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Prophylactic trimethoprim/sulfamethoxazole (TMP/SMX) prevents Pneumocystis jirovecii pneumonia and nocardiosis in immunocompromised patients but sometimes is avoided because of purported allergies or side effects. Of 25 immunocompromised patients receiving alternative prophylaxis in whom nocardiosis developed, 16 subsequently tolerated TMP/SMX treatment. Clinicians should consider TMP/SMX allergy evaluation and rechallenging to assess patient tolerance.

Background and Aims: Molecular analysis is gold standard for diagnosis of synovial sarcoma (SS) but use of these ancillary techniques is limited by many practical issues like cost and limited resources. Several studies analyzed TLE1 as a diagnostic immunohistochemical marker for synovial sarcoma and few studies disagreed. The objective of the study was to evaluate immunohistochemical expression of TLE1 in synovial sarcoma and its histological mimics. Methods: The study included a total of 63 cases; of which 28 were synovial sarcomas (SS) and 35 its histologic mimics. A tissue microarray was constructed from these cases and subjected to TLE immunostaining. Nuclear immunoreactivity of TLE1 was graded as 0, 1+, 2+ and 3+ based on intensity and percentage of cells. Results: All SS except one (27/28; 96.4%) were positive for TLE 1. These included 18 of monophasic spindle cell type (94.7%), 5 biphasic type (100%), followed by two each (100%) of poorly differentiated and calcifying type of SS. Of the other tumours 2 GISTs (50%), 2 haemangiopericytoma (66.7%), 2 schwannomas (50%) and one mesenchymal chondrosarcoma (33.3%) were positive for TLE1. Conclusion: TLE 1 is a highly sensitive marker with reasonable specificity for synovial sarcoma. Awareness of TLE1 expression in other tumours, is important to avoid misdiagnosis.

Sn@Pt core-shell nanocatalysts, supported on Vulcan XC-72 and home-developed nitrogen-doped graphene (Sn@Pt/C and Sn@Pt/NG, respectively), were evaluated for the hydrogen oxidation reaction (HOR) in acid electrolyte. The nanocatalysts were synthesized by the bromide anion exchange (BAE) method. TEM characterization confirmed the nanosize nature of Sn@Pt/C and Sn@Pt/NG, with an average particle size of 2.1 and 2.3 nm, respectively. Sn@Pt/C delivered a similar mass limiting current density (jl, m) of the HOR compared to Sn@Pt/NG, which was higher than those of Pt/C and Pt/NG (ca. 2 and 2.3-fold increase, respectively). Moreover, the Sn@Pt/C and Sn@Pt/NG core-shell nanocatalysts demonstrated a higher specific activity related to Pt/C and Pt/NG. Mass and specific Tafel slopes further demonstrated the improved catalytic activity of Sn@Pt/C for the HOR, followed by Sn@Pt/NG. The application of the nanocatalysts was proposed for polymer electrolyte membrane fuel cells (PEMFC).

Trimethoprim/sulfamethoxazole (TMP/SMX) is the drug of choice for Pneumocystis jirovecii pneumonia (PJP) prophylaxis in immunocompromised patients (1). Second-line prophylactic agents include atovaquone, dapsone, pentamidine, and clindamycin with pyrimethamine. Alternative agents [...]

