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The present study evaluated the effects of omega-3 (ω-3) fatty acid-rich linseed supplementation on the reproductive performance, endocrine profile, and biochemical profile of ewes reared in subtropical climates. Forty-eight acyclic and clinically healthy Marwari sheep, aged 1.5–2.5 years with no parity, were divided into four groups (n = n = 12 in each). Ewes in the control group (group I) were fed only a basal feed, whereas ewes in the treatment groups II, III, and IV were fed the basal diet along with 10%, 15%, and 20% linseed, respectively, daily on a dry matter basis. The experiment was conducted during the typical breeding season (October–November) of the sheep. The estrus induction rate was significantly higher (p < 0.05) in all treatment groups than in the control group. The estrus induction interval was significantly lower (p < 0.05) in group III. The conception rate in group I was significantly lower (p < 0.05). In addition, ewes in the control group had a significantly lower (p < 0.05) lambing rate than all treatment groups. Serum progesterone concentrations differed significantly (p < 0.05) between the control and the treatment groups on days 15, 30, 45, and 60 of supplementation. On treatment days 15 and 30, the serum estrogen concentrations were significantly higher (p < 0.05) in all treatment groups compared to that in group I. In all treatment groups, monounsaturated fatty acid (MUFA) decreased significantly (p < 0.05), whereas polyunsaturated fatty acid (PUFA) increased significantly (p < 0.05) from day 15 onward. In conclusion, by providing 15% dietary linseed supplementation to ewes, their reproductive performance can be improved in subtropical climates. Future studies are recommended to further elucidate the role of linseed supplementation in sheep reproduction in subtropical climates.

Panchgavya represents milk, urine, dung, ghee, and curd, derived from cow and serves irreplaceable medicinal importance in Ayurveda and traditional Indian clinical practices. In Ayurveda, Panchgavya treatment is termed as ‘Cowpathy’. In India, the cow is worshipped as a god called ‘Gaumata,’ indicating its nourishing nature like a mother. Ayurveda recommends Panchagavya to treat diseases of multiple systems, including severe conditions, with almost no side-effects. It can help build a healthy population, alternative sources of energy, complete nutritional requirements, eradicate poverty, pollution-free environment, organic farming, etc. Panchgavya can also give back to mother nature by promoting soil fertility, earthworm production, protecting crops from bacterial and fungal infections, etc. Scientific efforts shall be taken to build evidence for the clinical application of Cowpathy. The present review aims to summarize the health and medicinal benefits of Panchgavya.

Peak ground acceleration (PGA) and study area (SA) distribution for the Patna district are presented considering both the classical and zoneless approaches through a logic tree framework to capture the epistemic uncertainty. Seismicity parameters are calculated by considering completed and mixed earthquake data. Maximum magnitude is calculated using three methods, namely the incremental method, Kijko method, and regional rupture characteristics approach. The best suitable ground motion prediction equations (GMPEs) are selected by carrying out an “efficacy test” using log likelihood. Uniform hazard response spectra have been compared with Indian standard BIS 1893. PGA varies from 0.38 to 0.30 g from the southern to northern periphery considering 2 % probability of exceedance in 50 years.

oronavirus (COVID-19) has caused marked impact on graduate medical education for all medical specialties. Radiation Oncology and the American Board of Radiology have also had to rapidly adapt to converting education and examinations to virtual platforms. We describe our small pilot experience in transitioning our in-person mock oral examinations to a virtual platform. Survey-based assessment revealed excellent feedback regarding ease of use and educational usefulness. Our mock oral examinations pilot experience adds to evidence that virtual mock oral examinations are an important considerationfor Radiation Oncology education and a feasible alternative to an in-person oral examination.

