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Objective: To aim at the preparation and characterization of a chitosan and betel leaf extract biopolymer followed by an assessment of mechanical and antibacterial properties. Material and Methods: A chitosan-betel leaf stock solution was prepared and dip-coated on thermoformed aligner cubes. The groups (five samples per group) involved were one control (only chitosan coating) and three test groups based on the duration of coating (coating with chitosan and betel extract coated for 5, 10, and 15 minutes, named B5, B10, and B15 respectively). The coating of the samples was confirmed by an FTIR test and anti-microbial properties were assessed by the disc diffusion method. Wear resistance assessment of the coating was carried out by scratch test. Results: Coating of the aligners with the extract was confirmed with FTIR. The zone of inhibition against S. mutans was noted to be the widest for aligners coated for 15 minutes (7± 0.5mm), and the intergroup difference was statistically significant (p

The legal framework governing abortion in India is, at its core, a cis-hetero-patriarchal framework that regulates pregnant persons' bodies using a punitive criminal justice system. The criminal framework encompasses Sections 312-318 IPC, provisions of the POCSO Act, and the PCPNDT Act, which prescribe significant state surveillance and allow for largely unchecked intimidation by law enforcement of both abortion providers and abortion seekers. Several case laws show the “chilling effect” of criminalization on healthcare providers, leading them to hesitate to provide safe abortion services. The stigma around abortions perpetuated by criminalization, leaves pregnant persons with limited reproductive choices – these include either availing of safe abortions and risking prosecution, availing of unsafe abortions and risking adverse health outcomes, or carrying unwanted pregnancies to term and avoiding prenatal and maternal healthcare. Criminalization disproportionately affects marginalized communities, with examples of legal reform showing carceral approaches' disregard for structural factors affecting certain groups' access to fundamental rights and healthcare services. It is, therefore, imperative to decriminalize abortion completely, framing avenues for redressal within a reproductive justice framework. The proposal to completely abolish penal provisions that govern forced abortions begets concerns about leaving marginalized pregnant persons who frequently experience forced abortions with no legal recourse. This feminist dilemma that ensues requires the adoption of decarceral, intersectional approaches that maintain structures of accountability for harm done, without posing any risk to the rights of marginalized pregnant persons. El marco jurídico que rige el aborto en India es fundamentalmente una estructura cis-heteropatriarcal, que utiliza un sistema de justicia penal punitivo para controlar los cuerpos de las personas embarazadas. Las secciones 312-318 del Código Penal indio, junto con la ley de Protección de los niños contra los delitos sexuales y la ley de Técnicas de diagnóstico prenatal y antes de la concepción, componen este marco penal, promoviendo una vigilancia estatal que intimida por igual a quienes practican el aborto y a quienes lo solicitan. Los casos judiciales ilustran vívidamente el perjudicial “efecto amedrentador” que tiene la penalización tanto sobre los proveedores de atención sanitaria como sobre quienes buscan abortar. El estigma vinculado a los abortos penalizados limita la autonomía de decisión reproductiva, obligando a las personas a elegir entre procedimientos seguros pero perseguibles, abortos inseguros con riesgos para la salud, o llevar a término embarazos no deseados. Esto afecta de manera desproporcionada a las comunidades marginadas, lo que pone de relieve la inadecuación de los enfoques carcelarios para abordar las barreras estructurales a la realización de los derechos reproductivos. Los activistas piden la despenalización completa, impulsando una transición hacia un marco de justicia reproductiva. La propuesta de abolir por completo las disposiciones penales que regulan los abortos forzados suscita la preocupación de dejar sin recursos legales a las personas embarazadas marginadas que suelen sufrir abortos forzados. El dilema feminista que se plantea exige la adopción de enfoques descarceladores e interseccionales que mantengan las estructuras de rendición de cuentas sin poner en peligro los derechos de las mujeres embarazadas marginadas.

