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To explore the possibility of using a novel technique, CT perfusion imaging, to monitor the response to anti-tubercular therapy (ATT) in patients with intestinal tuberculosis. A prospective observational study was performed in adults with treatment naive-intestinal tuberculosis. Clinical, endoscopic, and conventional radiological findings of patients were compared at baseline and post-ATT. CT perfusion imaging was performed with recording of six perfusion parameters (blood flow, blood volume, mean transit time, time to peak, maximum peak intensity, and permeability/blood flow extraction). Twenty-two patients (13 women, 59%) with a median age of 25 years were recruited. The terminal ileum and ileocaecal junction were the most frequent sites of involvement (59%), with multiple segments of the intestine being involved in 16 patients (73%). Median duration of ATT was 6 months (range 6–10 months). Complete clinical response was observed in 22/22 (100%) patients, endoscopic response in 12/12 (100%) patients, and radiological response in 10/13 (76%) patients. There was a significant decrease in mean blood flow, blood volume, maximum peak intensity, and an increase in mean transit time and time to peak on follow-up CT perfusion imaging performed after 6 months of ATT. Significant alterations in CT perfusion parameters were demonstrated following treatment, consistent with a decline in inflammation and vascularity. CT perfusion imaging of the bowel is a novel means to assess the radiological response to ATT in intestinal tuberculosis, although at the cost of a higher dose of radiation exposure. • Treatment endpoints for intestinal tuberculosis are controversial. • Radiological resolution lags behind clinical; routine CT scan insufficient. • CT perfusion imaging measures vascularity of inflamed bowel segments and nodes. • Treatments leads to reduced CT parameters of blood flow and time to peak intensity. • Remains to be seen if this can help decision to stop therapy, and utility vs. PET-CT. [ABSTRACT FROM AUTHOR]

We present a novel coarse-grain particle-based simulation technique for modeling self-developing flow of dilute and semi-dilute polymer solutions. The central idea in this paper is the two-way coupling between a mesoscopic polymer model and a phenomenological fluid model. As our polymer model, we choose Responsive Particle Dynamics (RaPiD), a Brownian dynamics method, which formulates the so-called "conservative" and "transient" pair-potentials through which the polymers interact besides experiencing random forces in accordance with the fluctuation dissipation theorem. In addition to these interactions, our polymer blobs are also influenced by the background solvent velocity field, which we calculate by solving the Navier-Stokes equation discretized on a moving grid of fluid blobs using the Smoothed Particle Hydrodynamics (SPH) technique. While the polymers experience this frictional force opposing their motion relative to the background flow field, our fluid blobs also in turn are influenced by the motion of the polymers through an interaction term. This makes our technique a two-way coupling algorithm. We have constructed this interaction term in such a way that momentum is conserved locally, thereby preserving long range hydrodynamics. Furthermore, we have derived pairwise fluctuation terms for the velocities of the fluid blobs using the Fokker-Planck equation, which have been alternatively derived using the General Equation for the Non-Equilibrium Reversible-Irreversible Coupling (GENERIC) approach in Smoothed Dissipative Particle Dynamics (SDPD) literature. These velocity fluctuations for the fluid may be incorporated into the velocity updates for our fluid blobs to obtain a thermodynamically consistent distribution of velocities. In cases where these fluctuations are insignificant, however, these additional terms may well be dropped out as they are in a standard SPH simulation. We have applied our technique to study the rheology of two different concentrations of our model linear polymer solutions. The results show that the polymers and the fluid are coupled very well with each other, showing no lag between their velocities. Furthermore, our results show non-Newtonian shear thinning and the characteristic flattening of the Poiseuille flow profile typically observed for polymer solutions. [ABSTRACT FROM AUTHOR]

