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Urothelial carcinoma and nephrolithiasis are a common cause of obstructive uropathy which can be relieved by percutaneous nephrostomy catheter placement. A rare, but known complication of this procedure is iatrogenic seeding of tumor cells along the nephrostomy tract. We describe a case of 68-year-old-female with cutaneous metastasis of high-grade urothelial carcinoma with seeding of tumor cells along the percutaneous nephrostomy catheter tract 8 months after the removal of the catheter. Given its severity, interventional radiologists should be mindful of the number of percutaneous access attempts, exchanges, and catheter manipulations in patients with urothelial carcinoma due to the risk of metastatic seeding along the percutaneous tract or to nearby tissues.

Main intention of the research is to understand about significance of techniques associated with HTO. This research reviewed the techniques of high tibial osteotomy namely high tibial osteotomy, open wedge high tibial osteotomy, closedhigh tibial osteotomy. Patients who are suffering from knee arthritis, high tibial osteotomy assists to prevent or delay the requirement for total or partial replacement of knee to preserve damaged tissue of joint. High tibial osteotomy technique is mainly suitable for active and young patients with knee osteoarthritis. Age plays a main factor in success rate of high tibial osteotomy technique. It could be done in open wedge or closed wedge high tibial osteotomy. For some cases, surgery could be done in combined method (open wedge and closed wedge high tibial osteotomy). When compared with clinical outcomes of closed wedge high tibial osteotomy and open wedge high tibial osteotomy, open wedge high tibial osteotomy performs well in reducing the pain, duration of weight-bearing and return to normal life as soon as possible.

Resistance to antibiotics in microbes is of serious concern to human health. Antibiotic resistance bacteria and genes are naturally present in pristine environment since ages. Animal feedlot wash, farm and agricultural wastewater, municipal wastewater, excessive production and illegal disposal of antibiotic drugs further aid to prevalence and development of antimicrobial resistance in the water environment. Resistance can be transferred to non-resistance strains through horizontal gene transfer and can directly or indirectly impact human health. In this scenario, much advancement in water treatment technologies has emerged to address the issue. However, a great deal of knowledge of different pathogenic microbes, their resistance mechanism and spread in environmental compartments and effect on health is lacking. Therefore, detailed study needs to be conducted to estimate potential risk and water treatment plants and effluent discharge should be designed and monitored meticulously.

We studied the clinical and epidemiologic features of an outbreak of Crimean-Congo hemorrhagic fever in Herat Province, Afghanistan. The study comprised 63 patients hospitalized in 2017. The overall case-fatality rate was 22.2%; fatal outcome was significantly associated with a negative IgM test result, longer prothrombin time, and nausea.

Groundwater is the major source of water for domestic purposes in Amingaon, North Guwahati, Assam which is contaminated with high concentrations of iron and fluoride. The household-level treatment for iron removal includes the use of indigenously fabricated water filter units comprising sand, gravel, and wooden charcoal. The filter media are arranged in layered form in RCC rings, tin containers, and plastic buckets. The RCC filter unit is the most commonly used, especially for iron removal. However, the contamination level of groundwater of Amingaon and the effectiveness of indigenously fabricated household filter units in iron and fluoride removal is neither estimated/evaluated by government agencies nor reported in the literature. The present study aims to investigate the level of contamination of groundwater for iron and fluoride as well as efficiency and effectiveness of an RCC filter unit in the removal of iron and fluoride over a period of 6 months. The groundwater in and around the IIT Guwahati campus has a high concentration of iron (0–11.3 mg/L) whereas the concentration of fluoride is in the range 0.13–0.66 mg/L. A set of two samples, one from the tube well and the other from the filtered water, was collected at an interval of 3 days from a selected household RCC filter. Water quality parameters, viz., iron, fluoride, pH, temperature, conductivity, turbidity, and dissolved oxygen were estimated for the collected samples of each set. The selected RCC filter unit is able to produce filtered water containing residual iron concentration of 0–0.08 mg/L from an initial iron concentration of 8.13–11.63 mg/L. The selected filter unit is also able to reduce the fluoride concentration from a value of 0.51–1.17 mg/L to 0.39–0.77 mg/L. The DO level in the groundwater increases as the same is poured into the filter unit thereby converting ferrous iron to ferric form. The ferric form of iron is filtered out as precipitate in the filter unit.