Abstract Objective To determine the correlation between posttreatment trunk range of motion (ROM) and isometric strength (TIS) and pain and disability in patients who underwent multimodal rehabilitation for low back pain (LBP). Methods In this prospective cohort study, 122 patients undergoing multimodal rehabilitation for LBP were analyzed. The pre- and posttreatment numerical pain rating scale (NPRS) and the Oswestry disability index (ODI) scores, as well as trunk ROM and TIS were compared. The Pearson correlation was used to determine correlation between posttreatment clinical outcomes and ROM and TIS. Results At the end of treatment, the mean NPRS (p< 0.0001) and ODI (p< 0.0001) scores, mean trunk extension (p< 0.0001), and flexion (p< 0.0001) ROMs improved significantly. Similarly, posttreatment, the mean extension (p< 0.0001) and flexion (p< 0.0001) TISs improved significantly. There was a weak correlation between the NPRS score and ROM extension (r = -0.24, p= 0.006) and flexion strength (r = -0.28, p= 0.001), as well as between the ODI score and TIS extension (r = -0.30, p= 0.0007) and flexion (r = -0.28, p= 0.001). Conclusion Despite significant improvement in pain, disability, trunk ROM, and TIS with multimodal treatment, there was a weak correlation between posttreatment pain and function and trunk ROM and TIS. Improvement in pain and function with physical rehabilitation treatment for LBP is a complex phenomenon and needs further investigation.

Morte, uma inevitável parte da vida, incita uma exploração a respeito da maneira e do método de sua ocorrência. Este estudo tem por objetivo analisar os padrões de lesões em casos de homicídios verificados em exames post-mortem. Em 2019, registrou-se um total de 28.918 casos de assassinato na India, mostrando um leve decréscimo de 0,3% em comparação com 2018 (29.017 casos). Este estudo objetiva entender os diferentes padrões de lesão em homicídios. No Departamento de Medicina Forense da Gandhi Medical College, em Bhopal, India, um total de 62 homens, 12 mulheres e uma pessoa de gênero não identificado, foram submetidas à análise post mortem. A maioria dos casos pertencia a áreas urbanas, com principal causa de morte sendo choque e hemorragia seguida de dano crânio cerebral. Este estudo conclui que arestas afiadas e cortes profundos foram os principais padrões de lesões em casos de homicídio.

This position paper has been drafted by the members of the Working Group for Children Under 6 [of Jan Swasthya Abhiyan (People’s Health Movement India) and the Right to Food Campaign]. It was published in abridged form as a letter to the editor in Economic and Political Weekly, January 2, 2016;Vol 2, No 1 under the title Hunger and Structural Inequality

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Employee well-being has been a focus area for Human Resource managers as well as top management alike. The belief that healthy, happy employees would be more efficient, and consequently contribute more, has verily driven the research to understand the implications of different aspects of an employee's health and happiness. Based on the work of key humour researcher Dr. Paul McGhee, it has been established that humour does play a key role in ensuring a happy and healthy workforce. The current study attempts to evaluate the benefits of the use of humour at the workplace, primarily in terms of influencing the work culture. The data for the study has been collected from the hotel sector and has been analysed to understand the use of humour and its influence on the work culture. The findings suggest that the presence and use of humour has a strong positive impact on work culture. The researchers also found that, contrary to previous literature, the use of humour did not depend on demographic variables like age, tenure in the current organization or total work experience. Furthermore, the study also attempts to understand how the use of humour would impact the work culture. In this regard, the researchers found that certain dimensions of humour at the workplace, had a stronger impact on the culture and it is expected that the findings would guide the behaviour of leaders and managers in the creation of a mutually beneficial workplace. [ABSTRACT FROM AUTHOR]

The misuse of antibiotics in food-producing animal farming practices exerts selective pressure on bacterial strains, intensifying the spread of pathogenic and commensal bacteria carrying antibiotic resistance genes (ARGs). We conducted a study aiming to investigate ARGs in chicken litter from farms in the State of Sergipe, Northeast Brazil. A total of 14 chicken litter samples were collected from twelve farms and subjected to total DNA extraction. The presence of ARGs in the obtained material was tested by Polymerase Chain Reaction (PCR) using primers for selected ARGs. ARGs were confirmed in all samples, and the highest resistance positivity was obtained for tetracyclines (tetA, tetM, and tetG), quinolones (gyrA and qnrS), beta-lactams (blaTEM), macrolides (ermB) and sulfonamides (sul-1). Sequencing and comparison with the GenBank database confirmed the identity of the ARGs. Some of the sequences that were amplified by PCR were similar to resistance factors found in Gram-positive and Gram-negative bacteria of different species, mostly enterobacteria. Furthermore, similarity was observed for resistance determinants located both on the chromosome and on plasmids, transposons, and integrons. Our results indicate the potential of poultry farming for the environmental dissemination of ARGs in the State of Sergipe.