Introduction: Cigarette smoking is the most predominant risk factor for development of chronic obstructive pulmonary disease (COPD). However, a considerable amount of patients do develop COPD without exposure to cigarette smoking. We aimed to analyze the incidence, demographic and clinical profile of nonsmoker COPD subjects at a tertiary care center. Methods: In this prospective observational study, 410 patients were screened for dyspnea. On the basis of spirometry findings, 360 patients were diagnosed as COPD and enrolled into the study. Patients were categorized into 2 groups on the basis of smoking habits (smoker and nonsmoker COPD). Clinical and demographic attributes were compared in between these two groups. This study was conducted over a period of one year, from August 2014 to July 2015. All statistical analyses were performed using Statistical Package for the Social Sciences version 19.0 (SPSS Inc, Chicago, IL, USA). Values were considered to be statistically significant at P < 0.05. Results: Out of 360 COPD cases, about 2/3rd (60%) were smokers and the rest nonsmokers. Majority of the patients were in the age group of 51-70 years. The mean age of smokers with COPD was significantly higher than nonsmokers with COPD (59.29 ± 10.28 years vs. 53.90 ± 8.77 years; P = 0.0001). Overall, males were predominant (57.2%) but there were higher number of female patients in nonsmoker group (25% vs. 70%; P = 0.001). At presentation, majority of nonsmoker with COPD were in GOLD severity grade II while in the smoking cohort majority were in GOLD severity Grade III. Among the 144 nonsmoker COPD patients, the most important and statistically significant risk factor was exposure to biomass smoke (68.06%). Other risk factors were long-standing asthma (37.50%), lower respiratory tract infection in childhood (32.60%), exposure to outdoor air pollution (17.92%). Conclusion: Nonsmoker COPD is emerging as a distinctive phenotype. They have less impairment in airflow limitation, and a lower prevalence of emphysema, chronic cough, and sputum compared with their smoking counterparts.

Objectives To determine the risk of obstructive sleep apnea (OSA) for male permanent driving license (DL) applicants of Lucknow, India. Material and Methods In this cross-sectional community based, study body mass index, waist–hip ratio, blood pressure of each subject were determined as an anthropometric parameter along with the history of habit of smoking, tobacco chewing, alcohol consumption. STOP-Bang (Snoring, Tired or sleepy, Observed apnea, high blood Pressure, Body mass index, Age, Neck, Gender) Questionnaire – a scoring risk assessment tool – was applied for assessment of OSA risk (high OSA risk defined by score ≥ 3) for 542 male DL recipients at 2 Regional Transport Office (RTO) centers in Lucknow, India. The statistical software SPSS 17.0 was applied to the testing. Results In total 23% (N = 125) of participants were found with the risk of OSA. High blood pressure (≥ 140/90 mm Hg) was found for the maximum number of participants (40.5%) followed by neck circumference > 40 cm (17.1%), age (> 50 years old) (15.3%), snoring (12.3%) and tired/sleepy (10.5%). Mean values of age, anthropometric measurements and blood pressure were observed significantly higher (p < 0.001) for participants with the OSA risk. In this population the risk of OSA risk (STOP-Bang score ≥ 3) was observed for 6.7% of young ( 45 years old). Conclusions In view of findings of this study a high number of male driving license applicants were observed with the risk of OSA. Therefore efforts should be made to develop a national screening guideline/protocol for the OSA risk assessment for driving license applicants in India. This may reduce the possibility of road traffic accidents due to the OSA-associated fatigue and drowsiness behind the wheels. Int J Occup Med Environ Health 2018;31(1):25–36

Secretory carcinoma (juvenile carcinoma) is one of the very rare breast malignancy reported to be prevalent in pediatric age group. We report imaging and clinicopathological features of secretory carcinoma breast with distant and axillary metastasis, in an 11-year-old girl, who presented with a painful lump in right breast. Ultrasound revealed a well-defined, partially microlobulated hypoechoic mass with skin and pectoralis muscle involvement and a suspicious morphology right axillary lymph node. Color Doppler revealed increased vascularity in both the breast mass and suspicious axillary node. Magnetic resonance imaging helped in better evaluation of pectoralis muscle involvement. Computed tomography (CT) neck, chest, and abdomen revealed multiple fibronodular opacities in bilateral lung fields. 18 Flouro-Deoxy-Glucose Positron Emission Tomography (FDG PET-CT) showed a hypermetabolic retroareolar breast mass with multiple hypermetabolic bilateral lung nodules suggesting lung metastasis. The histopathology confirmed the diagnosis of secretory carcinoma. The patient was offered chemotherapy for 2 years and put on follow-up since then.

Atopic dermatitis (AD) coexisting with allergic contact dermatitis (ACD) is not uncommon. There has been lot of controversies regarding this concept as the prevalence of ACD in AD is similar to that seen in nonatopics. There is increased susceptibility to ACD in AD as AD modulates the exposure to allergens. There is an impaired barrier function that predisposes to the development of ACD in AD. Patch testing is a standard test for detecting allergens in AD.