We present a coarse-grained particle-based simulation technique for modeling flow of complex soft matter fluids such as polymer solutions in the presence of solid interfaces. In our coarse-grained description of the system, we track the motion of polymer molecules using their centers-of-mass as our coarse-grain co-ordinates and also keep track of another set of variables that describe the background flow field. The coarse-grain motion is thus influenced not only by the interactions based on appropriate potentials used to model the particular polymer system of interest and the random kicks associated with thermal fluctuations, but also by the motion of the background fluid. In order to couple the motion of the coarse-grain co-ordinates with the background fluid motion, we use a Galilean invariant, first order Brownian dynamics algorithm developed by Padding and Briels [J. Chem. Phys. 141, 244108 (2014)], which on the one hand draws inspiration from smoothed particle hydrodynamics in a way that the motion of the background fluid is efficiently calculated based on a discretization of the Navier-Stokes equation at the positions of the coarse-grain coordinates where it is actually needed, but also differs from it because of the inclusion of thermal fluctuations by having momentumconserving pairwise stochastic updates. In this paper, we make a few modifications to this algorithm and introduce a new parameter, viz., a friction coefficient associated with the background fluid, and analyze the relationship of the model parameters with the dynamic properties of the system. We also test this algorithm for flow in the presence of solid interfaces to show that appropriate boundary conditions can be imposed at solid-fluid interfaces by using artificial particles embedded in the solid walls which offer friction to the real fluid particles in the vicinity of the wall. We have tested our method using a model system of a star polymer solution at the overlap concentration. [ABSTRACT FROM AUTHOR]

Background: Maternal inhalation of 35-40% oxygen concentration has no significant effect on foetal partial pressure of oxygen, and 60-100% produced maternal and foetal hyperoxia with increased free radical activity. The benefit of 50% maternal oxygen inhalation on foetal oxygenation, oxidant stress and total antioxidant status (TAS) during Caesarean section (CS) has not been simultaneously evaluated.Methods: In this prospective, randomized, controlled trial 120 ASA physical status I-II, term pregnant women were recruited to elective CS (n = 60) and emergency CS (n = 60) and received either 50% oxygen or air inhalation following subarachnoid block (SAB). Patients and investigators were blinded to the inhaled oxygen concentration. The primary outcome of the study was foetal umbilical artery (UA) malondialdehyde (MDA) at birth.Results: In both elective and emergency CS, there was no difference in foetal oxidative stress and TAS in spite of increase in maternal PaO2. In elective CS, maternal MDA was higher at delivery in mothers breathing 50% oxygen as compared to their own baseline values (P = 0.04). In emergency CS, maternal TAS at 10 min was lower in mothers inhaling 50% oxygen as compared to air (P = 0.01). The average duration of maternal oxygen supplementation was ~10.3 min in elective and ~7.4 min in emergency CS. Neonatal outcome, episodes of maternal hypotension and oxygen desaturation were similar in both the groups.Conclusion: Brief duration of 50% oxygen maternal inhalation during elective or emergency CS did not significantly affect foetal MDA and TAS under SAB. [ABSTRACT FROM AUTHOR]

Background and Objectives: Intermittent boluses for neural blockade provide better post-operative analgesia when compared to continuous infusion. However, these techniques of administration have not yet been compared while performing adductor canal block (ACB). We compared intermittent vs. continuous ACB for managing post-operative pain following anterior cruciate ligament (ACL) reconstruction. The primary endpoint was total morphine consumption for 24 h post-operatively in both the groups. Secondary outcomes included evaluation of pain scores and opioid-related side effects.Methods: After ethics board approval, subjects presenting for ACL reconstruction were randomized to receive either continuous ACB (n = 25) with 0.5% ropivacaine infusing at 2.5 ml/h or intermittent boluses (n = 25) of 15 ml of 0.5% ropivacaine every 6 h. Total morphine consumption 24 h following surgery was recorded in each group.Results: Fifty subjects completed this study. The mean 24-h total morphine consumption in the intermittent group, [11.36 (6.82) mg], was significantly reduced compared with the continuous group, [23.40 (10.45) mg] (P < 0.001). The mean visual analogue scale (VAS) pain score at rest and on knee flexion was significantly reduced in the intermittent group at 4, 6, 8, and 12 h compared with the continuous group.Conclusion: Intermittent ACB allowed significantly reduced consumption of morphine for 24 h in the post-operative period compared with continuous ACB when identical doses of ropivacaine were used in each group. [ABSTRACT FROM AUTHOR]