Objective: To evaluate the perception and self-confidence of Dental interns regarding endodontic treatment performed on patients. Material and Methods: A total of 111 dental interns from 5 different educational institutes of a state in South India participated in a questionnaire-based survey. The questionnaire consisted of 12 questions related to root canal procedures performed on patients. Analysis was done using SPSS version 17.0. Results: Sixty-five interns (59%) performed less than 10 root canal treatments on patients during the course of the internship. Twenty-eight interns (25% of the intern population) took up more than 10 root canal treatment cases, whereas only 18 interns (16%) did not perform the treatment on patients and answered the questionnaire based on their experience with extracted teeth model work. Only five interns out of 111 were ‘Very confident’ and 22 were ‘Confident’ in performing the root canal treatment. Conclusion: The present study indicates that the self-perceived confidence level among dental interns can affect their clinical performance. It also recommends additional hands-on workshops, problem-based learning and clinical guidance for the dental interns to become more confident with the root canal procedure.

Gamification has gone through a faddish cycle. It first gained prominence around 2012 and was quickly abandoned, as practitioners did not achieve the outcomes they expected. According to Gartner’s Hype Cycle, Gamification is at a point at which one might expect wide scale adoption. However, if history is not to repeat itself and results are to be achieved as theoretically predicted, a deeper understanding of the concept is essential. In the current study, the researchers attempt to evaluate a gamified learning experience. The participants were students of a Master in Business Administration course. The students were asked to participate in a gamified module and relevant data was collected, before and after the intervention. Based on a review of literature, the researchers identified the exogenous variables of Valence, Attitude towards use of Technology and Experience with Technology. The endogenous variables identified included Reaction and Learning. The findings of the study suggest that the gamified module resulted in increase in knowledge and that Attitude, Experience and Valence significantly predicted the Learner’s reaction to the experience. The findings of the study provide support to key theories in the area of gamification and insights for practitioners, on the factors to be considered before using a gamified learning intervention.

ABSTRACT Introduction: Micro-osteoperforation is a minimally invasive technique that has been used to accelerate orthodontic tooth movement and reduce treatment duration. However, literature presents conflicting reports about this technique. Objective: To evaluate the effectiveness of micro-osteoperforations on the rate of canine retraction and expression of biomarkers in gingival crevicular fluid (GCF). Methods: This was a randomized clinical trial with split-mouth study design. Thirty adult subjects with age above 18 years (20.32 ± 1.96) who required fixed orthodontic treatment and extraction of maxillary first premolars were enrolled and randomly allocated to either the experimental or control group. Randomization was performed by block randomization method, with a 1:1 allocation ratio. The experimental group received three micro-ostoperforations (MOPs) distal to maxillary canine, using the Lance pilot drill. The retraction of maxillary canine was performed with NiTi coil-spring (150g) in both experimental and control groups. The primary outcome was the evaluation of canine retraction rate, measured on study models from the baseline to 16 weeks of canine retraction. Secondary outcomes were the estimation of alkaline and acid phosphates activity in GCF at 0, 1, 2, 3, and 4 weeks. Results: There was a statistically significant difference in the rate of canine retraction only after the first 4 weeks. Subsequently there was no statistically significant difference from the eighth to the sixteenth weeks between MOPs and control group. There was a statistically significant difference in alkaline and acid phosphates activity in GCF between MOPs and control groups during the initial 4 weeks of canine retraction. Conclusion: Micro-ostoperforation increased the rate of tooth movement only for the first 4 weeks; thereafter, no effect was observed on the rate of canine retraction during 8, 12 and 16 weeks. A marked increase in biomarker activity in the first month was observed.

Abstract Two siblings presented with clinical and biochemical features of rickets, initially suspected as hypophosphatemic rickets. There was no improvement initially, hence the siblings were reinvestigated and later diagnosed as having vitamin D-dependent rickets (VDDR) type 1 due to a rare mutation in the CYP27B1 gene encoding the 1α-hydroxylase enzyme. Both siblings improved with calcitriol supplementation. The initial presentation of VDDR is often confusing and algorithmic evaluation helps in diagnosis. We also present a brief review of the literature, including genetics.