Malformations involving the brainstem are very rare and present with a varied spectrum of clinical symptoms due to multiple cranial nerve palsies and pyramidal tract involvement. Of these, pontine tegmental cap dysplasia is a very unusual malformation, characterized by ventral pons hypoplasia and an ectopic dorsal band of tissue, projecting into the fourth ventricle, from dorsal pontine tegmentum. A 4-year-old male child, presenting with left facial nerve palsy, revealed hypoplastic ventral pons and an ectopic structure on magnetic resonance imaging (MRI). The ectopic structure was isointense to pons, arose from the left side of dorsal pontine tegmentum, at pontomedullary junction and protruded into the fourth ventricle, impinging upon the left seventh and eighth cranial nerves. Diffusion tensor imaging (DTI) depicted abnormal white matter tracts in ectopic tissue with absent transverse pontine fibres and abnormal middle and superior cerebellar peduncles. The typical MRI appearance, coupled with DTI, helped us reach an accurate diagnosis of pontine tegmental cap dysplasia, in a setting of neurological dysfunction.

Sarcoidosis and tuberculosis are both granulomatous diseases that may involve multiple systems but predominantly involve the lungs. Although both these diseases have different etiological factors and line of management, the clinical and histological characteristics are often similar. Owing to this, it can be difficult to make the distinction between the two, as occasionally they may coexist. Here, we present a case of a 21-year-old male patient who was initially diagnosed with pulmonary tuberculosis, but as symptoms increased, further evaluation revealed sarcoidosis. Diagnosis was supported by Gene Xpert, high-resolution computed tomography of the chest, and serum angiotensin-converting enzyme. The patient responded to antitubercular therapy and oral steroids.

Pulmonary mucoepidermoid carcinoma (MEC) is an uncommon tumor constituting only 0.1% to 0.2% of all lung carcinoma. It is classified under “salivary gland type” tumors in the World Health Organization (WHO) classification of lung cancers. It generally carries a better prognosis than the more common small cell and nonsmall cell lung carcinomas. It is pathologically classified into high-grade and low-grade tumors. High-grade tumors are usually unresectable at presentation. However, surgery is the mainstay of treatment, which aims at surgically negative margins for a complete cure. In our patient, pulmonary MEC presented with intrathoracic mass with pericardial effusion. It came out to be low-grade neoplasm, which was treated with platinum-based doublet chemotherapy and responded well with near-total disappearance of tumor, like a vanishing lung tumor.

BackgroundChronic Obstructive Pulmonary Disease (COPD) is associated with an increased risk of myocardial infarction and stroke but it remains unclear how to identify microvascular changes in this population.ObjectivesWe hypothesized that simple non-mydriatic retinal photography is feasible and can be used to assess microvascular damage in COPD.MethodsNovel Vascular Manifestations of COPD was a prospective study comparing smokers with and without COPD, matched for age. Non-mydriatic, retinal fundus photographs were assessed using semi-automated software.ResultsRetinal images from 24 COPD and 22 control participants were compared. Cases were of similar age to controls (65.2 vs. 63.1 years, p = 0.38), had significantly lower Forced Expiratory Volume in one second (FEV1) (53.4 vs 100.1% predicted; p < 0.001) and smoked more than controls (41.7 vs. 29.6 pack years; p = 0.04). COPD participants had wider mean arteriolar (155.6 ±15 uM vs. controls [142.2 ± 12 uM]; p = 0.002) and venular diameters (216.8 ±20.7 uM vs. [201.3± 19.1 uM]; p = 0.012). Differences in retinal vessel caliber were independent of confounders, odds ratios (OR) = 1.08 (95% confidence intervals [CI] = 1.02, 1.13; p = 0.007) and OR = 1.05 (CI = 1.01, 1.09; p = 0.011) per uM increase in arteriolar and venular diameter respectively. FEV1 remained significantly associated with retinal vessel dilatation r = -0.39 (p = 0.02).ConclusionsNon-mydriatic retinal imaging is easily facilitated. We found significant arteriole and venous dilation in COPD compared to age-matched smokers without COPD associated with lung function independent of standard cardiovascular risk factors. Retinal microvascular changes are known to be strongly associated with future vascular events and retinal photography offers potential to identify this risk.Trial registrationclinicaltrials.gov NCT02060292.

Objective: Tobacco is the legally and commonly available substance that will kill almost 30-50% of its users so curtailing its use can significantly reduce the global mortality and morbidity.Objective of this study was to record the tobacco quit rates in apparently healthy individuals.Abstinence up to the time of 6 months of follow up was set as the primary outcome measure Methods: Single center study was undertaken in 524 subjects over a period of 18 months at King George's Medical University,Lucknow,India. Apparently healthy attendants accompanying patients attending the departmentof Respiratory Medicine were the subjects for the study.Along with intensive counselling,demonstration videos and live interaction of patients were taken help of in the study. Results: Smokeless tobacco use was seen in 326(62%) subjects,remaining 198(38%) were smokers.85% of subjects were males.18.7% quit rate was eventually recorded at the end of study. Conclusion:Around 60% of its consumers want to quit but roughly only about 10% succeed.We observed better quit rates(18.7%) in our study,rigorous follow ups coupled with specialist behavioral were the key elements of the study. Implementation of strict policies for use of tobacco is the need of the hour.