Background: Unintentional intraneural injection under ultrasound guidance (USG) with fine caliber needles and lower success rate with large caliber Tuohy needles in supraclavicular brachial plexus block (SCB) have been reported. Materials and Methods: We undertook study to standardize the use of 20-gauge short versus blunt bevel needle for SCB. After approval of Institutional Ethics Committee and written informed consent, patients were randomized using computer-generated random number table to either of the two groups; blunt bevel needle group (n = 30): SCB under USG using 20-gauge Tuohy needle or short bevel needle group (n = 30): SCB under USG using 20-gauge short bevel needle. The primary outcome of the study was time to establishment of sensory and motor block of individual nerves, and secondary outcome was tolerability and any adverse effects. Results: The time to establishment of sensory and motor block in individual nerve territory was similar in both the groups. The complete sensory and motor anesthesia was achieved in 78.3% patients and complete sensory and motor anesthesia after supplementary block was achieved in 86.6% patients. Paresthesias during SCB were recorded in 15 patients. Out of these eight patients were of blunt bevel group and seven patients were of short bevel group. None of the patients experienced any neurological adverse effects. Conclusion: The establishment of sensory and motor blockade of individual nerves was similar to 20-gauge short and blunt bevel needle under ultrasound guide with no neurological adverse events. [ABSTRACT FROM AUTHOR]

Background: Flupirtine is a unique non-opioid, centrally acting analgesic with muscle relaxant properties. So far no study has evaluated, use of preoperative flupirtine on postoperative morphine sparing effect in patients undergoing total abdominal hysterectomy (TAH). Materials and Methods: We performed a prospective, controlled, and randomized study in 50 female patients of American Society of Anesthesiologists physical status I-II, aged between 30 and 60 years scheduled for TAH under general anesthesia (GA). Patients were randomized to receive either single dose flupirtine 100 mg or placebo 1 h prior to surgery. A standard anesthetic and analgesic protocol was followed in both the groups. Postoperatively, a titrated loading dose of intravenous morphine 0.1 mg/kg was followed with patient-controlled analgesia with morphine (bolus of 0.01 mg/kg with a lockout time of 7 min). The primary outcome was cumulative morphine consumption at 48 h postoperatively. Secondary outcomes included hemodynamics, visual analog scale (VAS) at rest, VAS on cough, and any adverse effects. Results: All enrolled 50 patients completed the follow-up. The cumulative mean morphine consumption (standard deviation [SD]) at 48 h (40.4 [6.0] vs. 47 [6.6] mg, P = 0.001) was reduced in-group flupirtine as compared with placebo. The cumulative mean VAS at rest (SD) (3 [0.7] vs. 3.7 [0.7], P = 0.001) and on cough (3 [0.9] vs. 3.8 [0.5], P = 0.002) were reduced in-group flupirtine as compared with placebo at 48 h postoperatively. Conclusion: Preoperative use of flupirtine exhibited morphine sparing effect in patients following TAH under GA at 48 h. [ABSTRACT FROM AUTHOR]

Disperse dyes, which are suitable for dyeing synthetic fibres, are responsible for the great majority of allergic contact dermatitis (ACD) cases to textile dyes. The aim of the present study was to investigate the sensitising potential of various disperse dyes using a biphasic protocol of the local lymph node assay (LLNA). Briefly, mice were shaved over a surface of approximately 2 cm on their backs and treated using a “sensitisation-challenge protocol”. The shaved surface was treated once daily on days 1–3 with 50 μl of the test solution. Animals remained untreated on days 4–14. On days 15–17, mice were treated with 25 μl of the test solution on the dorsum of both ears. Mice were killed on day 19 with deep CO anaesthesia, the lymph nodes prepared and various end points, such as ear thickness, ear punch weight, lymph node weight, lymph node cell count and the proportion of various lymphocyte subpopulations, were determined by flow cytometry. The results were compared to control group treated with the vehicle alone. Our results showed that almost all of the tested textile dyes caused a significant increase in lymph node cell count and lymph node weight. We also observed an increase in ear thickness and ear punch weight in most of the concentrations tested for various textile dyes. We observed a decrease in CD4+ and CD8+ cells and an increase in CD19+, CD45+ and CD45+/1A+ cells in most of the cases, which is characteristic for allergens. The CD4+/CD69+ cells increased in only few experiments mainly with Disperse Blue 124 and Disperse Blue 106. Based on our results, the disperse dyes could be arranged in four groups on the basis of their sensitising potency in the following decreasing order (in parenthesis: lowest concentration causing a significant increase in lymph node cell number): group 1, strong: Disperse Blue 124 and Disperse Blue 106 (0.003%); group 2, moderate: Disperse Red 1 and Disperse Blue 1 (3%); group 3, weak: Disperse Orange 37 and Disperse Blue 35 (10%); and group 4, very weak: Disperse yellow 3 and Disperse Orange 3 (increase at 30% or no increase at 30%). In conclusion, our study shows that the biphasic LLNA protocol was proficient enough to study the sensitisation potential of tested textile dyes and provides data allowing to discriminate them according to their potency. [ABSTRACT FROM AUTHOR]

