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Brucella is one of the most important causative agent in bovine abortion and have significance zoonotic importance in developing countries. Brucellosis in India is yet very common but often neglected disease. The protocol was tested on different vaginal swab samples collected from 88 cattle with the history of abortion and retention of placenta and it showed that out of the 88 swab samples, 38(43.18%) Brucella detected by PCR. Brucella spp. was appeared as most prevalent microorganism responsible for causing abortion in cattle. Preventive and control measures should be implemented and pursued more strictly to reduce and/or eradicate brucellosis. [ABSTRACT FROM AUTHOR]

This study delves into the rare occurrence of rhabdomyolysis induced by wasp stings, emphasizing its toxic systemic repercussions. Drawing parallels with documented instances of insect bites worldwide, including those by honey bees and Africanized bees, the research explores the correlation between multiple wasp stings and acute renal failure associated with rhabdomyolysis. The venom's active components, such as amines, kinins, and histamine-releasing peptides, underpin toxic systemic reactions, leading to hemolysis, coagulopathy, and severe cytotoxicity-induced acute renal failure. Noteworthy is the emergence of blackish necroses at the sting site, suggesting intense cytotoxicity. The study also highlights skin necrosis as a prognostic indicator for toxic systemic reactions. The presented case manifests an anaphylaxis-like reaction, revealing insights into toxic responses devoid of IgE-mediated allergic reactions. Timely intervention, encompassing hydration, transfusion, and dialytic support, proves imperative in scenarios involving multiple wasp stings, offering successful outcomes documented through plasma exchange in severe cases. This research prompts considerations beyond anaphylaxis, urging exploration of severe toxic systemic reactions in the context of multiple wasp stings., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Kurmana et al.)

With the rapid growth in the data and processing over the cloud, it has become easier to access those data. On the other hand, it poses many technical and security challenges to the users of those provisions. Fog computing makes these technical issues manageable to some extent. Fog computing is one of the promising solutions for handling the big data produced by the IoT, which are often security-critical and time-sensitive. Massive IoT data analytics by a fog computing structure is emerging and requires extensive research for more proficient knowledge and smart decisions. Though an advancement in big data analytics is taking place, it does not consider fog data analytics. However, there are many challenges, including heterogeneity, security, accessibility, resource sharing, network communication overhead, the real-time data processing of complex data, etc. This paper explores various research challenges and their solution using the next-generation fog data analytics and IoT networks. We also performed an experimental analysis based on fog computing and cloud architecture. The result shows that fog computing outperforms the cloud in terms of network utilization and latency. Finally, the paper is concluded with future trends.

Diabetes mellitus (DM) is a chronic metabolic disease with debilitating complications. Diabetic Patients should follow self-care activities like healthy diet, physical activity, self-monitoring of blood glucose, treatment compliance in order to achieve good glycaemic control, control the progression of the disease, reduce complications, and quality of life improvement. We aimed to assess the effect of diabetes self-management education program on HbA1c levels in patients with diabetes., Material: The present study was conducted at a tertiary care centre in central Rajasthan after written consent. Adults with 18 years and above age with Diabetes were included. Patients who refused to give consent, critically ill patients, pregnant females, patients with severe cognitive impairment and whose HbA1c targets were achieved were excluded. It was an open label randomised control study. Simple randomization was done. Cases were then provided with Diabetes self-management education (DSME). The information was provided in local language. One twenty patients were studied during the period from 01/12/2020 to 1/12/2021. All patients underwent complete history taking, physical examination, routine laboratory examination and HbA1c levels. After providing the cases with DSME, all patients were followed up at 6 months. HbA1c level was measured again at 6 months. Pre and post test data of both control and intervention arm were collected. Data was analysed using Statistical package for social science (SPSS) software ver. 2021 and student t test and chi square tests were applied., Observation: The mean age of participants was 49.07 years, male patients represented 57.5%. About two-thirds were from urban areas. 59.16% were diabetics for 5-10 years. After the DSME program, there was a statistically significant decrease in HbA1c level in intervention group compared to controls (p value<0.05). 56% used oral hypoglycaemic agents, 24% used insulin and 20% used combination therapy of oral hypoglycaemic agents and insulin. Hypertension was the most common co-morbidity followed by dyslipidaemia among patients. There was no significant difference in age, gender and duration of diabetes between the two groups., Discussion: DSME plays a significant role in enabling patients to undertake self-management activities to combat their diabetes-related complications and potential premature deaths., Conclusion: DSME may prevent the onset and the progression of diabetic complications. It is important and promising to raise the self-management capacity of Type 2 Diabetes mellitus patients in low-resource settings., (© Journal of the Association of Physicians of India 2011.)

