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Objectives:. Long-term surveillance of branch-duct intraductal papillary mucinous neoplasms (BD-IPMN) remains controversial, particularly regarding cysts follow-up >5 years. The primary endpoint of this study was to assess the risk of malignant transformation of presumed BD-IPMN during follow-up and identify clinical and morphological predictors of malignancy. Methods:. We performed a retrospective analysis of data from all patients with a presumed BD-IPMN diagnosis at the CIUSSS de l’Estrie CHUS, from 2004 to 2018. Results:. The final database included 380 patients with presumed BD-IPMN with a median follow-up of 43.9 months (interquartile range [IQR] 28.6–73.3 months). Mean age at diagnosis was 65.5 years [27–90], 159 patients (42.8%) were male and 17 patients (4.5%) underwent resection of their lesion during their surveillance period. In our cohort, 132 patients (34.7%) had a follow-up of >5 years. Overall risk of malignancy was 2.1% [0.9%–4.1%]. During follow-up, neoplastic transformation was observed in 2 of 132 patients (1.5%) surveilled >5 years. Malignancy was significantly associated with cyst growth >2.5 mm/y (57.1% vs 5.8%; P < .001) dilated MPD (71.4% vs 4.9%; P < .001), solid component (71.4% vs 1.3%; P < .001), positive cytology (37.5% vs 0.5%; P < .001), development of high-risk stigmatas (87.5% vs 1.9%; P < .001), or worrisome features (87.5% vs 23.9%; P < .001) during follow-up and symptoms of jaundice (25% vs 0.5%; P = .002) and abdominal pain (50% vs 9.4%; P = .005). Conclusion:. While overall malignancy risk remains low in presumed BD-IPMN, continuous surveillance should be pursued after 5 years in surgically fit individuals, particularly in patients who develop our identified risk factors.

Purpose: The purpose of this analysis is to examine the theoretical foundations of materiality research within sustainability reporting, the current state of research and the legitimacy of different approaches, and to compare between different normalizations and frameworks. Methodology/approach: Employing a content analysis approach, this study used a scoping review. Over 86 related papers were analyzed. Data were extracted from Scopus and Google Scholar on April 22, 2024. Findings: Our review reveals the growing importance of double materiality in sustainability reporting research, driven by stakeholders’ expectations and regulatory demands. Theoretical frameworks like stakeholder and legitimacy theory help explain the complexities in materiality assessments, while inconsistent standards highlight the need for harmonization. We emphasize the critical role of stakeholder engagement and call for further research on standardization, sector-specific challenges, and the implementation of double materiality. Research limitations: This article has certain limitations. Methodologically, it uses a limited set of search keywords. Regarding the findings, this study shows a scarcity of papers on materiality in sustainability reporting. Practical implications: This study aims to provide managers and public policymakers with insight into the degree to which materiality and double materiality are incorporated into essential elements of organizations, such as governance, stakeholder requirements, and social impact evaluations. Originality/value: As of the date this article was written, and to the extent of our knowledge, there are no existing research papers specifically using a scoping review on materiality assessment within this scope.

Restaurants need to have a strong awareness of e-customer perception and a dedication to continuous improvement to succeed in the digital environment. Thus, conducting a thorough analysis of the digital elements affecting e-customer satisfaction is crucial. This study utilises the expectation-confirmation theory to investigate how e-service quality and e-reputation management affect restaurant e-customer satisfaction. A questionnaire was used to collect information from Egyptian restaurant customers. Structural equation modelling analysed the relationships between the identified constructs. The findings indicate that e-customer satisfaction is positively influenced by e-service quality and e-reputation dimensions, except locality information and brand characteristics. This study expands the application of expectation confirmation theory to online restaurant interactions. By identifying key touchpoints that influence e-customer satisfaction, this research empowers restaurants to map customer journeys. These insights can then be leveraged to develop targeted online marketing and service strategies, ultimately optimising the restaurant's online presence and driving success in the digital marketplace.