Chronic postsurgical pain (CPSP) is a distressful condition following hernia surgery. A 25-year-old, 55 kg male patient presented with severe pain on the right side of the lower abdomen that radiated to the testicle and the inner side of the thigh. Patient was symptomatic since 5 months following inguinal herniorrhaphy surgery. The pain was not relieved with pharmacological and interventional nerve blocks. An ultrasound-guided ilioinguinal-iliohypogastric (II-IH) block with extended duration (42°C, four cycles of 120 s each) pulsed radiofrequency (PRF) and a diagnostic genital branch of genitofemoral nerve (GGFN) block provided pain relief. After 1-month, an extended duration PRF in GGFN resulted in complete resolution of symptoms. During a regular follow-up of 9 months, patient reported an improved quality-of-life. We believe the successful management of CPSP following hernia repair with single extended duration PRF of II-IH and GGFN has not been described in the literature. [ABSTRACT FROM AUTHOR]

Abstract: The aqueous leaf extract of Euphorbia hirta decreased the gastrointestinal motility in normal rats and decreased the effect of castor oil-induced diarrhoea in mice. [Copyright &y& Elsevier]

The present study aimed to compare the efficacy for the therapy of GERD of pantoprazole alone with a combination of pantoprazole and mosapride. The study was a prospective, randomized trial involving 68 patients suffering heartburn and/or regurgitation at least twice a week for 6 weeks. Sixty-one patients consented to be randomized to receive either pantoprazole 40 mg b.i.d. (n = 33, group A) or pantoprazole 40 mg b.i.d. plus mosapride 5 mg t.d.s. (n = 28, group 13) for 8 weeks. Twenty-four-hour esophageal pH-metry and endoscopy were conducted at recruitment and endoscopy was repeated at 8 weeks in all the patients studied. There were no differences in symptomatic responses to therapy between the groups (69.7% vs 89.2%; P = 0.11). The mean symptom score after 8 weeks was significantly lower in group B (3.78 ± 3.62 vs 1.67 ± 2.09; P = 0.009). Non-erosive esophagitis was present in 29 patients. In patients with nonerosive CERD there was no significant difference in symptomatic response to either regimen (17/20 in group A and 7/9 in group 13 responded; P = 0.63). In erosive esophagitis, symptomatic responses occurred more frequently in group 13, 18/19 (94.7%), than in group A, 6/13 (46.2%; P = 0.003). However endoscopic healing of esophagitis occurred equally with either regimen (6/11, 54.5% in group A; 12/17, 70.5% in group 13; P = 0.44). In nonerosive CERD, the addition of mosapride offers no benefit over pantoprazole alone. A combination of pantoprazole and mosapride is more effective than pantoprazole alone in providing symptomatic relief to patients with erosive CERD. [ABSTRACT FROM AUTHOR]

A framework for predicting fan related noise from high bypass ratio engines is presented. The methodology accounts for both fore and aft radiation and includes the effects of liner treatment on the engine walls. Solutions are obtained through a combination of Euler and linearized Euler solvers, coupled with a Kirchhoff formulation for far-field noise prediction. The nacelle region is solved using the Euler solver, whereas the linearized Euler solver is used for the fan exhaust stage. Switching to the linearized Euler solver in the aft region has been necessary to overcome difficulties experienced due to the coupling of the acoustic modes with flow near the engine exhaust boundary and appearance of flow instabilities in the shear layer trailing the exhaust shroud. Results are presented for spinning modes from a turbofan engine with acoustic treatment. [ABSTRACT FROM AUTHOR]

This paper reports the case of decapitation during suicidal hanging of an 82 yr old male weighing 48 kg. He reportedly jumped into a well almost 25 feet deep with a thick jute rope tied around his neck. External findings included complete transection of the neck at the level of C2-C3 vertebral body. Decapitation is an infrequent complication of hanging. The cause for such a rare event can be attributed to the inelasticity of the rope and fall of several meters. [ABSTRACT FROM AUTHOR]

Presents information relating to the publication of an introductory numerical scheme used for solving the equations governing matrix heat exchanger thermal performance. Circumstances surrounding the correcting of parameter relating to longitudinal heat transfer in the approximate analytical solution for the balanced flow case; Accountability of analysis; Information on the defined axial conduction parameter.

