs, such as syphilis, HIV, gonorrhea, chlamydiasis, trichomoniasis, candidiasis, bacterial vaginosis (BV), chancroid and genital herpes. . Gender distribution and syndromic diagnoses, including Vaginal/Cervical Discharge and Genital ulcers, were also considered. Referrals to Integrated Counseling and Testing Centres for HIV testing were analyzed. Results: The results reveal a substantial burden of STIs, with 3.06% showing reactivity to syphilis , 1.74% testing positive for HIV, 3.36% for Gonorrhoea, 11.78% for Chlamydiasis, 1.05% for Trichomoniasis, 26.24% for Candidiasis, 9.97% for Bacterial Vaginosis (BV), 7.80% for Chancroid, 11.64% for Herpes genitalis , and 4.01% for other non STI infections. Attendees' interactions included 34.36% of referrals to Integrated Counseling and Testing Centres for HIV testing. The gender distribution showed 58.92% male and 40.94% female attendees. Conclusion: Syndromic diagnoses, including Vaginal/Cervical Discharge (21.22%) and Genital Warts (8.00%), highlight prevalent conditions, necessitating routine screening, early detection, and targeted interventions for effective disease control and prevention. These findings underscore the significance of integrated screening, patient education, and proactive strategies to safeguard public health in the face of rising STI rates.

This report describes the status of childhood cancer control initiatives in Latin America and the Caribbean (LAC). Progress between 2017 and 2023 is measured using the outcome indicators from the Pan American Health Organization (PAHO) childhood cancer logic model aligned with the World Health Organization Global Initiative for Childhood Cancer (GICC). This report also describes the advances, barriers, and facilitators for the implementation of the GICC at the Regional level. Methods used in this report encompassed a comprehensive approach, incorporating a literature review, interviews, surveys, and a Delphi study developed by the technical team of the PAHO Non-Communicable Diseases and Mental Health Department and by the GICC LAC working group. Since 2017, there has been a substantial increase in the number of countries that have included childhood cancer in their national regulations. Currently, 21 LAC countries are involved in the GICC implementation, activities, and dialogues. However, the objectives for 2030 will only be achieved if Member States overcome the barriers to accelerating the pace of initiative implementation. There is an urgent need to increase the efforts in childhood cancer control in LAC, especially regarding the prioritization of timely detection, essential diagnostics, access to cancer treatment, palliative care, and close follow-up of children and adolescents with cancer.

This article explores the concept of Industrial Heritage and its relevance within the Indian context. Conservation in India has unique challenges arising out of the limited protection framework, the complexity of heritage resources and limited awareness and priority. The main issues confronting the preservation of Industrial Heritage sites in India are related to its lack of identification as a cultural resource and lack of awareness in local communities due to their perception and attitudes towards it. But the question has remained as to how to generate public opinion towards the need to preserve and promote our industrial heritage in a holistic manner, for its conservation as a cultural legacy and part of our identities in this globalizing world. This article explores the challenges in documenting, protecting, restoring, and managing Industrial Heritage sites in India, drawing upon personal experience of the last 27 years in attempting to conserve them.

ABSTRACT Objective: The present study was conducted to investigate the effects of leukocyte-platelet-rich fibrin (L-PRF) on the rate of maxillary canine retraction for a period of 5 months. Methods: A split-mouth study was conducted on 16 subjects (9 males and 7 females; age range 17-25 years; mean age, 21.85±2.45 years) who required therapeutic extraction of bilateral maxillary first premolars. After the initial leveling and alignment, L-PRF plugs were placed in a randomly selected extraction socket (Experimental Group), and the other side served as a control (Control Group). Canine retraction was carried out by the activation of nickel-titanium (NiTi) closed-coil springs delivering 150 g of force. The rates of canine movement, canine rotation, tipping, root resorption, and molar movement were assessed at monthly intervals for five months (T0-T5). Pain, swelling and discomfort accompanying the procedure were assessed using a Likert scale. Results: The study revealed a significant increase in the rate of canine movement on the experimental side in the first two months, and significant molar anchorage loss was observed only in the first month for control side. There were no statistically significant differences between the groups regarding canine rotation, tipping, probing depth, root resorption, and pain perception. Conclusions: The use of L-PRF plugs in extraction sockets considerably enhanced the rate of canine movement only in the first two months, and long-term efficacy was not observed in this study.