Digital information plays a crucial role in shaping tourists' expectations and impressions of potential destinations and activities. This study explores how perceptions of digital information vary across different tourism experience types (adventure, leisure, cultural) and examines the complex interactions between digital information perception and tourism engagement. A survey was conducted among tourists actively participating in various tourism types to collect data on their digital information consumption habits and their influence on their overall perceptions. The findings reveal that leisure and adventure tourists demonstrate a stronger initial reliance on digital information compared to cultural tourists. However, all tourism types exhibit negative interaction effects, suggesting diminishing returns of digital information as engagement increases. Specifically, leisure and adventure tourism show stronger positive main effects on digital information perception compared to cultural tourism. Interestingly, leisure and adventure tourism also display more pronounced negative interaction effects than cultural tourism. These insights suggest that destination marketers should employ nuanced, personalized strategies catered to specific tourism types, considering the varying levels of digital information reliance and the changing needs of tourists as their engagement progresses. For leisure and adventure tourism, this may involve front-loading comprehensive digital information, while cultural tourism may benefit from a more consistent information flow throughout the experience. These tailored approaches could enhance destination brand affinity and improve the overall tourist experience across different tourism segments.

Polycystic ovary syndrome (PCOS) is a common condition in reproductive-age women. Women with PCOS are at higher risk of pregnancy complications, including gestational diabetes (GDM). The prevalence of PCOS and GDM varies according to the diagnostic criteria used. The mechanism for the occurrence of GDM in women with PCOS is still unclear. Materials and Methods: A systematic search of the electronic database was done using keywords like PCOS and GDM to include studies between April 2008 and March 2023 where uniform diagnostic criteria were used. After assessing the risk of bias, studies with a high risk (of bias) were excluded, and a meta-analysis was conducted using relative risks and confidence intervals. Results and Discussion: Out of 1896 search results, 95 were selected for full-text review. The quality of the studies was scrutinized and a total of 28 studies were included as they fulfilled the inclusion criteria. The incidence of GDM in women with PCOS was found to be 10.55% (2.9–54.9%) from pooled data involving 1,280,245 women. The prevalence of PCOS in women diagnosed with GDM, based on pooled data from 36,351 women across retrospective studies, was found to be 2.47% (ranging from 1.5% to 50.1%). Selection predominantly included cohort studies, most commonly from China. The meta-analysis found that the risk of GDM is higher in women with PCOS than in those without PCOS (HR: 1.59, 95% CI: 1.27–1.91, p < 0.001). Family history of diabetes, ethnicity, high pre-pregnancy BMI, insulin resistance, gestational weight gain, use of assisted reproductive techniques, and multifetal gestation were found to be associated with GDM in women with PCOS. Conclusion: The prevalence of GDM in patients with PCOS is high, but the causality is complex. The newer predictive models are promising in clarifying the causative relationships, yet use various parameters with different cut-offs. There is a need for the development of universally acceptable parameters for the early prediction of GDM in women with PCOS.

Aim This study aimed to investigate the prevalence of Diabetes Mellitus (DM) and associated complications, such as Diabetic Peripheral Neuropathy (DPN) and Peripheral Vascular Disease (PVD), among security personnel in the United Arab Emirates (UAE). Methods Data were gathered from a sample of 166 security professionals, aged 25–65 years, with a minimum of 8 hours of daily work and at least 2 years of experience, using an observational, cross-sectional study design. The 10 g Semmes Weinstein monofilament testing, Michigan Neuropathy Screening Instrument, and vibration pressure threshold were used for DPN screening followed by the DN4 questionnaire, and the Ankle Brachial Index (ABI) was used for PVD assessment. Ethical clearance was obtained from the Institutional Research Board (IRB), and informed consent was obtained from all subjects. Results The study found a prevalence of 9.6% of DM among security personnel in the UAE. We also found a statistically significant and strong association between DM and DPN (r=0.83; p < 0.001). In contrast, a moderate correlation was observed with PVD (r= 0.56). SPSS version 29 was used for data analysis, and statistical significance was set at a p-value ≤0.05. Conclusion The prevalence of DM among securities in UAE is 9.6%, which is significant, as the total DM prevalence in UAE according to the 2021 report is 12.3%. There is a strong correlation between DM and DPN, suggesting that security personnel could be at higher risk of developing “Diabetic Foot Syndrome” due to the nature and demands of the job. In addition, neuropathy and peripheral vascular disease can increase risk and cause associated foot complications.