Introduction: Difluoromethylornithine (DFMO) is a potential chemotherapeutic agent and currently in Phase II trials for colon and prostate malignancies. DFMO will potentially be used for chemotherapy in postoperative patients in low dosage. Therefore, we studied the effect of low dosage DFMO on wound healing. Methods: Two groups of twenty male Sprague Dawley rats underwent a midline dorsal incision with implantation of polyvinyl alcohol sponges into subcutaneous pockets. In Exp 1, ten rats were injected daily with DMFO (500 mg/kg IP) starting on day of wounding while controls (ten rats) received equivalent volume of normal saline. In Exp 2, DFMO and normal saline treatments were delayed until post-wounding day 3. All rats were sacrificed on day 10 post-wounding. Incisional wound breaking strength (WBS, g) and sponge hydroxyproline (OHP, g/100mg sponge) content (collagen deposition), were assessed. Efficacy of DFMO treatment was assessed by measuring wound fluid polyamines, putrescine (PUT) and spermidine (SPER)(M) Results: Treatment with DFMO starting on day 0 (Exp 1) resulted in a significant decrease in collagen deposition and wound breaking strength. Neither of the wound healing parameters was affected when treatment was begun 3 days post-wounding (Exp 2). Conclusion: Wound healing is decreased when DFMO treatment is started on the day of surgery. This suggests that DFMO treatment may play a critical role in the synthesis of collagen in early wound healing and chemotherapy with DFMO should be delayed for patients requiring surgery. TABLE—ABSTRACT P116GroupWBSOHPPUTSPEREXP 1Control409 ± 821435 ± 10211.6 ± 3.4NDDFMO340 ± 41&ast;1014 ± 67&ast;&ast;2.2 ± 0.4&ast;&ast;NDEXP 2Control376 ± 941568 ± 9015.3 ± 5.295.4 ± 18.6DFMO354 ± 411624 ± 1505.7 ± 5.4&ast;&ast;63.1 ± 12.8&ast;&ast;Mean ± standard deviation.&ast;P < 0.05 and&ast;&ast;P < 0.005 by t-test; Student’s t-test; ND—not determined. [Copyright &y& Elsevier]

Introduction Urea breath test (UBT) has become a diagnostic method of choice for Helicobacter pylori (Hp) infection. Density of Hp organism in gastric mucosa has a prognostic significance. Objective To study whether C14UBT counts can assess Hp density. Methods 53 consecutive patients with active duodenal ulcer positive for Hp (by rapid urease test) were studied. Patients who had received proton pump inhibitors and/or anti H. pylori therapy during preceding one month were excluded. C14 UBT was performed on all patients prior to therapy. Hp density was determined on histopathology of gastric biopsies obtained from anterior and posterior wall the antrum (2-5 cm from the pylorus) as well as the corpus (10 cm from the cardia). Hp density was graded according to the Sydney system Grades of Hp density in the antrum and in the corpus were correlated with UBT counts. Results H. pylori density in the antrum as well as in the corpus was correlated with the UBT counts. Correlation of H. pylori density with UBT counts ANTRUM r=0.1622* CORPUS r=0.0419* Conclusion C14 Urea breath test counts do not assess Helicobacter pylori density. [ABSTRACT FROM AUTHOR]

This paper describes a frequency-domain numerical method for predicting noise radiation from ducted fans, including acoustic treatment and non-uniform background flow effects. The method solves the Euler equations linearized about a mean flow in the frequency domain. A pseudo-time derivative term is added to the frequency-domain equations so that a time marching technique can be employed to drive the acoustic field to steady state explicitly. This approach makes distributed parallel computing more viable for equations of this type and will allow for future use of well-known convergence acceleration techniques, such as multigrid, to obtain the solutions efficiently. Simulations of the JT15D static test inlet are performed including the effects of liners, and the results are compared with experimental data. A generic engine geometry is used for demonstrating further the prediction capability of the code, calculating the attenuation effects of different liner impedances and liner installation locations on the radiated sound fields. [Copyright &y& Elsevier]