Objective: To compare and evaluate the clinical efficacy of diode laser and cryosurgery for treating melanin pigmentation of gingiva. Material and Methods: A total of twenty-five subjects with physiological gingival pigmentation on the facial aspect of both maxillary and mandibular anterior arches (50 sites), both male and female, with an average age ranging from 18-35 years, participated in the study. The sites were randomly divided into Group I: depigmentation by Laser and Group II: depigmentation by Cryosurgery. The following parameters were assessed for the evaluation of treatment results: Melanin Oral Pigmentation Index (PI), Visual Analogue Scale (VAS) for pain evaluation and Healing index (HI). The data collected was statistically evaluated. Results: On intergroup comparison, there was no statistical difference in the score from baseline (p>0.05); however, a statistically significant difference was seen at the end of 1 year (p

Objective: To identify the potential determinants of tobacco counseling implementation among oral health professionals in India. Material and Methods: A cross-sectional survey was carried out among the 298 dentists of Aligarh and Gwalior. The questionnaire used in the study had sections on dentists' sociodemographic data and a 35-item questionnaire to assess the potential determinants of tobacco cessation counseling. Descriptive statistics were carried out, and a Chi-square test was utilized to determine the association. P-value

The severe acute respiratory syndrome coronavirus 2 pandemic started in the December of 2019 at China. The second wave of the pandemic in India peaked between April-May 2021. In order to reduce the transmission and infectivity of the virus several vaccines were approved for emergent use. Studies have shown the effectiveness of vaccination in reducing the clinical severity of infection by the corona virus. In this study we aim to assess the effect of vaccination on the computed tomography severity score (CTSS). The study included 140 patients who tested positive for COVID 19 on RT PCR or rapid antigen test. Seventy of these patients had received at least one dose of vaccination and 70 patients were unvaccinated. CT scan of the chest was done for all patients and a CTSS ranging from 0 to 25 was assigned depending on the extent of lobar involvement. We found that a higher percentage (72.86%) of unvaccinated patients had severe disease compared to the vaccinated group (38.57%), 5.71% of unvaccinated patients had mild disease compared to 30% of vaccinated patients. The difference between the two groups was found to be statistically significant. On comparing the CTSS of patients with and without vaccination in our study, we found a significant reduction in the severity scores in the vaccinated group. Through this study the vaccine’s efficacy could be validated objectively. This article aims to emphasize the role of vaccination in our fight against the pandemic caused by the corona virus.

Abstract Objective To investigate the effects of combination therapy with cholecalciferol and lansoprazole on residual β-cell function and glycemic control in children with new-onset type 1 diabetes. Methods Children aged 6-12 years with type 1 diabetes were allocated to receive cholecalciferol and lansoprazole (Group 1) or no treatment (Group 2). Children were maintained on their respective insulin regimens and kept records of blood sugar and insulin doses taken. Children were followed at three-month intervals for six months. Changes in mean fasting C-peptide and HbA1c levels, daily insulin doses, fasting blood glucose and mean blood glucose levels from baseline to end of the study were analyzed. Results Twenty-eight children (14 per group) met the eligibility criteria. Fasting C-peptide levels decreased significantly from baseline to study end in both groups (mean decrease -0.19±0.09ng/mL and -0.28±0.08ng/mL, p=0.04 and p=0.001; Group 1 and Group 2 respectively). However, fasting C-peptide level drop was significantly smaller in Group 1 compared to Group 2 (30.6% and 47.5% respectively; p=0.001). Likewise, daily insulin doses decreased significantly in both groups (-0.59±0.14units/kg and -0.37±0.24units/kg respectively; p=0.001). All patients recruited completed the study. No adverse events were reported. Conclusion Combined therapy with cholecalciferol and lansoprazole for six months was associated with smaller decline in residual β-cell function and lower insulin requirements in children with new-onset type 1 diabetes. Preliminary findings of this small-scale study need to be confirmed by larger studies. Registry of Clinical Trials (www.ctri.nic.in) under number REF/2021/03/041415 N.

Abstract Introduction Varying public views on cannabis use across countries may explain the variation in the prevalence of use, policies, and research in individual countries, and global regulation of cannabis. This paper aims to describe the current state of cannabis use, policies, and research across sixteen countries. Methods PubMed and Google Scholar were searched for studies published from 2010 to 2020. Searches were conducted using the relevant country of interest as a search term (e.g., “Iran”), as well as relevant predefined keywords such as “cannabis,” “marijuana,” “hashish,” “bhang “dual diagnosis,” “use,” “addiction,” “prevalence,” “co-morbidity,” “substance use disorder,” “legalization” or “policy” (in English and non-English languages). These keywords were used in multiple combinations to create the search string for studies’ titles and abstracts. Official websites of respective governments and international organizations were also searched in English and non-English languages (using countries national languages) to identify the current state of cannabis use, policies, and research in each of those countries. Results The main findings were inconsistent and heterogeneous reporting of cannabis use, variation in policies (e.g., legalization), and variation in intervention strategies across the countries reviewed. European countries dominate the cannabis research output indexed on PubMed, in contrast to Asian countries (Thailand, Malaysia, India, Iran, and Nepal). Conclusions Although global cannabis regulation is ongoing, the existing heterogeneities across countries in terms of policies and epidemiology can increase the burden of cannabis use disorders disproportionately and unpredictably. There is an urgent need to develop global strategies to address these cross-country barriers to improve early detection, prevention, and interventions for cannabis use and related disorders.