Background: Antiretroviral therapy (ART) has transformed the life of PLHIV with a longer life expectancy. The rising coexistence of non-communicable diseases (NCD)s especially type 2 diabetes mellitus (DM) and hypertension (HTN) among PLHIV (people living with HIV) is much more complicated and demanding for the health system, patients, and their families. To document the current status of type 2 DM and HTN among known diabetic/hypertensive PLHIV attending ART center, tertiary care hospital of South Gujarat. Materials and Methods: A mixed method study (cross-sectional survey followed by qualitative in-depth interview) was conducted among 184 PLHIV on ART with history of Type 2 DM and/or Hypertension who were registered and availing services from ART center, tertiary care hospital. Convenient sampling technique was used. All the participants were interviewed using pre-designed, semi-structured questionnaire, during their routine visits. In -depth interview (IDI) has been conducted to explore the delivery of NCD services at ART Centre. Results: Out of 184 PLHIV on ART, the most common co-morbidities were Type 2 DM (46.2%), HTN (39.13%), and 14.67% had both. Among total 184 participants, 64.1% were males and 35.9% were females. Only 22.3% of participants were availing treatment services for the above at tertiary care hospital. The study results showed a range of findings involving ART adherence, BMI, RBS, and BP measurements were included. IDI results described the NCD service delivery at ART Center. Conclusions: Study results suggest that the services received by PLHIV with NCD require an overhauling. Routine monitoring and strengthening of existing services should be focused to upgrade the quality and continuum of the care provided to PLHIV with NCD.

Introduction: Bell’s palsy is a lower motor neuron (LMN) palsy that affects the facial nerve (CN VII) and causes weakness or paralysis of the facial muscles. It can be associated with various causes, including neurovascular cross-compression (NVCC). This case report highlights the challenges in treating recurrent Bell’s palsy caused by NVCC and the need for a multidisciplinary approach. Case report: A 17-year-old girl presented with recurrent right-side Bell’s palsy along with NVCC involving the right and left anterior inferior cerebellar artery forming a loop around the VII and VIII cranial nerve complex. Motor Nerve Conduction Studies (NCS) indicated a right-side facial nerve lesion with prolonged distal latency. Discussion: Despite prior physiotherapy sessions, which proved effective, the patient showed no improvement after five sessions, leading to further investigations. This case also underscores the diagnostic and therapeutic complexities associated with NVCC-induced Bell’s palsy, which emphasizes the urgency of quick diagnosis and intervention to prevent functional limitations. Conclusion: Continued research and advancements in diagnostic and therapeutic modalities are required for better outcomes and improving the quality of life in such patients, particularly in such cases.

Background: In India, TB diagnosis and treatment practices among Private Practitioners (PPs) vary widely and are not properly regulated by the national TB program. Despite their irrational and inequitable practises, PPs remain an important and preferred primary care provider for many people. The study was done to with the objectives to describe different diagnosis and treatment practices of Tuberculosis among private practitioners and their involvement in National Tuberculosis Elimination Program (NTEP). Material and Methods: A cross sectional study was performed among 303 PPs during October 2020 to March 2021 by using stratified random sampling to select private practitioners based on their speciality. Results: Most preferred investigation was Chest X ray (45.2%) followed by sputum smear microscopy (29.7%). Only 71.3% PPs practiced the correct regimen for new cases of Pulmonary TB according to NTEP. More than half of the PPs had TB training (59.7%). Majority of the PPs (90.1%) were involved in NTEP mainly by referral of TB patients to local government centres for treatment purpose. Conclusion: Preferred investigation for diagnosis of pulmonary TB was chest X-ray followed by sputum examination among PPs. The treatment regimen and duration of treatment varies among PPs as per their clinical judgement and practice.