Objective: To evaluate and compare the effectiveness of transcutaneous electrical nerve stimulation (TENS) therapy on whole salivary flow in patients with xerostomia and healthy adults. Material and Methods: Thirty subjects with a history of xerostomia and subjects with unstimulated salivary flow equal to or less than 0.5 ml in 5 min were included in the study group, and 30 healthy subjects were included in the control group. Low forced spitting unstimulated saliva was collected for five minutes in a test tube fitted with a funnel. Then electrode pads of the TENS unit were applied bilaterally on skin overlying the parotid glands and at optimal intensity, stimulated saliva was collected for 5 minutes with the same method in a separate graduated test tube. The salivary flow rate (per minute) was calculated by dividing the amount of collected saliva (volume in mL) by the duration of collection period (5 minutes) and the salivary flow rates prior and after electrostimulation were compared for both groups. The Student’s t-test (unpaired and paired) was performed for group-wise comparisons. Results: In study group, the mean unstimulated salivary flow rate was 0.07 ± 0.01 mL/min. There was an 85.71% increase in salivary flow (0.13 ± 0.03 mL/min) during the TENS application and the difference was highly significant (p0.05). Conclusion: TENS can be an effective therapy in increasing whole salivary flow rates in patients with xerostomia.

Abstract Background: Intra-articular injections of platelet-rich plasma to treat symptoms of knee osteoarthritis have been successfully used in young patients. However in most of these studies the control and test knees were present in different patients thus incorporating a large amount of bias in the results. Therefore, the present study was designed in which patients with bilateral osteoarthritis knee were included and platelet-rich plasma was administered in one knee and normal saline in another knee of same patient. Methods: 20 patients aged 30–65 years with bilateral osteoarthritis knees (ASA class I and II) of either gender were included in the study. Patients were randomized to receive platelet-rich plasma and normal saline in one of the two knees. The primary outcome was VAS and WOMAC score at 6 months after procedure. The secondary outcome included changes in joint stiffness, physical function, any adverse effects noted during the course of study. Results: The baseline VAS score in platelet-rich plasma knee was 8.4 ± 0.88 which improved significantly to 4.85 ± 2.48 (p < 0.001) at 6 months as compared to normal saline knee (p = 0.017). The WOMAC pain score also improved from baseline (14.5 ± 1.3) to over 6 month 7.00 ± 4.24 (p < 0.001) in platelet-rich plasma knee while in the normal saline knee, no significant change occurred from baseline to six months (10.2 ± 1.2 to 10.05 ± 1.23). There was also significant decrease in stiffness and improvement of physical activity in the platelet-rich plasma knee as compared to normal saline knee. Conclusion: The present study showed significant decrease in pain and stiffness and improvement of physical functions of knee joint with intra-articular platelet-rich plasma injection as compared to normal saline.

In the present paper author derive a number of integrals concerning various special functions which are applications of the one of Osler result. Osler provided extensions to the familiar Leibniz rule for the nth derivative of product of two functions.

Abstract A 45-year-old woman with known hypothyroidism and no other comorbidities was incidentally found to have multiple right renal artery aneurysms. The largest aneurysm measured 5 x 4.5 cm and arose from an inferior segmental branch while two smaller aneurysms arose from an upper segmental branch of the right renal artery. We performed an ex-vivo repair with reverse saphenous vein graft under cold preservation followed by orthotopic kidney auto-transplantation. Her postoperative course was unremarkable and at 1-year follow-up her right kidney is preserved. In this article, we report successful treatment of complex multiple right renal artery aneurysms and describe the surgical technique used for successful repair.

Abstract Background Variations in the upper limb arterial pattern are commonplace and necessitate complete familiarity for successful surgical and interventional procedures. Variance in the vascular tree may involve any part of the axis artery of the upper limb, including the axillary artery and brachial artery or its branches, in the form of radial and ulnar arteries, which eventually supply the hand via anastomosing arches. Objectives To study the peculiarities of the arterial pattern of the upper limb and to correlate them with embryological development. Methods The entire arterial branching of forty-two upper limbs of formalin fixed adult human cadavers was examined during routine dissection for educational purposes, conducted over a 3-year period in the Department of Anatomy, Lady Hardinge Medical College, New Delhi. Results The study found: 1) One case in which a common trunk arose from the third part of the axillary artery, which immediately splayed into four branches (2.4%); 2) High division of the brachial artery into ulnar and radial arteries, in 3 cases (7.1%); 3) Pentafurcation of the brachial artery into ulnar, interosseus, radial, and radial recurrent arteries and a muscular twig to the brachioradialis in 1/42 cases (2.4%); 4) Incomplete Superficial Palmar arch in 3/42 cases (7.1%); and 5) Presence of a median artery in 2/42 case(4.8%) Conclusions This study observed and described the varied arterial patterns of the upper limb and identified the various anomalous patterns, supplementing the surgeon’s armamentarium in various surgical procedures, thereby helping to prevent complications or failures of reconstructive surgeries, bypass angiography, and many similar procedures.