Haemangioma is the most common benign tumour of the liver. However, an exophytic hepatic haemangioma, especially the pedunculated form, is very rare. Giant pedunculated haemangiomas are prone to complications because of the narrow size of the pedicle. A large number of lesions can potentially present as exophytic liver masses, and accurate diagnosis can sometimes be challenging. We report a case of an incidentally discovered asymptomatic giant pedunculated liver haemangioma in the region of the lesser sac in a prospective renal donor, which was initially suspected to be a gastrointestinal stromal tumour of the stomach wall. Multiphasic computed tomography and confirmatory magnetic resonance imaging scans ultimately revealed the true nature of the lesion, which turned out to be an exophytic pedunculated hepatic haemangioma from the left lobe of the liver. The lesion was then surgically resected and histopathologically confirmed to be a haemangioma. The patient subsequently underwent successful renal donation as planned. Being a benign lesion with characteristic imaging features, accurate radiological diagnosis is absolutely essential for the appropriate management of such atypical haemangiomas.

Background: Oxidant-antioxidant imbalance forms a prime component in pathogenesis of chronic obstructive pulmonary disease (COPD). Studies of oxidative stress markers in South Asians were sparse. Methods: One hundred and eighty COPD patients and eighty healthy nonsmokers were enrolled in the study. Serum malondialdehyde (MDA) and iron levels were estimated for oxidative stress. Three antioxidant markers evaluated-catalase, superoxide dismutase (SOD), and serum copper. Patients on antioxidant therapy and with sepsis and chronic illness were excluded from the study. Results: The mean age of COPD patients was 59.29 ± 10.3 years. Serum levels of MDA and iron were significantly higher in COPD patients compared to controls (5.21 ± 1.9 vs. 0.71 ± 0.29 nmol MDA/ml, P = 0.0001 and 69.85 ± 85.49 vs. 79.32 ± 24.39 μg/dl, P = 0.0001, respectively). Mean level of all antioxidant enzymes catalase, SOD, and copper were significantly diminished in cases when compared to control population (P = 0.001). Levels of MDA and iron were found to be significantly elevated in higher Global Initiative for Chronic Obstructive Lung Disease (GOLD) classes (III, IV) when compared to lower GOLD Classes (I, II). The levels of serum antioxidants were significantly depleted in higher GOLD grades too. COPD patients who were male and smoked had significantly higher levels of oxidants and depleted antioxidant levels compared to female and nonsmoking compatriots. Serum MDA levels negatively correlated with forced expiratory volume 1 s and forced vital capacity (r = −0.19 and r = −0.21, P ≤ 0.01). The presence of a cough significantly correlated with higher levels of MDA and iron (P = 0.001). The levels of MDA negatively correlated with SOD and catalase levels. Conclusion: Oxidative markers (MDA and iron) are higher whereas antioxidants (catalase, copper, and SOD) are significantly reduced in patients of COPD. Serum MDA levels correlate with lung functions and disease severity.

An 8-year-old girl presented with a scalp swelling. The swelling was recurrent, reappearing everytime after local excision. She underwent surgery and the histopathologic diagnosis was malignant hidradenoma. This very rare and aggressive tumor is known to occur in elderly population and is histopathologically distinct from its commonly occuring benign counterpart. Malignant hidradenoma is resistant to chemotherapy and radiotherapy. We empahsize that being cognizant of the possibility of this rare tumor would assist in timely action in the form of wide resection, with possible reduction in morbidity and mortality.

Introduction : The decreased level of immunity in Human Immunodeficiency Virus (HIV) infected patients increases their vulnerability to various opportunistic fungal infections. Oral candidiasis has been found to be the most common fungal infection among HIV infected patients. The present study was conducted to evaluate the spectrum of various opportunistic fungal infections and their correlation with CD4+ counts. Methods: A total of 163 clinically suspected cases of fungal infections with HIV seropositive status were studied. Results: The most common infections observed were oropharyngeal candidiasis (39.26%) followed by cryptococcal meningitis (6.74%). The study showed opportunistic fungal infections in 46.6% of HIV infected patients with CD4+ counts ≤200 cell/ µl. Conclusion: Early diagnosis and prompt antifungal treatment is necessary to decrease the morbidity and mortality associated with the infections to increase the survival of HIV infected patients. J Med Microbiol Infec Dis, 2014, 1 (2): 4 pages.