Breast cancer is the most common cancer in women. Several multigene-based assays have been developed to predict the outcome of breast cancer and guide adjuvant systemic therapy. The Oncotype DX [...], * Context.--The Oncotype DX Recurrence Score (RS) predicts recurrence and chemotherapy benefit in early-stage estrogen receptor-positive breast cancer patients. Cost and unavailability are 2 major disadvantages of the assay. Multiple models have been developed to predict the RS. Objective.--To predict RS based on histopathologic and biomarker features, and to measure concordance and correlation with RS of the following 3 algorithms: breast cancer prognostic score, Magee0, and Magee2. Design.--Breast cancer cases with available RSs were reviewed (n = 442). RS categories were stratified by pathologic and biomarker variables. Histopathologic and biomarker data were abstracted from pathology reports, and RS was calculated by each model. Correlation and concordance between models and RS were calculated. Results.--Less than 5% of breast cancers with lobular features, low-grade tumors, carcinomas with high progesterone receptor content, or luminal A tumors had an RS greater than 25. Breast cancer prognostic score, Magee0, and Magee2 demonstrated correlation coefficients with RS of 0.63, 0.61, and 0.62, respectively. Two-step discordances were uncommon. When an RS of 25 was used to separate high-risk from non-high-risk cases, concordance rates of 86% to 88% were achieved. Conclusions.--High RS was observed only in a small percentage of pure or mixed lobular carcinomas, low-grade or luminal A tumors, and tumors with high progesterone receptor expression, suggesting that these cancers may not require Oncotype testing. All 3 surrogate models demonstrated comparable correlation and high concordance with the RS when a cutoff of 25 was used, suggesting their utility in cases where the actual RS is unavailable. doi: 10.5858/arpa.2021-0367-OA

Background: Elevated vitamin B12 (B12) levels are linked to an increased risk of cancers, including hematological malignancies. This study focuses on the relationship between elevated B12 and myeloproliferative neoplasms (MPNs): Polycythemia Vera (PV), Primary Myelofibrosis (MF), Essential Thrombocytosis (ET), and Chronic Myeloid Leukemia (CML). Elevated B12 in MPNs is believed to arise from increased transcobalamin I (TCI) secretion by proliferating leukocytes, leading to higher serum levels. B12 may serve as a diagnostic and prognostic biomarker for these conditions. However, its sensitivity, specificity, and cutoff levels are unclear. Aim: To assess the prevalence of high B12 levels in MPN patients, determine the median levels, identify a diagnostic cutoff, and evaluate the sensitivity and specificity of B12 as a marker. Methods: Data were retrieved from the National Center for Cancer Care and Research in Doha, Qatar, for MPN patients from January 2016 to December 2022. Results: A total of 467 patients were included: 232 with CML, 98 with PV, 88 with ET, and 50 with MF. The majority were male (66%) and of Asian origin (56%), with a median age of 48.7 years. CBC results showed median hemoglobin of 9.2 g/dL, WBC count of 73 x 10^3/uL, and platelet count of 531 x 10^3/uL. Elevated B12 levels were found in 95 patients (20%): 71% CML, 14% PV, 10% MF, and 5% ET. Extreme elevations were seen in 59 patients. The mean B12 level decreased from 747.3 ± 686.5 pg/mL before treatment to 397.9 ± 343.7 pg/mL after one year (p=0.01). Median levels were 458 pg/mL (718) before treatment and 301 pg/mL (229) after. In the extreme high B12 group, the mean was 1722 pg/mL before and 677 pg/mL after treatment. Conclusion: Elevated B12 levels are associated with disease activity in CML. However, their role as a reliable marker for disease monitoring remains uncertain, and further studies are needed to confirm their utility for CML progression. [ABSTRACT FROM AUTHOR]

Background: Optimal infant and young child feeding practices (IYCF) are effective public health intervention to enhance child survival, nutrition and development. There is also documented evidence regarding the protective effect of optimal IYCF practices against diarrhea and ARTI. Objectives: 1) To assess knowledge and practices regarding IYCF among study participants. 2) To explore the association of feeding practices of mothers with the morbidities (infections) in their children. Methodology: The present study was a hospital based cross-sectional study, carried out during September 2019 to March 2021. A total of 380 mothers of children less than two years attending OPD of Institute of child health, Nirmal hospital private limited, a tertiary care multi-specialty hospital were interviewed using pre-designed and pretested questionnaire. Results: Feeding practices during early days of life to be reasonably good among study participants with almost 2/3rd of the study participants practicing them. Mean number of morbidity episodes requiring consultation were significantly lower in the children whose mothers practiced optimal IYCF practices. Conclusion: Satisfactory knowledge and practices were observed among study participants regarding various infant and young child feeding practices. Poor feeding practices in children had significant association with morbidity episodes of diarrhea and ARTI in children.