Objectives: To evaluate the cardiac autonomic dysfunction and QT dispersion in newly diagnosed HIV/AIDS patients and to correlate the cardiac autonomic dysfunction with CD4 count., Methods: It was a prospective study conducted on 50 patients (25 HIV positive without AIDS and 25 HIV with AIDS) and 50 healthy controls in the department of General Medicine, JLN Hospital, Ajmer. Autonomic function was assessed by Ewing battery of autonomic function tests and QT dispersion was calculated., Results: In the present study 16% of HIV positive with AIDS had abnormal autonomic dysfunction and 4% of HIV positive without AIDS had abnormal autonomic dysfunction. 48% of patients in AIDS group and 16% of patients in HIV positive without AIDS group showed abnormal QT dispersion. There was no statistically significant correlation with CD4 count., Conclusion: Apart from opportunistic infections, autonomic dysfunction itself can contribute to mortality and morbidity in HIV/AIDS patients. Our study showed that cardiac autonomic dysfunction is a common and relevant clinical problem. It is significantly affected in both HIV positive without AIDS and HIV positive with AIDS groups. QT dispersion is a sensitive predictor of cardiac dysautonomia. But there is no statistically significant correlation with CD4 count., (© Journal of the Association of Physicians of India 2011.)

Coarctation of aorta is a common congenital heart defect. The diagnosis may be missed unless a highindex of suspicion is maintained, and is often delayed until the patient develops congestive heart failure (CHF), (common in infants) or hypertension (common in older children). It seldom goes undiagnosed till adulthood and frequently leads to complications as a result of long-standing high blood pressure. Intracranial haemorrhage, premature coronary artery disease, aortic aneurysms and rupture have all been reported. But it is rare to see a patient with preductal (infantile) coarctation survive childhood and presents with an infarct in adulthood. We herein present a case report of a young woman who came with vomiting and giddiness and was diagnosed as a case of cerebellar infarct due to a concealed preductal (infantile) coarctation of aorta., (© Journal of the Association of Physicians of India 2011.)

It is believed that most of the serious and life threatening complications are caused only by P falciparum infection while P vivax infections are relatively mild and run a benign course and usually not required hospitalisation but in the last few years hospitalisation rate and complications are also increasing in P vivax infection; so we planned this study to evaluate the severity and complicated presentation of P vivax malaria. This hospital-based study conducted in Jawahar Lal Nehru Hospital Ajmer, India. One hundred and two indoor patients with isolated P vivax malaria were included in this study with exclusion of other causes of fever including P falciparum malaria. All patients of severe and complicated P vivax malaria were admitted and treated as severe P falciparum malaria. Severe complications like significant hepatomegaly, thrombocytopenia, acute renal failure, severe anaemia, leucopoenia, electrolyte disturbance, acute respiratory distress syndrome, cerebral malaria, multiorgan dysfunction, hepatic dysfunction, pancytopenia, and death seen in 21.57%, 18.63%, 11.76%, 8.82%, 5.88%, 5.88%, 3.92%, 2.94%, 1.96%, 1.96%, 0.98%, 1.96% patients respectively. A significant proportion of morbidity and mortality in malaria also observed in P vivax infection as seen in P falciparum infection and require hospitalisation.

Blackwater fever is a rare manifestation of falciparum malaria characterized by sudden intravascular hemolysis followed by fever and hemoglobinuria. We present a case of blackwater fever, having occurred after administration of quinine, which was treated successfully with artemether.

Aim: To establish the etiology of recent out break of polyarthritis which occurred in Kanvari village of Churu district of Rajasthan in August, 1999., Methodology: Forty eight patients of polyarthritis were studied by Hb, TDLC, ESR, CRP, throat swab Gram's stain and culture, blood culture, ASO titer, rheumatoid factor, Rose Bengal plate agglutination test, standard tube agglutination test for brucellosis, widal test, urine examination, X-ray chest, ECG and X-ray of the affected joint., Results: Forty eight patients presented with acute polyarthritis with low grade fever of 1-2 week duration. Most common joint involved was sacroiliac joint (52.08%). Most of patients had multiple joint involvement (93.75%). The Rose Bengal plate agglutination test and standard tube agglutination test for brucella were positive in high titres in 44 (91.60%) patients. All the patients were treated with therapy for brucellosis and followed up for 12 weeks and responded well without complications., Conclusion: In case of polyarthritis possibility of brucellosis should always be kept in mind.