The role of Fuzzy topology in logic programming and algorithm has been recognized and applied on various programs to and more accurate result. In particular, topological methods are employed in order to obtain fixed point semantics for logic programs. In this paper, we prove some fixed point theorems in fuzzy metric spaces. As an application, some consequence theorems are given in support of our result.

Traditional conflict resolution mechanisms can play a significant role in conflict management which has gained widespread acceptance among both the general public and the legal protection in recent years. Some courts now gain some parties to resort to traditional conflict resolution mechanisms. Before permitting the parties case to be tried expressly contemplate to called compulsory mediation, while the general objective of this study is to assess traditional conflict resolution mechanism and the specific objective include collecting the data. This study used interviews and personal observation; both qualitative and quantitative data have used. The finding of the study revealed that traditional conflict resolution mechanisms had gained widespread acceptance, because of its application and its benefits. TCRM is the most effective way of conflict resolution rather than constitutional litigation. Lastly, as a recommendation, TCRM should be encouraged because it has an economic and social benefit for the society and also others like political advantages. TCRM eliminates expenses among disputants from incurring prosecution cost, writing cost, transportation cost; it strengths the solidarity of the two disputants because both of them are winners in TCRM. To mean that they are not victims of expending much cost. Another aim of this study is to examine the conflicts in the world by using social network analysis method. In the study, the conflict data obtained from the GDELT data set between 1981-2020 were analyzed using the “igraph” package of the R software. As a result of the analysis, it was concluded that the two biggest actors in the conflicts in the world are the USA and Russia, respectively. From these results, it can be said that almost all of the conflicts in the world are related to these two countries. In the social network analysis for the discovery of the relationship between the conflicts in the world, in the criteria calculated to determine the position of Ethiopia, to explain its place among the countries and to make inferences about the whole network; The numerical data related to the centrality criteria of the Ethiopia network were found as Grade Center 1, Proximity Center (Normalized) 0.0217391 and Between Center 0.000000. Based on these data, it can be said that Ethiopia is not very connected (correlated) with other countries and is not an actor in the formation of conflicts in the world. Also, the results showed that the biggest actor in the cluster of 31 nodes is the USA. Again from this result, it is concluded that the biggest power in the world today is the USA.

The Poor People’s Campaign: A National Call for Moral Revival is a national campaign in the U.S. that has grown to more than 40 states across the country. Taking up the legacy of Rev. Dr. Martin Luther King, the Campaign is targeting the interrelated injustices of systemic racism, poverty, ecological devastation and militarism, and the distorted moral narrative that perpetuates them. It is redefining morality, religion and human rights through its fusion coalition model of organizing, and challenging the existence of poverty in the U.S. In June 2019, the Poor People’s Campaign released a Poor People’s Moral Budget: Everybody Has the Right to Live! The Moral Budget establishes that there is an abundance of resources to meet the needs and demands of the poor and, in fact, if the country allocated its resources towards meeting those needs, its economy would grow and its delicate social fabric would be renewed.

In this paper we present a new extension of tripled fixed point theorems in metric spaces endowed with a reflexive binary relation that is not necessarily neither transitive nor antisymmetric. The key feature in this tripled fixed point theorems is that the contractivity condition on the nonlinear map is only assumed to hold on elements that are comparable in the binary relation. Next on the basis of the tripled fixed point theorems, we prove the existence and uniqueness of positive definite solutions of a nonlinear matrix equation of type

This study aims to assess the relationship between entrepreneurial guidance and cost practices in hotels. The material to carry out descriptive and relational research with a quantitative approach was a self-administered questionnaire answered by hotel managers in 16 cities in the South region of Brazil. The data collected were analyzed using ANOVA and Spearman's correlation analysis. The results of this study showed that hotels that adopt the activity-based costing method and form the price considering market values ​​are the ones that have the highest entrepreneurial orientation, respectively. Among the practical implications, the results can assist in management decision-making. At the same time, when working with the formation of the daily rate, it is found that the hotels that carry out pricing based on market values ​​are the ones that have the best cost practices. The study has originality, as it demonstrates a conservative attitude in hotels regarding risk-taking.