Purpose: The purpose of this analysis is to examine the theoretical foundations of materiality research within sustainability reporting, the current state of research and the legitimacy of different approaches, and to compare between different normalizations and frameworks. Methodology/approach: Employing a content analysis approach, this study used a scoping review. Over 86 related papers were analyzed. Data were extracted from Scopus and Google Scholar on April 22, 2024. Findings: Our review reveals the growing importance of double materiality in sustainability reporting research, driven by stakeholders' expectations and regulatory demands. Theoretical frameworks like stakeholder and legitimacy theory help explain the complexities in materiality assessments, while inconsistent standards highlight the need for harmonization. We emphasize the critical role of stakeholder engagement and call for further research on standardization, sector-specific challenges, and the implementation of double materiality. Research limitations: This article has certain limitations. Methodologically, it uses a limited set of search keywords. Regarding the findings, this study shows a scarcity of papers on materiality in sustainability reporting. Practical implications: This study aims to provide managers and public policymakers with insight into the degree to which materiality and double materiality are incorporated into essential elements of organizations, such as governance, stakeholder requirements, and social impact evaluations. Originality/value: As of the date this article was written, and to the extent of our knowledge, there are no existing research papers specifically using a scoping review on materiality assessment within this scope. [ABSTRACT FROM AUTHOR]

Background: Antiretroviral therapy (ART) has transformed the life of PLHIV with a longer life expectancy. The rising coexistence of noncommunicable diseases (NCD)s especially type 2 diabetes mellitus (DM) and hypertension (HTN) among PLHIV (people living with HIV) is much more complicated and demanding for the health system, patients, and their families. To document the current status of type 2 DM and HTN among known diabetic/hypertensive PLHIV attending ART center, tertiary care hospital of South Gujarat. Materials and Methods: A mixed method study (cross-sectional survey followed by qualitative in-depth interview) was conducted among 184 PLHIV on ART with history of Type 2 DM and/or Hypertension who were registered and availing services from ART center, tertiary care hospital. Convenient sampling technique was used. All the participants were interviewed using pre-designed, semi-structured questionnaire, during their routine visits. In -depth interview (IDI) has been conducted to explore the delivery of NCD services at ART Centre. Results: Out of 184 PLHIV on ART, the most common co-morbidities were Type 2 DM (46.2%), HTN (39.13%), and 14.67% had both. Among total 184 participants, 64.1% were males and 35.9% were females. Only 22.3% of participants were availing treatment services for the above at tertiary care hospital. The study results showed a range of findings involving ART adherence, BMI, RBS, and BP measurements were included. IDI results described the NCD service delivery at ART Center. Conclusions: Study results suggest that the services received by PLHIV with NCD require an overhauling. Routine monitoring and strengthening of existing services should be focused to upgrade the quality and continuum of the care provided to PLHIV with NCD. [ABSTRACT FROM AUTHOR]

Canola meal, the by-product of canola oil refining, is a rich source of phenolic compounds and protein. The meal, however, is primarily utilized as animal feed but represents an invaluable source of nutraceuticals. Of particular interest are the sinapates, sinapine and sinapic acid, with the decarboxylation of the latter to form canolol. Extracting these phenolics has been carried out using a variety of different methods, although there is an urgent need for environmentally safe and sustainable methods. Microwave-assisted solvent extraction (MAE), as a green extraction method, is receiving considerable interest. Its ease of use makes MAE one of the best methods for studying multiple solvents. The formation of canolol, from sinapine and sinapic acid, is primarily dependent on temperature, which favors the decarboxylation reaction. The application of MAE, using the MultiwaveTM 500 microwave system with green extractants, was undertaken to assess its ability to enhance the yield of sinapates and canolol. This study examined the effects of different pre-treatment temperature-time combinations of 140, 150, 160, and 170 °C for 5, 10, 15, 20, and 30 min on the extraction of canolol and other canola endogenous phenolic compounds. Total phenolic content (TPC), total flavonoid content (TFC), as well as metal ion chelation (MIC) and DPPH radical activity of the different extracts were assessed. The results confirmed that extractability of canolol was optimized with methanol at 151 °C and with ethanol at 170 °C with pre-treatment times of 15.43 min and 19.31 min, respectively. Furthermore, there was a strong positive correlation between TPC and TFC (p < 0.05) and a negative correlation between TFC and DPPH radical activity. Interestingly, no significant correlation was observed between MIC and DPPH. These results confirmed the effectiveness of MAE, using the novel MultiwaveTM 500 microwave instrument, to enhance the yield of canolol. This was accompanied by substantial improvements in the antioxidant activity of the different extracts and further established the efficacy of the current MAE method for isolating important natural phenolic derivatives for utilization by the nutraceutical industry.