Acute mountain sickness (AMS) occurs when there is failure of acclimatisation to high altitude. The aim of this study was to describe the relationship between physiological variables and the incidence of AMS during ascent to 5300 m. A total of 332 lowland‐dwelling volunteers followed an identical ascent profile on staggered treks. Self‐reported symptoms of AMS were recorded daily using the Lake Louise score (mild 3–4; moderate‐severe ≥5), alongside measurements of physiological variables (heart rate, respiratory rate (RR), peripheral oxygen saturation (SpO2) and blood pressure) before and after a standardised Xtreme Everest Step‐Test (XEST). The overall occurrence of AMS among participants was 73.5% (23.2% mild, 50.3% moderate–severe). There was no difference in gender, age, previous AMS, weight or body mass index between participants who developed AMS and those who did not. Participants who had not previously ascended >5000 m were more likely to get moderate‐to‐severe AMS. Participants who suffered moderate‐to‐severe AMS had a lower resting SpO2 at 3500 m (88.5 vs. 89.6%, p = 0.02), while participants who suffered mild or moderate‐to‐severe AMS had a lower end‐exercise SpO2 at 3500 m (82.2 vs. 83.8%, p = 0.027; 81.5 vs. 83.8%, p < 0.001 respectively). Participants who experienced mild AMS had lower end‐exercise RR at 3500 m (19.2 vs. 21.3, p = 0.017). In a multi‐variable regression model, only lower end‐exercise SpO2 (OR 0.870, p < 0.001) and no previous exposure to altitude >5000 m (OR 2.740, p‐value 0.003) predicted the development of moderate‐to‐severe AMS. The Xtreme Everest Step‐Test offers a simple, reproducible field test to help predict AMS, albeit with relatively limited predictive precision. [ABSTRACT FROM AUTHOR]

Abstract: Background: Despite potential differences in patient perception of chronic constipation (CC) in geographically and culturally distinct regions, head‐to‐head studies comparing the clinical profile, constipation severity, impact on quality of life (QOL) and economic impact are lacking. Methods: We conducted a cross‐sectional cohort study of patients presenting with CC to tertiary care centers in the USA and India. Standardized instruments were used to assess constipation subtype, disease severity, disease‐specific QOL, somatization, and psychiatric comorbidities. We used multivariable linear regression to determine the predictors of QOL and number of healthcare visits. Key Results: Sixty‐six and 98 patients with CC were enrolled in the USA and India, respectively. Indian patients with CC had significantly more frequent bowel movements/week compared to their USA counterparts (Median 5 vs 3, P < .0001). The proportion of patients with Bristol stool form scale type 1 and 2 was significantly higher in the USA compared to India (65.5% vs 48%, P = .04). Higher depression score (P = .001), more severe constipation symptoms (P = .001) and site of the study being USA (P = .008) independently predicted worse QOL. Indian patients (P < .001) and worse QOL (P = .02) were independent predictors of number of healthcare visits in the last 12 months. Conclusions and Inferences: Indian patients with CC have more frequent and softer bowel movements compared to those in the USA suggesting significant differences in perception of CC in different geographic and cultural settings. QOL and economic impact related to constipation varies with geographic/cultural setting irrespective of other clinical and psychosomatic features. [ABSTRACT FROM AUTHOR]

Background Brucellosis caused by Brucella suis is a notifiable disease that has recently emerged in dogs in New South Wales ( NSW). Given the potential for zoonotic transmission, euthanasia of affected dogs is recommended, but this action is not mandatory. We report the clinical management of three dogs that underwent treatment at their owners' request. Case reports A 14-month-old spayed female crossbreed originally obtained from an urban animal shelter underwent extensive investigations in 2011-12 for lameness and back pain, culminating in decompressive laminectomy. Diagnosis of multifocal discospondylitis and spinal empyema was made, with B. suis cultured from surgical biopsy specimens. The dog responded to long-term treatment using rifampicin and doxycycline. A second case of B. suis infection was diagnosed in January 2016 in a 3-year-old crossbreed pig-hunting dog with unilateral testicular enlargement. Following serological diagnosis the dog was given preliminary therapy using rifampicin and doxycycline, the affected testis was resected and the patient given a further month of combination therapy. In March 2016 a 7-year-old crossbreed pig-hunting dog with brucellosis was handled similarly, although both testes were removed. Conclusion Brucellosis should be considered in the differential diagnosis of back pain, discospondylitis, lameness, abortion, prostatic abscessation and testicular/epididymal enlargement in dogs, especially if there is exposure to feral pigs or consumption of uncooked feral pig meat. Euthanasia is the only guarantee of reducing the public health risk to zero. However, where treatment is desired by the owner, combination therapy using rifampicin and doxycycline appears to be effective, when combined with surgical resection of infected tissues. Further monitoring of dogs during and after treatment is required to document cure. [ABSTRACT FROM AUTHOR]