Sociological transactions play an important role in human behaviour and social standing. The Titanic was the perfect example as the passengers belonged to high income, middleincome, and low-income groups. It is interesting to see how social factors influenced who was going to survive. The data was collected from the website “Kaggle.com”, and machine learning algorithms were applied after carrying out an exploratory and visual analysis. The hypothesis that women and children were saved (which became famous after Steven Spielberg’s Titanic (1975)) was tested by random forest algorithm as well as the hypothesis that family density played a major role in survival. The results showed that title and sex were the most important factors influencing if the passenger was to survive. RESUMEN Las transacciones sociológicas cumplen un papel importante en el comportamiento humano y la posición social. El Titanic era la paradoja perfecta ya que los pasajeros pertenecían a grupos de altos ingresos, de ingresos medios y de bajos ingresos. Es interesante ver cómo los patrones en el sentido sociológico decidieron cómo iba a sobrevivir. Los datos fueron recolectados del sitio web “Kaggle.com” y se aplicaron algoritmos de aprendizaje automático después de un análisis visual y exploratorio. La hipótesis, las mujeres y los niños se salvaron y se hicieron famosos después de que la película Titanic de Steven Spielberg (1975) se pusiera a prueba mediante un algoritmo forestal aleatorio junto con la hipótesis de que la densidad familiar desempeñaba un papel importante en la supervivencia. El resultado enumeró ese título y el sexo fue el factor más importante que decidió la tasa de supervivencia de los pasajeros.

In this paper, without assuming continuity, commutativity and compatibility of self maps, some common fixed theorem for weak contraction of integral type in complete metric spaces are proved. An example and some remarks are also given to justify that our contraction is new and weaker than other existing contractions.

In the present economic scenario, the pursuit of knowledge and curiosity to expand our horizon of information is breaking down fast the boundaries of our world. The science is somewhat fragmented, conferring supremacy on certain regions of the global world for this purpose. It is therefore understood that international cooperation becomes a critical element to give relevance to research and increase the chances of publishing in general. ...

In this paper, first we discuss the variants of the weakly commuting and compatible mappings in the context of coupled fixed point theory of fuzzy metric spaces. Secondly, we investigate the existence and uniqueness of the common fixed point for pairs of weakly compatible mappings satisfying a new contraction condition in the setup of fuzzy metric spaces with Had i type t-norm . Further, we talk about some results for the variants of weakly commuting and compatible mappings. At the end, as an application, we obtain metrical version of the discussed results.

O artista, ativista e escritor Sunil Gupta entrevista Stuart Hall em sua casa em 2001, quando Hall recebeu um diploma honorário da University of the West Indies. Stuart Hall discute a importância da fotografia - a fotografia britânica negra em particular - e seu interesse pelo visual.

OBJECTIVE: The aim of this cross sectional study was to assess serum insulin-like growth factor-1 (IGF-1) levels in female and male subjects at various cervical vertebral maturation (CVM) stages. MATERIAL AND METHODS: The study sample consisted of 60 subjects, 30 females and 30 males, in the age range of 8-23 years. For all subjects, serum IGF-1 level was estimated from blood samples by means of chemiluminescence immunoassay (CLIA). CVM was assessed on lateral cephalograms using the method described by Baccetti. Serum IGF-1 level and cervical staging data of 30 female subjects were included and taken from records of a previous study. Data were analyzed by Kruska-Wallis and Mann Whitney test. Bonferroni correction was carried out and alpha value was set at 0.003. RESULTS: Peak value of serum IGF-1 was observed in cervical stages CS3 in females and CS4 in males. Differences between males and females were observed in mean values of IGF-1 at stages CS3, 4 and 5. The highest mean IGF-1 levels in males was observed in CS4 followed by CS5 and third highest in CS3; whereas in females the highest mean IGF-1 levelswas observed in CS3 followed by CS4 and third highest in CS5. Trends of IGF-1 in relation to the cervical stages also differed between males and females. The greatest mean serum IGF-1 value for both sexes was comparable, for females (397 ng/ml) values were slightly higher than in males (394.8 ng/ml). CONCLUSIONS: Males and females showed differences in IGF-1 trends and levels at different cervical stages.

Do início até meados do século XX, os cruzeiros turísticos ao longo da costa sul-africana eram uma atividade de lazer popular, empreendida pelas elites (brancas) europeias (predominantemente os britânicos), americanas e sul-africanas, com paradas que incluíam diversas cidades portuárias do oceano Índico, como Cidade do Cabo e Durban, na África do Sul, e Lourenço Marques e Beira, no Moçambique português. Considerando as cidades portuárias anteriormente mencionadas como cidades-gêmeas em relação aos seus entrelaçados passados coloniais e turísticos e como funcionando dentro de um “corredor cultural” regional distinto (NUTALL, 2009) da África do Sul, este artigo explora uma série de portos de lazer interligados via cruzeiros de passageiros. A base da minha navegação histórica são os anuários de turismo produzidos pelas companhias de cruzeiro marítimo Union-Castle Line e serviço Round África em 1939 e 1949, respectivamente. A justificativa é que esses guias de viagem servem como entrada ao microcosmo cosmopolita de barcos de cruzeiro, o que os torna inestimáveis para entender a história do lazer (concomitantemente aos bens de consumo e publicidade relacionados) na África do Sul.