ABSTRACT Objective: To investigate the impact of “Brush Up” - a mobile application, on oral hygiene behaviours of 4-6-year-old children in Bangalore city. Methods: In this experimental study, 247 children aged 4-6, were randomly divided into three groups. Considering “Brush Up” is a mobile application, parents of the children in Group 1 (n=82) downloaded the application on their smartphones. Children in Group 2 (n=83) and Group 3 (n=82) received tooth brushing instructions by an educative video and manual demonstration, respectively. Effectiveness of tooth brushing was assessed with plaque scores, which were recorded for all the groups at baseline and one month using Visible Biofilm Index. Results: Wilcoxon signed rank test showed a significant improvement in the tooth brushing behaviour for the Brush Up group, which was indicated by a lower plaque score after a follow-up of one month. Kruskal-Wallis test followed by post-hoc test showed that the mean ranks of plaque scores of Brush Up group are consistently lower than those of video demonstration group and manual demonstration group. Conclusions: The lower plaque score in subsequent follow-up in Brush Up group suggests that using a smart system can enhance learning a correct tooth brushing method in young children and can also help in implementing the required reinforcement and motivation to brush and aid in better plaque control.

Abstract: BACKGROUND: Narrow-band UVB (NB-UVB) has been shown to be one of the most effective treatment modalities for psoriasis. Tazarotene, a known effective anti-psoriatic modality, when combined with NB-UVB may enhance the therapeutic success. OBJECTIVE: To study clinical efficacy and safety of combination of NB-UVB with topical tazarotene 0.05% gel in psoriasis. METHOD: Thirty patients with plaque psoriasis having symmetrical lesions were enrolled for 12 weeks. All patients were instructed to apply tazarotene gel on target plaque on left side of body once daily. In addition, the whole body was irradiated with NB-UVB twice weekly. Efficacy was assessed by target plaque scoring and number of treatment sessions for clearance. RESULT: Our study resulted in 3 key findings: Firstly, therapeutic efficacy of NB-UVB was enhanced by addition of tazarotene. This enhanced efficacy was more apparent in decreasing scaling and thickness as compared to decrease in erythema. Secondly, combination therapy showed faster clearance of target plaques, with reduction in mean number of treatment sessions. Thirdly, mean cumulative NB-UVB dose needed to achieve clearance of target plaques was significantly reduced with combination therapy. STUDY LIMITATIONS: The study was not randomized or controlled, but an open-label trial. The study period was relatively short, i.e., 12 weeks, without any follow-up period. CONCLUSION: Tazarotene gel significantly enhances the therapeutic efficacy of NB-UVB irradiation with faster clearance and without serious side effects.

Abstract: Background: Narrow-band UVB is the most innovative steroid sparing treatment in atopic dermatitis. There are studies showing efficacy of Narrow-band UVB in childhood atopic dermatitis, but there is lack of clinical trials in the literature determining the length of remission. Therefore, we sought to highlight its efficacy, safety and its post-treatment efficacy in childhood atopic dermatitis. Objective: To assess the clinical efficacy, safety of Narrow-band UVB in the treatment of paediatric atopic dermatitis and length of remission during 2 years of post-treatment follow-up. Methods: Thirty children (4-14 years) having moderate to severe AD (SCORAD index > 25) were enrolled for 12 weeks. Narrow-band UVB phototherapy was administered twice a week on non-consecutive days for three months. SCORAD index was calculated by the same dermatologist at baseline, 6th, 12th, 18th and 24th treatment session. Secondary outcomes were measured using visual analog scale for pruritus and sleep loss. Patients were also followed-up for 2 years to know the length of remission after end of therapy. Results: There was a significant reduction in SCORAD index at 6th, 12th, 18th and 24th treatment session in comparison to baseline. This improvement in SCORAD was also maintained during the 2 years of post-treatment follow-up period. Consequently, pruritus and sleep loss improved significantly from baseline to end of therapy and even during the 1st and 2nd year of follow-up. Study limitation: Open-label trial without control group. Conclusions: Narrow-band UVB is an efficacious and safe modality of treatment in childhood atopic dermatitis with good therapeutic index and minimal side effects.

The research is grounded in responses of multicultural team members at multinational workplaces from 14 different countries that provided their preferences or choice of nationalities of members that they would like to hire/work with. Results show clear differences in ‘levels of comfort’ displayed by managers and members having particular national cultural background in what concerns their preferences and choices of colleagues with origins from other national cultures. These variations results into designation of rankings to the destination regions based on preference by the respondents from the source countries. Results also show a somewhat common pattern of preferences irrespective of their national origins that has been described.