Gestational trophoblastic diseases (GTDs) encompass a spectrum of conditions characterized by abnormal trophoblastic cell growth, ranging from benign molar pregnancies to malignant trophoblastic neoplasms. This systematic review explores the molecular underpinnings of GTDs, focusing on genetic and epigenetic factors that influence disease progression and clinical outcomes. Based on 71 studies identified through systematic search and selection criteria, key findings include dysregulations in tumor suppressor genes such as p53, aberrant apoptotic pathways involving BCL-2 (B-cell lymphoma), and altered expression of growth factor receptors and microRNAs (micro-ribose nucleic acid). These molecular alterations not only differentiate molar pregnancies from normal placental development but also contribute to their clinical behavior, from benign moles to potentially malignant forms. The review synthesizes insights from immunohistochemical studies and molecular analyses to provide a comprehensive understanding of GTD pathogenesis and implications for personalized care strategies. [ABSTRACT FROM AUTHOR]

Despite the effectiveness of insulin injections in managing hyperglycemia in type 1 diabetes mellitus (T1DM), they fall short in addressing autoimmunity and regenerating damaged islets. This review aims to explore the potential and prospects of emerging treatment modalities for T1DM, including mesenchymal stem cells (MSCs), MSC-derived exosomes, gene therapy, islet allotransplantation, pancreatic islet cell transplantation, and teplizumab. We review emerging treatment modalities for T1DM, highlighting several promising strategies with varied mechanisms and outcomes. Mesenchymal stem cells demonstrate potential in modulating the immune response and preserving or restoring beta-cell function, although variability in sources and administration routes necessitates further standardization. Similarly, MSC-derived exosomes show promise in promoting beta-cell regeneration and immune regulation, supported by early-stage studies showing improved glucose homeostasis in animal models, albeit with limited clinical data. Gene therapy, utilizing techniques like CRISPR-Cas9, offers targeted correction of genetic defects and immune modulation; however, challenges in precise delivery and ensuring long-term safety persist. Islet allotransplantation and pancreatic islet cell transplantation have achieved some success in restoring insulin independence, yet challenges such as donor scarcity and immunosuppression-related complications remain significant. Teplizumab, an anti-CD3 monoclonal antibody, has demonstrated potential in delaying T1DM onset by modulating immune responses and preserving beta-cell function, with clinical trials indicating prolonged insulin production capability. Despite significant progress, standardization, long-term efficacy, and safety continue to pose challenges across these modalities. Conclusion: While these therapies demonstrate significant potential, challenges persist. Future research should prioritize optimizing these treatments and validating them through extensive clinical trials to enhance T1DM management and improve patient outcomes. [ABSTRACT FROM AUTHOR]