The main aim of this paper is to prove fixed point theorems via notion of pairwise semi-compatible mappings and occasionally weakly compatible mappings(owc) in fuzzy metric spaces satisfying contractive type condition.

The Riemann-Liouville and Erdélyi-Kober operators of fractional integrals and derivatives,those were generalized by Saigo, are invoked to the generalized Mittag-Lefflerfunction. Some apparent particular cases are mentioned

Cyathodium is a thalloid marchantialean liverwort with five species reported for the Neotropics. Three species that occur in Panama (C. bischlerianum, C. spruceanum, C. cavernarum) and one from Costa Rica (C. foetidissimum) were studied chemically. Female and male plants of the dioecious C. spruceanum were very similar in their chemical composition except for two compounds that were found only in female plants. All samples of C. spruceanum and C. bischlerianum contained, in less than three percent, the sesquiterpenes germacrene D and bicyclogermacrene. The presence of these compounds suggests a close affinity between these two species. Cyathodium bischlerianum contained mainly aromatic monoterpenes with nerolidol as the main compound. Cyathodium cavernarum also had a very distinct chemical composition with an octane derivative as its major compound. Indole compounds were found only in C. foetidissimum. The presence of these compounds in plants from Costa Rica and Tahiti suggests that they could be considered as potential chemosystematic markers for the species. Based on their chemical composition there is a clear distinction between the four species of Cyathodium studied. The chemistry of these species supports previous morphological and genetic studies. Only two compounds could be identified in Leiosporoceros dussii. There is a need for additional genetic and chemical studies on neotropical Cyathodium and Leiosporoceros. Key

The article explains why Brazil’s popular sectors made claims for health during the 1970s and why they did not do so during the 1990s. I argue that the intervention of “external actors”—better situated individuals and social groups—makes all the difference for popular mobilization. This is because they have the skills and resources to challenge dominant ideas, construct mobilization frames and inspire belief among the popular sectors that their actions can be successful. Health movements emerged in the mid-1970s with the intervention of doctors, medical students and the Catholic Church. During the 1990s, however, these external actors largely retreated from an activist role and took up more routine activities. Based on my research in Sapopemba (São Paulo), I argue that without the engagement of middle-class professionals and progressive Church officials, the popular sectors were caught in a “cognitive trap” so that they did not believe their actions would be successful.

Benign endobronchial tumors are uncommon. Bronchoscopic removal is the preferred modality of treatment although surgery may be required in some cases. Rigid bronchoscopy is usually recommended in the management of these tumors. However, flexible bronchoscopy is also used in many centers. We present a case of endobronchial lipoma, where an unusual complication during flexible bronchoscopic resection using snare forceps necessitated urgent rigid bronchoscopy. This case highlights the importance of rigid bronchoscopy in the management of endobronchial tumors. We believe that with a large benign endobronchial tumor in tracheal or main-stem bronchus, physicians should initially employ rigid bronchoscopy, switching to flexible if more peripheral treatment is required. Resumo: Os tumores endobrônquicos benignos são raros. A remoção broncoscópica é a modalidade de tratamento preferida, embora a cirurgia possa ser necessária em alguns casos. A broncoscopia rígida é geralmente considerada a modalidade preferencial na abordagem destes tumores. No entanto, a broncoscopia flexível também é utilizada em muitos centros. Apresentamos um caso de lipoma endobrônquico, onde uma complicação invulgar durante a ressecção broncoscópica flexível utilizando pinças de laço necessitou de uma urgente broncoscopia rígida. Neste caso, destaca-se a importância da broncoscopia rígida na abordagem dos tumores endobrônquicos. Acreditamos que com um tumor endobrônquico benigno de grandes dimensões da traqueia ou do brônquio principal, os médicos devem inicialmente utilizar a broncoscopia rígida, alternando para a flexível, se for necessário um tratamento mais periférico. Keywords: Bronchoscopy, Lipoma, Endobronchial tumor, Electrocautery, Interventional pulmonology, Palavras-chave: Broncoscopia, Lipoma, Tumor endobrônquico, Electrocautério, Pneumologia interventiva

In 1553, the corpse of Jesuit missionary Francisco Xavier was declared miraculously preserved and shipped to Goa. How did the idea of his material incorruptness (through signifiers of blood, smell, and skin) get sustained over the long durée of the Estado da Índia? This paper examines a series of medical examinations (1554, 1614, 1782, 1859, 1952) that were issued to sanction this saint’s public displays or Exposições as colonial officials eventually called them. That these autopsy reports discursively lie between Catholic hagiography and Western medicine makes them compelling for understanding the changing anatomy of church and state relations in Portuguese India.