In this paper, first we discuss the variants of the weakly commuting and compatible mappings in the context of coupled fixed point theory of fuzzy metric spaces. Secondly, we investigate the existence and uniqueness of the common fixed point for pairs of weakly compatible mappings satisfying a new contraction condition in the setup of fuzzy metric spaces with Had i type t-norm . Further, we talk about some results for the variants of weakly commuting and compatible mappings. At the end, as an application, we obtain metrical version of the discussed results.

Abstract: Dyshidrosiform pemphigoid is an acquired autoimmune variant of bullous pemphigoid with persistent vesicobullous eruptions localized on the palms or soles, or both. It generally occurs in the elderly and is rarely reported in childhood. Hereby, we describe the first case of dyshidrosiform pemphigoid in a 12-year-old child, which was limited to the dorsal hands and treated successfully with dapsone (diaminodiphenyl sulfone). Along with this report, we also review the clinical features of various types of dyshidrosiform pemphigoid.

BACKGROUND: CMAC videolaryngoscope has recently been introduced for videoscope guided intubation. The aim of our study was to compare and evaluate the efficacy of the conventional blade and the angulated D blade of the CMAC videolaryngoscope with the direct laryngoscopes in simulated cervical spine injury patients on the airway manikin. MATERIALS AND METHODS: Following power analysis, 33 resident doctors were enrolled to perform endotracheal intubation using all the 4 different laryngoscopes namely the Macintosh laryngoscope, McCoy laryngoscope, conventional CMAC videolaryngoscope and the D blade of the CMAC videolaryngoscopes on the airway manikin in simulated cervical spine injury. The demographic variables of the resident doctors were recorded. The outcomes measured included vocal cord visualization (Cormack-Lehane grading), time taken to intubate, number of attempts for successful intubation and optimizing maneuvers required. RESULTS: The use of indirect videolaryngoscopes resulted in better glottic visualization in comparison to the direct laryngoscopes (CL-I) in 20/33 (60.6%) in the Macintosh group, 24/33 (72.7%) in McCoy group, 30/33 in (90.9%) in Vlc group and 32/33 (96.9%) in Vld group. The time taken to intubate averaged to 15.54 ± 2.6 in Macintosh group, 18.90 ± 4.47 in McCoy group, 20.21 ± 7.9 in Vlc group and 27.42 ± 9.09 in Vld group. The 1st attempt intubation success rate was 84.8% (Macintosh), 72.7% (McCoy), 90.9% (Vlc) and, 78.7% (Vld). CONCLUSIONS: The overall performance of the conventional CMAC blade proved to be the best when compared with the D-blade CMAC, Macintosh blade and the McCoy blade for intubation in simulated cervical spine patients by anesthesia residents.

OBJECTIVE: The aim of this cross sectional study was to assess serum insulin-like growth factor-1 (IGF-1) levels in female and male subjects at various cervical vertebral maturation (CVM) stages. MATERIAL AND METHODS: The study sample consisted of 60 subjects, 30 females and 30 males, in the age range of 8-23 years. For all subjects, serum IGF-1 level was estimated from blood samples by means of chemiluminescence immunoassay (CLIA). CVM was assessed on lateral cephalograms using the method described by Baccetti. Serum IGF-1 level and cervical staging data of 30 female subjects were included and taken from records of a previous study. Data were analyzed by Kruska-Wallis and Mann Whitney test. Bonferroni correction was carried out and alpha value was set at 0.003. RESULTS: Peak value of serum IGF-1 was observed in cervical stages CS3 in females and CS4 in males. Differences between males and females were observed in mean values of IGF-1 at stages CS3, 4 and 5. The highest mean IGF-1 levels in males was observed in CS4 followed by CS5 and third highest in CS3; whereas in females the highest mean IGF-1 levelswas observed in CS3 followed by CS4 and third highest in CS5. Trends of IGF-1 in relation to the cervical stages also differed between males and females. The greatest mean serum IGF-1 value for both sexes was comparable, for females (397 ng/ml) values were slightly higher than in males (394.8 ng/ml). CONCLUSIONS: Males and females showed differences in IGF-1 trends and levels at different cervical stages.