Hundred confirmed cases of malaria were included in the present study to determine the clinical and prognostic implications of hypocalcemia and corrected QT interval (QTc) prolongation in malaria. Peripheral blood smear examination was done to determine the parasite species and the parasite load. Serum calcium level and QTc measurements in electrocardiogram were done for each patient. Fifty patients were of P. falciparum malaria (38 complicated and 12 uncomplicated), 40 of vivax malaria and 10 patients were having mixed (P. falciparum and P. vivax) infection. Hypocalcemia was found in 26 cases in which QTc was prolonged. Ten patients who had convulsions, all of them were having QTc prolongation and eight had hypocalcemia. A total number of eight patients had muscle spasm, of which six had QTc prolongation and four had hypocalcemia. There were 34 cases of cerebral malaria, of which 18 had hypocalcemia as well as QTc prolongation, 12 of them developed renal failure and 14 had high parasitaemia. Four patients died who had hypocalcemia and QTc prolongation due to hepatorenal syndrome. The mean parasite load, QTc interval and serum calcium were 2.69 +/- 1.0, 0.468 +/- 0.055 sec and 8.16 +/- 0.86 mg/dl respectively in complicated falciparum malaria; 1.6 +/- 0.55, 0.442 +/- 0.043 sec and 8.72 +/- 0.97 mg/dl in complicated mixed (Pf + Pv) infection. 1.33 +/- 0.52, 0.435 +/- 0.035 sec and 9.77 +/- 1.34 mg/dl in uncomplicated falciparum malaria and 1.35 +/- 0.58, 0.403 +/- 0.019 sec and 9.68 +/- 0.99 mg/dl in vivax malaria. The difference was significant between complicated falciparum and mixed (Pf + Pv) infection when compared to uncomplicated falciparum and vivax malaria (p < 0.05).

This study was conducted on 50 patients of diabetes mellitus type 2 and 20 healthy controls to correlate severity of diabetic cardiac autonomic neuropathy with QTc interval and QTc dispersion. Five standard cardiovascular response tests were carried out (i.e. Valsalva ratio, expiration-inspiration ratio, immediate heart rate response to standing, fall of systolic blood pressure on standing and sustained hand grip test) to determine the severity of cardiac autonomic neuropathy by scoring system. QTc dispersion was determined by subtracting heart rate-corrected minimum QTc interval (QTc min) from maximum QT interval (QTc max) from standard electrocardiogram. Severity of cardiac autonomic neuropathy strongly correlated with QTc dispersion (r = 0.760; p = 0.0001). Correlation of severity of cardiac autonomic neuropathy with QTc max and QTc mean was also found but weaker than with QTc dispersion (r = 0.663, r = 0.542, p = 0.0001 each) and no correlation was found with QTc min (r = 0.177; p = 0.17). This shows that QTc dispersion is a better predictor of cardiac autonomic neuropathy than any of above three QTc intervals. QTc max, QTc mean and QTc dispersion were significantly higher (p < 0.001) in diabetics with autonomic neuropathy (450 +/- 23, 423 +/- 22 and 57 +/- 12 msec; n = 30) than without neuropathy (407 +/- 14, 397 +/- 15 and 20 +/- 7 msec; n = 20) and control subjects (408 +/- 20, 399 +/- 19 and 19 +/- 7 msec; n = 20) but QTc min remained same in the three groups (393 +/- 21, 387 +/- 12, 388 +/- 19 msec, respectively) (p > 0.05). Correlation of QTc dispersion was stronger with QTc max (r = 0.781; p < 0.001) than QTc mean (r = 0.625; p = 0.001) but not with QTc min (r = 0.097; p = 1.0) which suggests that regional increase in QT interval due to regional autonomic denervation leads to increased QTc dispersion. Thus, QTc dispersion is a sensitive, non-invasive, simple and cost-effective predictor of cardiac dysautonomia.