Globally, nearly 20 million children under five suffer from Severe Acute Malnutrition (SAM), a condition which contributes to one million child deaths annually. In India 48% of children under five years of age are stunted and 43 percent are underweight; almost 8 million suffer from SAM. Malnutrition is not a new problem in India, nor is SAM. Several hospitals and non-government organizations are engaged in community-based management of malnutrition using locally produced/procured and locally processed foods along with intensive nutrition education. These programs enable parents to meet the nutritional requirements of their children with foods that are available at low cost. The Supreme Court of India has also directed the government to universalize the Integrated Child Development Scheme and provide one hot cooked meal to children under six years of age to supplement their nutrition. The blame for the increasing number of severely malnourish children can be laid at the door of policies that have destroyed poor people’s access to food. Nonetheless, there is urgent need to ensure that these children do not die; that they recover and maintain a healthy nutritional status. The current thinking – that a centrally produced and processed Ready-to-Use Therapeutic Food (RUTF) should supplant the locally prepared indigenous foods in treatment of SAM – ignores the multiple causes of malnutrition and destroys the diversity of potential solutions based on locally available foods. This position paper has been drafted by Dr. Vandana Prasad, Radha Holla and Dr. Arun Gupta, members of the Working Group for Children Under Six – a joint effort of Jan Swasthya Abhiyan (People’s Health Movement – India) and the Right to Food Campaign which been advocating for the last three years with the Indian government for decentralized and community-based strategies to combat and prevent malnutrition in children.

This article explores the way that “received ideas” about space and place have shaped, and continue to shape, the common sense of the anthropological task. Specifcally, we want to inquire how the renewed interest in postmodern and feminist theory about space theorization (revealed in notions such as vigilance, panopticism, simulacrum, deterritorialization, postmodern hyperspace, frontiers and marginality), has forced us to revaluate key anthropological analytical concepts such as “culture” and “cultural difference”.

Purpose: To evaluate if high resolution adaptive optics confocal scanning laser ophthalmoscopy (AO-SLO) can be used as an adjunct complementary diagnostic tool to spectral domain optical coherent tomography (SD-OCT) in characterizing three macular diseases: rod-cone dystrophy, acute retinal pigment epitheliitis (Krill’s disease), and occult macular dystrophy. Methods: As part of a complete clinical examination, each patient was subjected to color fundus pictures, multimodal imaging scans with Heidelberg SpectralisTM and high resolution retinal images with a custom built adaptive optics scanning laser ophthalmolscope (AO-SLO). The registered AO-SLO images were averaged to improve the signal to noise ratio and used to generate larger photoreceptor mosaics. Results: AO-SLO mosaics for all three conditions showed distinct, characteristic disruptions of the photoreceptors in areas that corresponded to the abnormalities observed on fundus photography and SD-OCT scans. Conclusions: AO-SLO defined fine structural changes associated with retinal pathology at the photoreceptor level that could not be achieved using standard diagnostic methods. A combination of adaptive optics scanning laser ophthalmoscopy (AO-SLO) and SD-OCT provided views of the retina with enhanced lateral and axial resolution. High-resolution, ultra-structural details of the retina may provide additional insights into the disease etiology, progression and management of patients with vision threatening macular diseases.

O autismo é um transtorno fortemente genético, com uma herdabilidade estimada de mais de 90%. Uma combinação de heterogeneidade fenotípica e o provável envolvimento de múltiplos loci que interagem entre si dificultam os esforços de descobertas de genes. Conseqüentemente, a etiologia genética dos transtornos relacionados ao autismo permanece, em grande parte, desconhecida. Nos últimos anos, a convergência entre tecnologias genômicas em rápido avanço, a finalização do projeto genoma humano e os crescentes e exitosos esforços em colaboração para aumentar o número de pacientes disponíveis para estudo conduziram às primeiras pistas sólidas sobre as origens biológicas desses transtornos. Este artigo revisará a literatura até nossos dias, resumindo os resultados de estudos de ligação genética, citogenéticos e de genes candidatos com um foco no progresso recente. Além disso, são consideradas as vias promissoras para pesquisas futuras.Autism is a strongly genetic disorder, with an estimated heritability of greater than 90%. A combination of phenotypic heterogeneity and the likely involvement of multiple interacting loci have hampered efforts at gene discovery. As a consequence, the genetic etiology of the spectrum of autism related disorders remains largely unknown. Over the past several years, the convergence of rapidly advancing genomic technologies, the completion of the human genome project, and increasingly successful collaborative efforts to increase the number of patients available for study have led to the first solid clues to the biological origins of these disorders. This paper will review the literature to date summarizing the results of linkage, cytogenetic, and candidate gene studies with a focus on recent progress. In addition, promising avenues for future research are considered.