Hepatoid adenocarcinoma is a rare Alpha Fetoprotein (AFP) producing extrahepatic malignant tumour commonly seen in the stomach but can also arise from the ovary, endometrium lung. It is a rare type of adenocarcinoma with hepatocyte like histological differentiation and occurs outside the liver. In the lung, it is often presented as a bulky tumour, highly malignant, and associated with a poor prognosis. Early diagnosis and appropriate treatment options can result in long term survival. Here, authors reported a case of 58-year-old male patient, with no history of smoking presented as an Unknown Primary (UKP) with cervical and mediastinal lymphadenopathy which was later diagnosed histopathologically and confirmed by Immunohistochemistry (IHC) as Hepatoid Adenocarcinoma Lung (HAL) without any lesion in the lung on Computed Tomography (CT) chest. The serum AFP levels were normal. It expressed IHC markers Cytokeratin (CK7), CDX-2, Hep Par1 positivity, Thyroid Transcription Factor 1 (TTF-1) cytoplasmic positivity, and abnormally raised serum Carcinoembryonic Antigen (CEA). The patient was treated with definitive lower neck and mediastinal irradiation followed by adjuvant chemotherapy with five cycles of three weekly pemetrexed and carboplatin. Post treatment the serum CEA levels are decreasing and attained clinically complete response. The patient was in a close follow-up. To date, the review of literature about HAL didn’t showed any case presented as UKP with neck nodes without any lesion in the lung. The purpose of this case report was to present a new case of HAL with nodal metastasis, its unique histological findings, and its approach to diagnosis and treatment.

The 2004-tsunami affected the South Andaman coast experiencing dynamic changes in the coastal geomorphology making the region vulnerable. We focus on pre-and post-tsunami shoreline and Land Use Land Cover changes for the period 2004, 2005, and 2022 to analyse the dynamic change in hazard. We used GEBCO bathymetry data to calculate Run-up (m), arrival times (Min), and inundation (m) at 13 different locations using the 2004 Sumatra Earthquake source parameters. The Digital Shoreline Analysis System is used for the shoreline change estimates. The Landsat data is used to calculate shoreline and LULC change in five classes, namely Built-Up Areas, Forests, Inundation areas, Croplands, and water bodies during the above period. We examine the correlation between the LULC changes and the dynamic change in shoreline due to population flux, infrastructural growth, and Gross State Domestic Product growth. India industry estimates the Andaman & Nicobar Islands losses exceed INR 10 billion during 2004 that would see a five-fold increase in economic loss due to a doubling of built-up area, a three-fold increase in tourist inflow, and a population density growth. The unsustainable decline in the forest cover, mangroves, and cropland would affect sustainability during a disaster despite coastal safety measures. [ABSTRACT FROM AUTHOR]

Objective Identifying the factors responsible for the delay in the diagnosis of tuberculosis (TB). Patients and methods In this retrospective study, data on pulmonary and extrapulmonary forms of TB, registered for the treatment at the directly observed treatment, short course, centre were analysed. Results Of 163 patients, 34 (20.86%) were diagnosed at the first visit. The delay in seeking medical care ranged from 0 to 25 days from the diagnosis. A total of 110 (67%) patients started on the same day or the day after diagnosis, less than 1 month in 33 (20.25%) and 1–3 months in 83 (51%). Delay from patient and health services (both combined) ranged from half a month to 48 months; the mean±SD diagnostic delay was 4.09±4.19 days (range: 0–24 days), whereas the mean±SD treatment delay (n=162) was 2.19±3.89 days. of the 124 patients who received medical help, 90% of them did so within six months of onset of Symptoms. There was a statistically significant difference in patients’ delay in receiving the treatment/medical care by sex. Mean±SD delay for pulmonary and extrapulmonary TB was 48±24 and 240±386 days, respectively. Conclusion Delay in diagnosis is a preventable factor. Patient delay is longer compared with healthcare delays. Active surveillance, even in the urban areas by healthworkers, may help in reducing this delay.