Background Differentiation between intestinal tuberculosis and Crohn's disease is difficult and may require therapeutic trial with anti-tubercular therapy in tuberculosis-endemic regions. Aim To evaluate the role of therapeutic trial with anti-tubercular therapy in patients with diagnostic confusion between intestinal tuberculosis and Crohn's disease. Methods We performed retrospective-comparative ( n = 288: 131 patients who received anti-tubercular therapy before being diagnosed as Crohn's disease and 157 intestinal tuberculosis patients) and prospective-validation study ( n = 55 patients with diagnostic confusion of intestinal tuberculosis/Crohn's disease). Outcomes assessed were global symptomatic response and endoscopic mucosal healing. Results In the derivation cohort, among those eventually diagnosed as Crohn's disease, global symptomatic response with anti-tubercular therapy was seen in 38% at 3 months and in 37% who completed 6 months of anti-tubercular therapy. Ninety-four per cent of intestinal tuberculosis patients showed global symptomatic response by 3 months. Endoscopic mucosal healing was seen in only 5% of patients with Crohn's disease compared with 100% of intestinal tuberculosis patients. In the validation cohort, all the patients with intestinal tuberculosis had symptomatic response and endoscopic mucosal healing after 6 months of anti-tubercular therapy. Among the patients with an eventual diagnosis of Crohn's disease, symptomatic response was seen in 64% at 2 months and in 31% who completed 6 months of anti-tubercular therapy, none had mucosal healing. Conclusions Disproportionately lower mucosal healing rate despite an overall symptom response with 6 months of anti-tubercular therapy in patients with Crohn's disease suggests a need for repeat colonoscopy for diagnosing Crohn's disease. Patients with intestinal tuberculosis showing significant symptomatic response after 2-3 months of anti-tubercular therapy, suggest that symptom persistence after a therapeutic trial of 3 months of anti-tubercular therapy may indicate the diagnosis of Crohn's disease. [ABSTRACT FROM AUTHOR]

The article focuses on intentional use of fires to transform land which has decreased and mentions market-oriented approaches and moral suasion which has been less effective. Topics discussed include polluted air which is health risk factor along with seasonal smog which imposes costs, alternative to crop residue burning and agriculture in northwestern India's Indo-Gangetic plains.

Background: Use of i.v. paracetamol for postoperative pain is well documented, but it is unclear if it can reduce the consumption of opioids during patient-controlled epidural analgesia (PCEA) in labouring parturients.Methods: In this randomized, double-blind, placebo-controlled clinical trial conducted in a tertiary care hospital, 80parturients were randomly assigned to two groups of 40 each, to receive either 1000 mg (100 ml) i.v. paracetamol or 100 ml normal saline as placebo, 30 min before the procedure. After insertion of the epidural catheter, all patients received 10 ml of levobupivacaine 0.1% with 2 μg ml-1 fentanyl, followed by continuous background epidural infusion of 6 ml h-1 with a provision of patient-controlled bolus 5 ml of same drug with a lock-out interval of 12 min.The primary outcome was hourly mean consumption of levobupivacaine and fentanyl mixture (ml.h-1). Secondary outcomes included pain score ,: sensory and motor block, haemodynamic parameters of mother, duration of second stage of labour, mode of delivery, Apgar scores, foetal heart rate and adverse effects.Results: The hourly mean drug consumption in the Paracetamol group was significantly lower as compared with the Placebo group (7.03 ml.h-1, SD 0.83 vs. 8.12 ml.h-1, SD 1.34; p < 0.001). The mean number of boluses taken were also significantly less in the paracetamol group (1.00, SD 0.93 vs. 1.43, SD 0.90; p = 0.036). Pain scores decreased in both the groups without significant inter-group differences.Conclusions: Use of 1000 mg i.v. paracetamol decreases the mean hourly drug consumption through epidural route. Thus i.v. paracetamol is a safe and effective adjunct to PCEA in labour analgesia.Clinical Trial Registration: Clinical Trials Registry-India (http://ctri.nic.in/Clinicaltrials/login.php), trial registration number 2013/09/003968. [ABSTRACT FROM AUTHOR]