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Abstract Fracture acetabulum is a grave injury and a challenge for orthopedic surgeons. Anterior and posterior approaches have been described for fixation of acetabulum fractures. The modified Stoppa approach is considered an alternate to anterior approach, which provides access to pelvis from inside the cavity. The purpose of this article is to review the available literature on use of the modified Stoppa approach in acetabulum fractures. The available data suggest that modified Stoppa approach is useful in anterior acetabulum fractures and some posterior acetabulum fractures, especially where buttressing of medial wall is required.

Abstract Background: Efficacy of preoxygenation depends upon inspired oxygen concentration, its flow rate, breathing system configuration and patient characteristics. We hypothesized that in actual clinical scenario, where breathing circuit is not primed with 100% oxygen, patients may need more time to achieve EtO2 ≥ 90%, and this duration may be different among various breathing systems. We thus studied the efficacy of preoxygenation using unprimed Mapleson A, Bain's and Circle system with tidal volume breathing at oxygen flow rates of 5 L.min−1 and 10 L.min−1. Methods: Patients were randomly allocated into one of the six groups, wherein they were preoxygenated using either Mapleson A, Bain's or Circle system at O2 flow rate of either 5 L.min−1 or 10 L.min−1. The primary outcome measure of our study was the time taken to achieve EtO2 ≥ 90% at 5 and 10 L.min−1 flow rates. Results: At oxygen flow rate of 5 L.min−1, time to reach EtO2 ≥ 90% was significantly longer with Bain's system (3.7 ± 0.67 min) than Mapleson A and Circle system (2.9 ± 0.6, 3.3 ± 0.97 min, respectively). However at oxygen flow rate of 10 L.min−1 this time was significantly shorter and comparable among all the three breathing systems (2.33 ± 0.38 min with Mapleson, 2.59 ± 0.50 min with Bain's and 2.60 ± 0.47 min with Circle system). Conclusions: With spontaneous normal tidal volume breathing at oxygen flow rate of 5 L.min−1, Mapleson A can optimally preoxygenate patients within 3 min while Bain's and Circle system require more time. However at O2 flow rate of 10 L.min−1 all the three breathing systems are capable of optimally preoxygenating the patients in less than 3 min.

Resumo Justificativa A eficácia da pré‐oxigenação depende da concentração inspirada de oxigênio, do fluxo de gases, da configuração do circuito respiratório e das características do paciente. Nossa hipótese foi que, no cenário clínico real, no qual o circuito respiratório não é preparado com 100% de oxigênio, os pacientes podem precisar de mais tempo para atingir EtO 2 ≥ 90% e essa duração pode ser diferente entre vários circuitos de respiração. Avaliamos, portanto, a eficácia da pré‐oxigenação com o uso dos circuitos não preparados Mapleson A, Bain e Circular com volume corrente de respiração com um fluxo de oxigênio de 5 L.min −1 e 10 L.min −1 . Métodos Os pacientes foram alocados aleatoriamente em um dos seis grupos, nos quais foram pré‐oxigenados com o uso do circuito Mapleson A, Bain ou Circular com um fluxo de O 2 de 5 L.min −1 ou 10 L.min −1 . O desfecho primário de nosso estudo foi o tempo necessário para atingir EtO 2 ≥ 90% com um fluxo de 5 e 10 L.min −1 . Resultados Com um fluxo de oxigênio de 5 L.min −1 , o tempo para atingir EtO 2 ≥ 90% foi significativamente maior com o circuito Bain (3,7 ± 0,67 min) do que com os circuitos Mapleson A e Circular (2,9 ± 0,6 e 3,3 ± 0,97 min, respectivamente). No entanto, com o fluxo de oxigênio de 10 L.min −1 foi significativamente menor e comparável entre os três circuitos respiratórios (2,33 ± 0,38 min com Mapleson; 2,59 ± 0,50 min com Bain e 2,60 ± 0,47 min com o Circular). Conclusões Durante respiração espontânea com volume corrente normal e com um fluxo de oxigênio de 5 L.min −1 , o sistema Mapleson A pode pré‐oxigenar o paciente de forma ideal dentro de três minutos, enquanto os sistemas Bain e Circular requerem mais tempo. Porém, com um fluxo de O 2 de 10 L.min −1 , todos os três circuitos respiratórios podem pré‐oxigenar o paciente de forma ideal em menos de três minutos. Background Efficacy of preoxygenation depends upon inspired oxygen concentration, its flow rate, breathing system configuration and patient characteristics. We hypothesized that in actual clinical scenario, where breathing circuit is not primed with 100% oxygen, patients may need more time to achieve EtO 2 ≥ 90%, and this duration may be different among various breathing systems. We thus studied the efficacy of preoxygenation using unprimed Mapleson A, Bain's and Circle system with tidal volume breathing at oxygen flow rates of 5 L.min −1 and 10 L.min −1 . Methods Patients were randomly allocated into one of the six groups, wherein they were preoxygenated using either Mapleson A, Bain's or Circle system at O 2 flow rate of either 5 L.min −1 or 10 L.min −1 . The primary outcome measure of our study was the time taken to achieve EtO 2 ≥ 90% at 5 and 10 L.min −1 flow rates. Results At oxygen flow rate of 5 L.min −1 , time to reach EtO 2 ≥ 90% was significantly longer with Bain's system (3.7 ± 0.67 min) than Mapleson A and Circle system (2.9 ± 0.6, 3.3 ± 0.97 min, respectively). However at oxygen flow rate of 10 L.min −1 this time was significantly shorter and comparable among all the three breathing systems (2.33 ± 0.38 min with Mapleson, 2.59 ± 0.50 min with Bain's and 2.60 ± 0.47 min with Circle system). Conclusions With spontaneous normal tidal volume breathing at oxygen flow rate of 5 L.min −1 , Mapleson A can optimally preoxygenate patients within 3 min while Bain's and Circle system require more time. However at O 2 flow rate of 10 L.min −1 all the three breathing systems are capable of optimally preoxygenating the patients in less than 3 min. [ABSTRACT FROM AUTHOR]

