Search

Byline: Prashant. Nasa, Deven. Juneja, Ravi. Jain, Sandeep. Golchha Introduction Paroxysmal bundle branch block (BBB) is a transient intraventricular conduction defect that terminates spontaneously or with an intervention. In contrast, [...]

Synechiae are intracavitary adhesions rarely reported in the urological literature. To date, very few cases of ureteral and vesical synerchiag (after urological surgery) have been reported. We report a rare case of prostatic urethral and vesical synechiae secondary to recurrent urinary tract infection (UTI). This was incidentally diagnosed on cystoscopy. A patient with known case of diabetes mellitus and ischemic heart disease presented with storage and voiding lower urinary tract symptoms. He had left epididymoorchitis and recurrent UTI. Investigations showed a left solitary functioning kidney with hydronephrosis and small capacity bladder. He had leucocytosis, raised serum creatinine, and positive urine culture. Under antibiotic cover, he was planned for cytoscopy left Double J (DJ) stenting. During cytoscopy, the patient had a short segment bulbar urethral stricture, which was managed with optical internal urethrotomy. Multiple bladder and prostatic urethral synechiae were found along with bladder diverticula and small bladder capacity. The left ureteric orifice was identified at 1-o’clock. Retrograde pyelography showed an upper ureteric kink and DJ stenting was difficult. The patient improved clinically and is under follow-up. Till date, retained suture material due to urological surgery has been identified as the cause of synechiae. However, our patient didn’t have a history of surgery. No foreign material was identified during cystoscopy. Hence, we postulate that recurrent UTI and bladder outlet obstruction (stricture urethra) contributed to the development of synechiae. Laser incision of synechiae is recommended as the treatment.

Highly infectious viral diseases are a serious threat to mankind as they can spread rapidly among the community, possibly even leading to the loss of many lives. Early diagnosis of a viral disease not only increases the chance of quick recovery, but also helps prevent the spread of infections. There is thus an urgent need for accurate, ultrasensitive, rapid, and affordable diagnostic techniques to test large volumes of the population to track and thereby control the spread of viral diseases, as evidenced during the COVID-19 and other viral pandemics. This review paper critically and comprehensively reviews various emerging nanophotonic biosensor mechanisms and biosensor technologies for virus detection, with a particular focus on detection of the SARS-CoV-2 (COVID-19) virus. The photonic biosensing mechanisms and technologies that we have focused on include: (a) plasmonic field enhancement via localized surface plasmon resonances, (b) surface enhanced Raman scattering, (c) nano-Fourier transform infrared (nano-FTIR) near-field spectroscopy, (d) fiber Bragg gratings, and (e) microresonators (whispering gallery modes), with a particular emphasis on the emerging impact of nanomaterials and two-dimensional materials in these photonic sensing technologies. This review also discusses several quantitative issues related to optical sensing with these biosensing and transduction techniques, notably quantitative factors that affect the limit of detection (LoD), sensitivity, specificity, and response times of the above optical biosensing diagnostic technologies for virus detection. We also review and analyze future prospects of cost-effective, lab-on-a-chip virus sensing solutions that promise ultrahigh sensitivities, rapid detection speeds, and mass manufacturability.

Venezuelan equine encephalitis (VEE) complex alphaviruses are important re-emerging arboviruses that cause life-threatening disease in equids during epizootics as well as spillover human infections. We conducted a comprehensive analysis of VEE complex alphaviruses by sequencing the genomes of 94 strains and performing phylogenetic analyses of 130 isolates using complete open reading frames for the nonstructural and structural polyproteins. Our analyses confirmed purifying selection as a major mechanism influencing the evolution of these viruses as well as a confounding factor in molecular clock dating of ancestors. Times to most recent common ancestors (tMRCAs) could be robustly estimated only for the more recently diverged subtypes; the tMRCA of the ID/IAB/IC/II and IE clades of VEE virus (VEEV) were estimated at ca. 149-973 years ago. Evolution of the IE subtype has been characterized by a significant evolutionary shift from the rest of the VEEV complex, with an increase in structural protein substitutions that are unique to this group, possibly reflecting adaptation to its unique enzootic mosquito vector Culex (Melanoconion) taeniopus. Our inferred tree topologies suggest that VEEV is maintained primarily in situ, with only occasional spread to neighboring countries, probably reflecting the limited mobility of rodent hosts and mosquito vectors.

Barbiturates are a class of sedative and hypnotic drugs. These are commonly used as antiepileptics and anesthetic agents now. Current usage of sedatives in India is about 1.08%, and the abuse is about 0.11%. Barbiturate overdose or poisonings can lead to severe central nervous system depression, potentially life-threatening respiratory depression, and may lead to respiratory arrest. Treatment in the majority of cases of barbiturate poisoning is artificial ventilation and other supportive therapies. Extracorporeal treatments (ECTRs) are required in only 0.1% of cases of poisoning. There is a lack of prospective intervention studies for obvious ethical reasons; however, the ECTR in poisoning (EXTRIP) workgroup recommends the use of ECTRs in severe barbiturate overdose/poisoning. [ABSTRACT FROM AUTHOR]

To understand experiences and perceptions on non-pharmacological treatment of vertebral fractures and virtual-care from the perspective of care professionals' (HCPs) We conducted semi-structured interviews with 13 HCPs within Canada (7 F, 6 M, aged 46 ± 12 years) and performed a thematic and content analysis from a post-positivism perspective. Two themes were identified: acuity matters when selecting appropriate interventions; and roadblocks to receiving non-pharmacological interventions. We found that treatment options were dependent on the acuity/stability of fracture and were individualized accordingly. Pain medication was perceived as important, but non-pharmacological strategies were also considered helpful in supporting recovery. Participants discussed barriers related to the timely identification of fracture, referral to physiotherapy, and lack of knowledge among HCPs on how to manage osteoporosis and vertebral fractures. HCPs reported positive use of virtual-care, but had concerns related to patient access, cost, and comprehensive assessments. HCPs used and perceived non-pharmacological interventions as helpful and selected specific treatments based on the recency of fracture and patient symptoms. HCPs' also believed that virtual-care that included an educational component, an assessment by a physiotherapist, and an exercise group was a feasible alternative, but concerns exist and may require further evaluation. Non-pharmacological strategies in combination with pain medication may be a more effective strategy to support recovery than pain medication alone but should be informed by fracture acuity and patient symptoms. To improve access to physiotherapy and other non-pharmacological treatment options during the acute or chronic management of vertebral fractures, it may be worthwhile to explore the effectiveness and feasibility of virtual-care. [ABSTRACT FROM AUTHOR]