Introduction: Mission Balam Sukham's Nutrition Rehabilitation Centre (NRC) combats malnutrition through prevention, treatment, and community engagement, ensuring children receive adequate nutrition for healthy growth. Objective: To document IYCF practices and risk factors of severe acute malnutrition (SAM) among NRC beneficiaries Methodology: A prospective cohort study was conducted comprising of 63 children aged 6 months to 5 years having SAM alongwith complications admitted at NRC of South Gujarat over the duration of 10 months. Observations: 90.5% poverty, 57.1% migrants, 7.9% single parent. 69.8% initiated breastmilk within 1hr, 15.9% weren't fed with colostrum, 6.3% were given pre-lacteals. 93.7% were exclusively breastfed, 6.3% initiated breastmilk at the time of 6 months. 16%, 60% and 9.8% met the criteria of MDD, MMF and MAD respectively. Boys show significant association on admission and discharge both (t = 2.43, p= 0.026 on admission and t= 2.66, p= 0.015 on discharge). In 13-24 months, MDD group (t = 2.34, p=0.02), children not suffering from anaemia shows significant weight (t=-2.540, p=0.18). Conclusion & Recommendations: Children's weight improvement is linked to better IYCF practices, emphasizing its importance of caregiver attention and education, highlighting need to address cultural barriers and promote practices like exclusive breastfeeding and continuous breastfeeding, focusing on empowering mothers and caretakers. [ABSTRACT FROM AUTHOR]

An immigrant woman in her 60s with a complex medical history and remote occupational exposure to patients with tuberculosis (TB) presented with abdominal pain, early satiety, bloating and weight loss. Physical exam showed abdominal distention and ascites. Diagnostic paracentesis revealed low serum ascites albumin gradient and elevated ascitic lymphocytic count. However, fluid cytology, bacterial and mycobacterial cultures were negative. An interferon-gamma release assay for TB was indeterminate. MRI of the abdomen and pelvis showed a thickened endometrial stripe. Endometrial biopsy demonstrated non-caseating granulomatous endometritis. No organisms were identified on Grocott methenamine silver or acid-fast bacilli special stains. A tissue block from the endometrial biopsy submitted for DNA sequencing was positive for mycobacterium tuberculosis (MTB) complex. Urine mycobacterial cultures were obtained and the patient was started on isoniazid, rifampin, ethambutol and pyrazinamide, with significant improvement in her symptoms. Urine mycobacterial cultures were eventually positive for pansusceptible MTB. [ABSTRACT FROM AUTHOR]

Background: With the improvement of basic maternal and child health care services, the deaths due to malnutrition and infections are on a descending trend and due to westernization and lifestyle modifications, perinatal deaths due to anomalies are in ascending trend. Aim & Objectives: The purpose of this study was to estimate the antenatal proportion of congenital anomalies, types, pattern of anomalies and factors associated with anomalies in Tertiary Care Centre, South Gujarat. Settings and Design: Cross-sectional study in Department of Fetal Medicine of New Civil Hospital, Surat. Methods and Material: Sample size was 435. First 10 consecutive high-risk ANC patients, who were referred to Fetal Medicine department from Obstetrics and Gynecology department per day were selected. Data was collected during September 2021 to February 2022. Statistical analysis used: Frequencies, proportions and tests of significance was applied for testing the association of sociodemographic variables, clinical variables etc on presence or absence of congenital anomalies. Results: Proportion of different types of congenital anomalies in high risk pregnant mother was 17.2%. There was significant association between presence of congenital anomalies with history of irregular menstruation (p value: 0.001, OR: 5.19, [CI: 1.76-15.27]) and inadequate amniotic fluid (p value: 0.00, OR: 14.5[CI: 7.23-29.06]). Among total detected anomalies in Ultrasonography scanning, most common anomalies were Cardio-vascular system anomalies (36.4%) and Central Nervous System anomalies (24%). Conclusions: Congenital anomalies were present in about 17 % of high risk antenatal mothers. [ABSTRACT FROM AUTHOR]

Le rhinosclérome est une affection granulomateuse spécifique et chronique d'évolution insidieuse, dont l'agent pathogène est le Klebsiella rhinoscleromatis. Il touche avec prédilection les fosses nasales, et pose parfois un problème de diagnostic positif. Nous rapportons le cas d'une patiente de 19 ans, qui présente un rhinosclérome atypique par sa localisation nasopharyngée rare, et son association exceptionnelle à une adénopathie cervicale sous angulo-mandibulaire droite. La mise en évidence des cellules de MIKULICZ à l'examen anatomo-pathologique a permis de poser le diagnostic. La patiente a été mise sous traitement antibiotique à base de ciprofloxacine pendant 16 semaines, associée à un nettoyage des fosses nasales par sérum physiologique. L'évolution était favorable avec un recul de 14 mois.