The diabetic status of the local Jhansi patients (120 cases) was established before and after antileprosy treatment. Control studies were performed in normal healthy subjects (50 persons) without family history of diabetes mellitus. Random normals showed an incidence of diabetes only 2%, while leprosy patients (94 males and 26 females) had incidence of diabetic status of 14.2%. The highest incidence (19.3 %) of diabetes was in lepromatous leprosy and lowest incidence (6.4%) in tuberculoid leprosy patients. Repeated studies in leprosy after treatment showed not only clinical improvement for leprosy but also disappearance of the chemical and latent diabetes mellitus and lowering of blood sugar levels in manifest diabetes mellitus. Incidently it was noted that `diabetic status' was worse among males (82.3%) and with advancing age. Association and improvement of diabetic status with specific treatment would tentatively suggest that Mycobacterium leprae lesions are not confined to skin alone but somehow also related to carbohydrate metabolism. A careful management of the chemical and latent diabetes may help in clinical management of leprosy too.

A middle aged man (48 years) with short duration of illness (7 days) was admitted in the state of acute renal failure with erythema nodosum leprosum. He had repeated episodes of erythema nodosum leprosum in the past. His blood pressure was normal (150/80 mm Hg). During his hospital stay he was in the state of progressive anaemia (Hb = 8.8 g/dl to 7.2 g/dl), oliguria (urine out-put = 250-350 ml/day), azotaemia (blood urea = 198 mg/d1 to 218 mg/dl) and impaired renal function tests with fatal outcome. Kidneys were smooth, congested and weighing 150 g each with histological features of rapidly progressive (crescentric) glomerulonephritis, a result of immune complex deposition from recurrent erythema nodosum leprosum episodes.

Sixty male patients of leprosy (mean age = 27.2+5.04 years) selected at random, were studied for gonadal involvement and therapeutic efficacy of two indigenous drugs. Of these 34 were married, with the mean duration of illness 4.17+3.27 years. Only those with lepromatous and dimorphous leprosy developed testicular and epididymal changes. Testicular pain and/or swelling (lepromatous =62.5%, dimorphous 30%) was the commonest presenting feature. Altered sexual function was observed in 34 (56.6%) cases, while 11 patients revealed altered sexual hair pattern and nine gynaeco-mastia. Reduced testicular size associated with soft feel was present in 25% of cases with no testicular sensation in 8 (13.3%) and impaired testicular sensation in 9 (15%) patients. Spermogram revealed azoospermia in 19 (35%) and oligospermia in 16 (26.6%) patients. Histopathological findings of testicle biopsy revealed evidence of leprous pathology irrespective of testicular size, semen picture and clinical manifestations. Histopatho-logical changes had shown marked variation and so did not enable categorising them into vascular, interstitial and obliterative phases. These changes were believed to be due to the altered gonadal state in leprosy. The therapeutic efficacy of the indigenous preparations, Speman and Tentex forte (Himalaya) was evaluated subjectively as well as objectively in 34 patients. 823% of cases showed subjective improvement while objective improvement in spermogram was noted in 87.5% cases with oligospermia. The drugs have no side effect and were well tolerated.