Genome-wide association studies have identified IL-23 receptor ( IL-23R) as a susceptibility locus for the pathogenesis of ulcerative colitis ( UC), which is characterized by exaggerated Th2/Th17 response. Studies have shown that vitamin A ( VA) reduces disease progression by promoting FOXP3⁺ T cells and curbing Th17 cells. In this study, we explored the association of colonic IL-23R and FOXP3 expression in fifty-one UC patients (23 in remission and 28 with active disease) with serum VA levels and disease activity. We observed that decreased serum VA levels were associated with increased disease activity. However, there was no significant difference in mucosal IL-23R and FOXP3 expression in UC patients with moderate-to-severe disease activity compared to those in remission. Also, no significant correlation was drawn between serum VA levels and mucosal IL-23R and FOXP3 expression. Our study suggests that even after an established role of VA in inhibiting Th17 responses in mice models and humans, serum VA levels and disease activity do not correlate with FOXP3 and IL-23R expression in colonic mucosa of UC patients. [ABSTRACT FROM AUTHOR]

We undertook a randomised, double-blind, placebo-controlled study to compare the analgesic efficacy of pre-operative stellate ganglion block on postoperative pain relief after upper limb orthopaedic surgery. Patients were administered a 3-ml injection during ultrasound-guided stellate ganglion block; 15 patients received lidocaine 2% and 15 patients received 0.9% saline. Following the block, all patients received standardised general anaesthesia. Postoperative analgesia included regular intravenous diclofenac, paracetamol and patient-controlled analgesia with tramadol for 24 h. Patients were observed at 0, 2, 4, 6, 8, 12 and 24 h after surgery for tramadol consumption, cardiovascular variables and visual analogue scale pain scores at rest and on movement. The mean ( SD) hourly tramadol consumption was significantly reduced in the lidocaine group compared with the saline group at 4 h (8.0 (10.1) mg vs 28.0 (12.6) mg, respectively; p = 0.001), 6 h (5.3 (10.8) mg vs 17.3 (12.7) mg, respectively; p = 0.013) and 8 h (5.3 (11.8) mg vs 21.3 (9.1) mg, respectively; p = 0.001). The cumulative 24-h tramadol consumption was 97.3 (16.6) mg in the lidocaine group and 150.6 (26.0) mg in the saline group (p = 0.001). There were significant differences in the pain visual analogue scale at rest at two time points; at 4 h the median (IQR [range]) visual analogue scale scores were 4 (4-6 [2-8]) in the lidocaine group and 5 (4-6 [2-7]) in the saline group (p = 0.03), and at 6 h visual analogue scale scores were 3 (3-4 [3-6]) and 4 (4-6 [2-7]), respectively (p = 0.04). Pain visual analogue scale on movement was lower in the lidocaine group at all time intervals compared with the saline group, but this did not reach statistical significance. The present study has demonstrated a postoperative tramadol-sparing and analgesic effect of pre-operative stellate ganglion block in patients undergoing upper limb orthopaedic surgery under general anaesthesia. [ABSTRACT FROM AUTHOR]

We present a randomised, controlled, crossover trial of the Caudwell Xtreme Everest (CXE) closed circuit breathing system vs an open circuit and ambient air control in six healthy, hypoxic volunteers at rest and exercise at Everest Base Camp, at 5300 m. Compared with control, arterial oxygen saturations were improved at rest with both circuits. There was no difference in the magnitude of this improvement as both circuits restored median (IQR [range]) saturation from 75%, (69.5-78.9 [68-80]%) to > 99.8% (p = 0.028). During exercise, the CXE closed circuit improved median (IQR [range]) saturation from a baseline of 70.8% (63.8-74.5 [57-76]%) to 98.8% (96.5-100 [95-100]%) vs the open circuit improvement to 87.5%, (84.1-88.6 [82-89]%; p = 0.028). These data demonstrate the inverse relationship between supply and demand with open circuits and suggest that ambulatory closed circuits may offer twin advantages of supplying higher inspired oxygen concentrations and/or economy of gas use for exercising hypoxic adults. [ABSTRACT FROM AUTHOR]

This article discusses the Pharmacokinetics of enrofloxacin. It was experimented on sheep following intravenous and subcutaneous administration. A synthetic antibacterial agent of the floroquinone group, enrofloxacin is mainly developed for veterinary use. Its characteristics include low host toxicity and high bioavailability, tissue penetration, long serum half-life, and wide spectrum of antibacterial and organisms' activity. Its indication is presented.

Examines the pharmacokinetics of enrofloxacin and its active metabolite ciprofloxacin in cows following single dose intravenous administration. Decline in the plasma concentration of enrofloxacin; Calculation of the therapeutic concentration of enrofloxacin and ciprofloxacin; Determination of the importance of ratio of antibiotic peak concentration to MIC for bactericidal activity and emergence of resistance.