Amyloidosis results from proteins being deposited as insoluble β-pleated sheets and disrupting organ function. Each precursor protein induces a separate spectrum of organ involvement, and different disease manifestations within the lung. Although autopsy findings often demonstrate amyloid deposits in various compartments of the lung, few are manifested pathologically. Amyloid lung nodules with positron emission tomography (PET) uptake are rare. We describe a rare case where PET uptake was detected in a pulmonary amyloid nodule. To our knowledge there are six previously reported cases in the English literature.This review also focuses on amyloid derived from immunoglobulin light-chain protein (AL disease), which most frequently involves the lung in both systemic and localized forms of the disease. Manifestations of AL-related lung disease range from nodules identified on incidental chest films to diffuse alveolar and septal deposition mimicking malignancy and or diffuse alveolar damage. Resumo: A amiloidose é causada por proteínas depositadas como lâminas β insolúveis e que interferem com o funcionamento dos órgãos. Cada proteína precursora induz um espectro diferenciado de envolvimento dos órgãos, e diferentes manifestações de doença no pulmão. Apesar dos achados de autópsias revelarem frequentemente depósitos de amilóide em vários compartimentos do pulmão, poucos se manifestam patologicamente. A captação de nódulos de amilóide do pulmão na tomografia de emissão de positrões (PET) é rara. Descrevemos um caso raro em que foram detectados nódulos de amiloidose pulmonar através do PET. Que seja do nosso conhecimento, existem seis casos registados anteriormente na literatura Inglesa.Esta análise também se centra na amiloidose derivada da proteína de cadeia leve de imunoglobulina (doença de AL â Amiloidose primária), que frequentemente envolve o pulmão tanto em formas localizadas como sistémicas da doença. As manifestações da doença pulmonar relacionadas com a AL variam desde nódulos identificados em incidências de raio-X do tórax até à deposição septal, simulando malignidade, e/ou em danos difusos alveolares. Keywords: Amyloidosis, Nodular, Local, PET scan, Tracheobronchial amyloidosis, Lung diseases, Palavras-chave: Amiloidose, Nodular, Local, Tomografia de emissão positrónica (TEP), Amiloidose traqueobrônquica, Doenças pulmonares

FUNDAMENTO: Diferenças entre regiões geográficas em relação à características de pacientes e desfechos, particularmente em síndromes coronarianas agudas, tem sido demonstradas em testes clínicos. Os desfechos clínicos após intervenções coronarianas percutâneas com o stent eluidor de Zotarolimus em uma população real foram analisados com o tempo. OBJETIVO: A influência da localização geográfica sobre os desfechos clínicos com o stent eluidor de Zotarolimus foi avaliada em três regiões: Pacífico Asiático, Europa e América Latina. MÉTODOS: Um total de 8.314 pacientes (6.572 da Europa, 1.522 do Pacífico Asiático e 220 da América Latina) foram acompanhados por 1 ano; 2.116 desses (1.613, 316, e 187, respectivamente) foram acompanhados por 2 anos. Características dos pacientes e lesões, terapia antiplaquetária dupla e desfechos clínicos foram comparados entre a América Latina e as outras duas regiões. RESULTADOS: Os pacientes da América Latina apresentavam a maior proporção de fatores de risco e infarto do miocárdio prévio. O uso da terapia antiplaquetária dupla declinou rapidamente na América Latina, de 44,9% em 6 meses para 22,5% em 1 ano e 7,8% em 2 anos (Europa: 87,4%, 61,5%, 19,7%; Pacífico Asiático: 82,4%, 67,0%, 45,7%, respectivamente). Não houve diferenças significantes entre a América Latina e a Europa ou Pacífico Asiático para qualquer desfecho em qualquer ponto do tempo. A incidência de trombose de stent provável e definitiva pelo Academic Research Consortium foi baixa (FUNDAMENTO: Las diferencias entre las regiones geográficas en relación con las características de pacientes y desenlaces, sobre todo en los síndromes coronarios agudos se ha demostrado en ensayos clínicos. Los desenlaces clínicos después de las intervenciones coronarias percutáneas con stent liberador de zotarolimus en una población real se analizaron a través del tiempo. Objetivos: La influencia de la ubicación geográfica sobre los desenlaces clínicos con el stent liberador de zotarolimus se evaluó en tres regiones: Pacífico Asiático, Europa y América Latina. MÉTODOS: A total of 8,314 patients (6.572 Europe, 1.522 Asia Pacific, and 220 Latin America) were followed for 1 year; 2.116 of these (1.613, 316, and 187, respectively) were followed for 2 years. Patient and lesion characteristics, dual antiplatelet therapy, and clinical outcomes were compared between Latin America and the other regions. RESULTADOS: Los pacientes en América Latina tuvieron la mayor proporción de factores de riesgo e infarto de miocardio previo. Hubo un rápido descenso en el uso de la terapia antiplaquetaria en América Latina, el 44,9% en 6 meses para 22,5% en 1 año y 7,8% en 2 años (Europa: un 87,4%, un 61,5%, un 19,7%; Pacífico Asiático: un 82,4%, un 67,0%, un 45,7%, respectivamente). No hubo diferencias significativas entre América Latina y Europa o Pacífico Asiático para cualquier desenlace en cualquier momento. La incidencia de trombosis de stent probable y definitiva por el Academic Research Consortium fue baja (< 1,2%) entre todos los pacientes en 1 año y 2 años. CONCLUSIONES: Los desenlaces clínicos fueron comparables entre los pacientes de América Latina y Europa, y América Latina y Pacífico Asiático, pese a los subgrupos clínicos menos favorables en América Latina, perfil de riesgo más elevado y menor uso acentuado de terapia antiplaquetaria doble con el tiempo. (Arq Bras Cardiol 2011;96(5):353-362)BACKGROUND: Differences between geographic regions in patient characteristics and outcomes, particularly for acute coronary syndromes, have been demonstrated in clinical trials. Clinical outcomes after percutaneous coronary interventions with the Zotarolimus-eluting stent in a real-world population were assessed over time. OBJECTIVE: The influence of geographic location on clinical outcomes with the Zotarolimus-eluting stent was assessed in 3 regions: Asia Pacific, Europe, and Latin America. METHODS: A total of 8,314 patients (6,572 Europe, 1,522 Asia Pacific, and 220 Latin America) were followed for 1 year; 2,116 of these (1,613, 316, and 187, respectively) were followed for 2 years. Patient and lesion characteristics, dual antiplatelet therapy, and clinical outcomes were compared between Latin America and the other regions. RESULTS: Patients in Latin America had the highest proportions of risk factors and prior myocardial infarction. Dual antiplatelet therapy usage rapidly declined in Latin America, from 44.9% at 6 months to 22.5% at 1 year and 7.8% at 2 years (Europe: 87.4%, 61.5%, 19.7%; Asia Pacific: 82.4%, 67.0%, 45.7%). There were no significant differences between Latin America and Europe or Asia Pacific for any outcome at either time point. The incidence of Academic Research Consortium definite and probable stent thrombosis was low (