Aims and Objectives: The aim of the study is to assess the knowledge, attitude, and practice regarding eye donation in patients attending outpatient department of a tertiary care hospital. Materials and Methods: The data were collected by the questionnaire method from 500 patients waiting in outpatient department of ophthalmology. The questionnaire included questions pertaining to demographic profile, literacy, occupation, awareness about eye donation, willingness to donate, reasons for not pledging, and the sources of information. Results: Percentage of awareness of eye donation was equal in males and females. Significantly less awareness of eye donation was found in illiterate individuals (P < 0.0001) and Muslims (P < 0.0001). 66.6% participants were aware of eye donation and eye camps were the major source of information. 51.50% were willing to pledge their eyes. Lack of awareness was the major reason for not willing to pledge in 32.91% participants. Chi-square analysis between “awareness” and “willingness” groups showed that age group, gender, residency, and occupations were independent factors contributing to willingness to donate, while religion and education showed significant association between awareness and willingness (P < 0.05). Participants who were initially not aware about eye donation (33.6%), after being counseled showed positive responses of willingness to pledge. Conclusion: The data showed that most of the people were aware about eye donation and were willing to donate their eyes; however, the attitude and practice showed mixed responses. Participants had misconceptions about eye donation. Therefore, to reduce the burden of avoidable corneal blindness effective measures should be taken by ophthalmologists, physicians, and especially religious leaders to educate and motivate people for eye donation.

Introduction: Paediatric brain tumours are the most common solid tumours in developing countries, leading to cancer related mortality in children globally. Enough data are available regarding the epidemiology of paediatric brain tumours in the western population. But limited data is available in India as only a few cases were reported. Aim: To evaluate the epidemiologic, clinicopathologic and histologic spectrum of paediatric brain and spinal cord tumours in a tertiary care referral centre of Southern India. Materials and Methods: This study was a retrospective, observational study which was undertaken at the Department of Pathology, Sri Venkateswara Institute of Medical Sciences, Tirupati, Andhra Pradesh, India. It’s a 25 years study from January 1993 to December 2017. Data were collected regarding the frequencies of primary brain and spinal cord tumours (diagnosed according to World Health Organisation (WHO) classification) in total of 151 paediatric patients (comprised of all children

Background: Trichomonas vaginalis (TV) is one of the most common pathogens causing sexually transmitted infections (STIs) in both men and women. Since there are no accurate prevalence data available on TV infection among women for Trinidad and Tobago and in the Caribbean region, there is a great need for research to study the dynamics of the infection and its transmission. Objectives: To determine the prevalence and diagnose TV infection in women attending the STI clinic and to provide recommendations for control and prevention of trichomoniasis in the community. Study Design: A cross-sectional study was designed after obtaining the informed consent. Following a routine clinical examination, vaginal swabs were collected – one for wet mount preparation, one for InPouch culture, and other two for OSOM rapid test/and fluorescent antibody testing. Cotton swabs and Dacron swabs were used for testing. Results: A prevalence of 16% of trichomoniasis out of 422 females was recorded. In all, 65 (65%) were in the age range of 15–29 years and peak of 30% in the age group of 20–24 years. Vaginal discharge was a common complaint (83%); 75.6% had foul odor and only 9.8% had typical fishy odor. The majority of them (87%) had whitish-yellow colored discharge. Conclusion: Prevalence of trichomoniasis is significant in the female population attending STI clinic. Targeting high-risk age group between 15 and 29 years for control and prevention would be beneficial. Prompt and accurate diagnosis using appropriate laboratory test is recommended.

Herein we report an innovative and reliable synthesis route to form layered V2O3–Al2O3 nanocomposite, where two separate reactions can be made to occur in a chain that leads to nanocomposite formation. The Al2O3 is helps in tackling the stability of V2O3 and ion transfer issues that usually metal oxides encounter. The formation of layered structures and lattice strain-induced V2O3–Al2O3 nanocomposite plays a major role in enhancing electrochemical performances. Also, the cyclic stability shows an significant increase with 84% capacitive retention even after 2500 cycles. The prepared layered V2O3–Al2O3 nanocomposite showcases exceptional specific capacitance values even at high scan rates (304 Fg−1 at 100 mV), and fast charge capacity, providing it with an edge over other materials to find applications in high-power utilities. [ABSTRACT FROM AUTHOR]

In this paper, we present fractional differential transform method (FDTM) and modified fractional differential transform method (MFDTM) for the solution of time fractional Black-Scholes European option pricing equation. The method finds the solution without any discretization, transformation, or restrictive assumptions with the use of appropriate initial or boundary conditions. The efficiency and exactitude of the proposed methods are tested by means of three examples.