The hepatoprotective activity of flavonoid rhamnocitrin 4'-β-D-galactopyranoside (RGP) obtained from leaves of Astragalus hamosus L. against N-diethylnitrosamine (DENA)-induced hepatic cancer in Wistar albino rats was evaluated. Hepatic cancer in rats was induced by single-dose intraperitoneal administration of DENA (200 mg/kg). Induction of hepatic cancer was confirmed after 7 days of DENA administration by measurement of elevated level of serum α-feto protein (AFP). Administration of DENA in a single dose lofted the levels of serum biochemical parameters like alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase, total bilirubin, total protein and AFP. Antioxidant enzymes like superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GPx), glutathione-S-transferase (GST) and lipid per oxidation (LPO) were annealed significantly by administration of RGP in a dose-dependant manner. The histopathological examination of rat liver section was found to reinforce the biochemical observations significantly. It was observed that a substantial and dose-dependent reversal of DENA-diminished activity of antioxidant enzymes like SOD, CAT, GPx, GST and the reduced DENA-elevated level of LPO with a marked change. Any elevation in the levels of serum markers along with suppression of free radical formation by scavenging the hydroxyl radicals is significantly prevented by RGP. It also modulates the levels of LPO and perceptibly increases the endogenous antioxidant enzymes level in DENA-induced hepatocellular carcinogenesis. The findings suggest that RGP prevents hepatocellular carcinoma by suppressing the marked increase in the levels of serum marker enzymes, and suppresses the free radical by scavenging hydroxyl radicals.

Cellulose degrading Bacillus spp. (AS1, AS2, and AS3) were isolated from cow dung and identified phylogenetically by 16S ribosomal RNA (16S rRNA) sequence analysis. Bacillus sp. AS1 showed 99% homology with Bacillus megaterium whereas, Bacillus sp. AS2 and AS3 were similar to B. subtilis. The activity of extracellular carboxymethyl cellulase in presence of 1% carboxymethyl cellulose at 50°C was 0.04 U/mL for Bacillus sp. AS1 and 0.06 U/mL for Bacillus sp. AS2 at pH 7.0, whereas higher activity of 0.08 U/mL was observed for Bacillus sp. AS3 at pH 9.0. Crude cellulase from all the three Bacillus sp. were stable over a wide range of pH (5.0–9.0) and thermally stable up to 60°C. Carboxymethyl cellulase, filter paperase, and β-glucosidase activity of Bacillus sp. AS3 was 0.07, 0.02, and 0.04 U/ml, respectively. Degradation of leaf litter biomass treated by Bacillus sp. AS3 showed 47% drop in carbon:nitrogen (C:N) ratio and x-ray diffractograph revealed decline in crystalline structure. © 2012 American Institute of Chemical Engineers Environ Prog, 32: 1195–1201, 2013

Introduction: Enteric fever remains a major public health problem in Asia. Planning appropriate preventive measures such as immunization requires a clear understanding of disease burden. We conducted a community-based surveillance for Salmonella Typhi infection in children in Karachi, Pakistan. Methodology: A de jure household census was conducted at baseline in the study setting to enumerate all individuals. A health-care facility-based passive surveillance system was used to capture episodes of fever lasting three or more 3 days in children 2 to 16 years old. Results: A total of 7,401 blood samples were collected for microbiological confirmation, out of which 189 S. Typhi and 32 S. Paratyphi A isolates were identified with estimated annual incidences of 451/100,000 (95% CI: 446 – 457) and 76/100,000 (95% CI: 74 – 78) respectively. At the time of presentation, after adjusting for age, there was an association between the duration of fever and temperature at presentation, and being infected with multidrug-resistant S. Typhi. Of 189 isolates 83 were found to be resistant to first-line antimicrobial therapy. There was no statistically significant difference in clinical presentation of blood culture sensitive and resistant S. Typhi isolates. Conclusion: Incidence of S. Typhi in children is high in urban squatter settlements of Karachi, Pakistan. Findings from this study identified duration of fever and temperature at the time of presentation as important symptoms associated with blood culture-confirmed typhoid fever. Preventive strategies such as immunization and improvements in water and sanitation conditions should be the focus of typhoid control in urban settlements of Pakistan.

Objective To determine the safety and logistic feasibility of a mass immunization strategy outside the local immunization program in the pediatric population of urban squatter settlements in Karachi, Pakistan. Methods A cluster-randomized double blind preventive trial was launched in August 2003 in 60 geographic clusters covering 21,059 children ages 2 to 16 years. After consent was obtained from parents or guardians, eligible children were immunized parenterally at vaccination posts in each cluster with Vi polysaccharide or hepatitis A vaccine. Safety, logistics, and standards were monitored and documented. Results The vaccine coverage of the population was 74% and was higher in those under age 10 years. No life-threatening serious adverse events were reported. Adverse events occurred in less than 1% of all vaccine recipients and the main reactions reported were fever and local pain. The proportion of adverse events in Vi polysaccharide and hepatitis A recipients will not be known until the end of the trial when the code is broken. Throughout the vaccination campaign safe injection practices were maintained and the cold chain was not interrupted. Mass vaccination in slums had good acceptance. Because populations in such areas are highly mobile, settlement conditions could affect coverage. Systemic reactions were uncommon and local reactions were mild and transient. Close community involvement was pivotal for information dissemination and immunization coverage. Conclusion This vaccine strategy described together with other information that will soon be available in the area (cost/effectiveness, vaccine delivery costs, etc) will make typhoid fever control become a reality in the near future.