ABSTRACT Langerhans cell histiocytosis (LCH) is characterised by an abnormal histiocytic accumulation in tissues such as the lung, spleen, bone marrow, skin, central nervous system, liver and lymph nodes, causing focal or systemic effects. No specific clinical & radiographic presentation of LCH is described in literature. This poses a diagnostic dilemma for surgeons. The scapula is the site of 3% of bone tumours, while for LCH it is the least common site. In a 10-year-old boy with isolated lesion of the scapula with no other systemic involvement, and no specific finding in MRI or CT scan of scapula, diagnosis was confirmed on biopsy. Division into single and multi-system disease is paramount in treatment, given that it is a single system disease. The patient improved clinically on follow-up of 2 years. The scapula is one of the rarest site of LCH, and because various lesions mimic each other, a biopsy is always required, with immunohistochemistry for CD68 & S-100. This was only a single system disease, so conservative management was performed, and the patent improved clinically.

Abstract The pollen collected by eusocial bees is often reported as being healthy food due to its important nutritional and therapeutic properties. However, studies reporting such properties are rare, especially for pollen collected by the genus Melipona in northeastern Brazil, which is the focus of this research. Pollen from seven species of stingless bees was analysed for its nutritional composition (sugar, lipid, protein and amino acids). The phenolic compound profile was described based on fourteen phenolic compounds (apigenin, kaempferol, luteolin, naringin, rutin, gallic acid, ferulic acid, caffeic acid, p-coumaric acid, chlorogenic acid, abscisic acid, protocatechuic acid, vanillic acid and trans-cinnamic acid). The antioxidant property was analysed by quantifying of total phenolic compounds, total flavonoids and DPPH. Chromatographic methods were used to identify and quantify the phenolic compounds and amino acids. The pollen samples from the bees under study showed good concentrations of proteins and amino acids and good antioxidant potential. The phenolic compounds luteolin, trans-cinnamic acid and apigenin were identified and described in pollen for the first time. Of the amino acids analysed, asparigine, glutamic acid, leucine and proline showed the highest concentrations. The research related to the theme showed that this is one of the first studies to identify and quantify the phenolic compounds and amino acids in stingless bee pollen, reflecting its importance in therapeutic use and as a food supplement.