Background:Though congenital rib anomalies are reported to be of rare occurrence, these are now and then encountered as an incidental finding in chest X-rays, however in most of these cases patients are having other health issues rather than things directly related to the rib anomalies. Aims: The aims of the study were to observe the detection rate of various kinds of rib anomalies, their association with gender, body side, other thoracic bony anomalies and associated symptoms. Material and methods:5,000 plain chest skiagrams were studied including 2,628 males and 2,372 females from September 2013 to September 2015. Results:Out of 5,000 total patients 82 patients (1.64%) were found with cervical rib, 22 patients out of 82 were having bilateral cervical rib(0.44%), bifid ribs were found in 59 patients(1.18%) out of which 3 patients (0.06%)were having both the anomalies, only one patient was seen with fused rib(0.02%),one with two ribs having less space in between(0.02%) and one patient was having rib with spur(0.02%). The occurrence (detection rate) of cervical rib on either side as well as bilaterally was higher in males. Bifid rib detection rate was higher on the right side in males and on left side in females.None of these patients were having any symptom related to their rib anomalies. Conclusion: there was a little higher detection rate seen regarding the presence of cervical rib in north Indian population however it was observed that the symptoms reported in literature in relation to the rib anomalies seemed to be overreported.

We present here a case of an uncommon complex uterine anomaly - Obstructed HemiVagina with Ipsilateral Renal Agenesis (OHVIRA), also known as Herlyn-Werner-Wunderlich syndrome in a 14-year-old girl along with sonographic (trans-abdominal and trans labial), and MRI findings. The patient underwent surgery wherein imaging findings were confirmed. An MRI has proved to be of great help in correct diagnosis avoiding surgical interventions/ laparoscopy, which were needed in past to diagnose this rare anomaly. We also discuss the development of this anomaly with the help of a relatively new theory of uro-genital development by Acien and review the literature.

Highly alkalitolerant and moderately thermotolerant Bacillus sp. NZ, isolated from degrading lignocellulose, produced a novel highly thermotolerant and alkalitolerant endoglucanase. Maximum activity of endoglucanase was observed in the medium with the initial pH=9 (920 U/L) after 72 h of fermentation with shaking (250 rpm) at 45 °C. Growth of the organism and enzyme production displayed a precise relationship, showing maxima after 72–96 h of fermentation; however, the organism formed maximum biomass at pH=8, but produced the highest enzyme titre at pH=9. Among the examined crude substrates, wheat bran gave maximum activity of endoglucanase (1960–2280 U/L), and was followed by wheat straw (1480–1760 U/L), filter paper (1360–1450 U/L) and sawdust (1160 U/L). Soybean meal served as a suitable nitrogen source for good production of endoglucanase. The enzyme showed activity over a broad pH range (5–10), with maximum at pH=9–10 (2240–2290 U/L). Endoglucanase was highly active (2210–2300 U/L) over a broad range of temperature (50–100 °C), with maximum activity at 50 °C (2290 U/L) and at 90 °C (2300 U/L). Significantly high activity was observed even at 100 °C (91.3 %). The enzyme was highly stable at temperatures from 60 to 90 °C for a period of 30 min. Endoglucanase was purified 23-fold using ammonium sulphate precipitation. Substantial activity and stability of endoglucanase at elevated temperatures and at pH extremes indicate a potential for its successful application in industries.

About 300 million people across the world suffer from thyroid gland dysfunction. Environmental factors play an important role in causation of autoimmune thyroid diseases in susceptible individuals. Genetics contributes to 70% of the risk. In order to reduce the risk, we need to understand the association of environmental agents with thyroid dysfunction. These factors are especially relevant for those at increased risk due to positive family history. The ideal study to see the impact of a thyroid toxicant consists of directly measuring the degree of exposure to toxicant in an individual with his thyroid status. Knowledge of various factors influencing thyroid dysfunction can help in interpreting the results of such studies in a better way. This article is an attempt to highlight the various possible toxicants affecting thyroid function so that adequate measures can be undertaken to control excessive exposure in future to reduce the prevalence of thyroid disorders.

A renal tumor in a 14-month- old child, who was initially diagnosed as mesoblastic nephroma, but on review post surgery was diagnosed as hyper-differentiated metanephric stromal tumor, with its excellent prognostic outcome. An attempt is made to document imaging features that may enable one to suspect this rare condition. The literature is reviewed with emphasis on its distinction from its look-alikes in the pediatric age group.