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Three cases of duodenal tuberculosis are presented. All had features of gastric outlet obstruction. Histopathological diagnosis of tuberculosis was obtained in two cases following endoscopic biopsy. Duodenal tuberculosis should be considered in patients presenting with gastric outlet obstruction, especially in areas where tuberculosis is endemic., INTRODUCTION Gastrointestinal tuberculosis is an important health problem in developing countries. However, with the advent of the acquired immune deficiency syndrome, its incidence in the developed countries is also on [...]

We give a short and direct proof of Getzler and Pandharipande's λg-conjecture. The approach is through the Ekedahl-Lando-Shapiro-Vainshtein theorem, which establishes the “polynomiality” of Hurwitz numbers, from which we pick off the lowest degree terms. The proof is independent of Gromov-Witten theory. We briefly describe the philosophy behind our general approach to intersection numbers and how it may be extended to other intersection number conjectures. Ideas from this paper feature in two independent recent enlightening proofs of Witten's conjecture by Kazarian [Adv. Math.] and Chen, Li, and Liu [Asian J. Math. 12: 511–518, 2009]. [ABSTRACT FROM AUTHOR]

Background: Oral Gastrografin® has been used to differentiate partial from complete small bowel obstruction. It may also have a therapeutic effect and predict the need for early surgery in adhesive intestinal obstruction. Aim: To assess the accuracy of Gastrografin® contrast in predicting the necessity of operative intervention in patients with adhesive intestinal obstruction and to decide on optimum period of observation in patients with adhesive intestinal obstruction. Materials and Methods: This prospective randomized controlled trial was performed on 32 patients with adhesive intestinal obstruction admitted in the Department of Surgery of a tertiary hospital. All patients were diagnosed with adhesive intestinal obstruction and were randomized into two groups, a Control group and a Gastrografin® group. Patients in the control group were treated conservatively. If symptoms of strangulation developed or if the obstruction did not resolve spontaneously after 48 hours of admission, a laparotomy was performed. Patients in the Gastrografin® group received 60 ml of Gastrografin® mixed with 40 ml of distilled water after two hours of gastric tube aspiration following admission. Those in whom the contrast medium reached the colon in 22 hours were considered to have partial intestinal obstruction and were fed orally. Any patient who did not tolerate feeds was surgically explored for persistent obstruction. All patients in whom Gastrografin® failed to empty into the ceacum within 22 hours of administration, were operated. Findings were analyzed by standard statistical tests. Qualitative data was analyzed by either Chi-square or Fisher Exact test. For the quantitative data, the means were compared by ANOVA-F test in the case of four groups whereas for two groups it was compared by using student's t test. Results: Oral Gastrografin® contrast study is safe and can facilitate the prediction of the necessity of early operative intervention compared to a plain radiograph. Oral Gastrografin® study was found to have an overall accuracy of 82.35% in predicting the need for operative intervention in patients with adhesive small bowel obstruction. Also it was seen that it was sufficient to study the patients for 18 hours after administration of oral Gastrografin rather than 24 hours. Conclusion: Oral Gastrografin® helps in the management of patients with adhesive intestinal obstruction. [ABSTRACT FROM AUTHOR]

Background: Superior mesenteric artery syndrome is a rare condition that has only around 400 reported cases so far. Typically, the superior mesenteric artery branches off the abdominal aorta at 45° to create an aortomesenteric distance of 10-28 mm, with the duodenum passing through. However, if this aortomesenteric angle reduces to less than 25°, the third portion of the duodenum becomes compressed between the SMA and aorta, causing mechanical obstruction., Case Presentation: This case report aims to demonstrate the diagnostic difficulties and the laparoscopic management of a 52-year-old Indian male presenting with abdominal pain and vomiting, with associated weight loss. Imaging was further suggestive of high intestinal obstruction, and he was later found to have superior mesenteric artery syndrome., Conclusion: Taking into account a significant reduction in morbidity, we propose laparoscopic duodenojejunostomy to be the new procedure of choice for superior mesenteric artery syndrome., (© 2024. The Author(s).)

Self-weighing is an evidence-based weight management strategy, which requires patients to have a home scale. For clinicians to effectively counsel patients on self-weighing, they should be aware of the costs and features available in typical home scales. Our objective was to describe the cost and features of the top bathroom scales available online. We performed content analysis of top 100 scales listed on a popular online retailer. Two coders independently extracted price and scale features (i.e., digital connectivity, body mass index [BMI] calculation, maximum weight accommodated). We used t-tests and ANOVA, as appropriate, to examine the relationships between price and features. Among the 97 scales included, mean scale price was $28.99 (SD $21.06; range $7.20-$139.95). Of the advanced features, 20.6% of scales had digital connectivity and 28.9% calculated BMI. Scales with advanced features cost significantly more than scales without (digital connectivity: $49.18 vs. $23.74, P < 0.001; BMI calculation: $42.92 vs. $23.33, P < 0.001). Most scales (76.2%) had a maximum weight of 351-400 lbs, and only 17.5% could accommodate >400 lbs. Price was higher for scales with a higher maximum weight (P = 0.002). No scale with maximum weight > 500 lbs had advanced features. Scales that have digital connectivity for telemedicine or can accommodate higher weights are less commonly available online and their costs may be prohibitive for some patients who need these features. Future research might consider testing whether insurance coverage for scales improves scale access and patient weight management outcomes., (© 2021 The Authors. Clinical Obesity published by John Wiley & Sons Ltd on behalf of World Obesity Federation.)

Preparation of amorphous solid dispersions using hot-melt extrusion process for poorly water soluble compounds which degrade on melting remains a challenge due to exposure to high temperatures. The aim of this study was to develop a physically and chemically stable amorphous solid dispersion of a poorly water-soluble compound, NVS981, which is highly thermal sensitive and degrades upon melting at 165 °C. Hydroxypropyl Methyl Cellulose (HPMC) based polymers; HPMC 3cps, HPMC phthalate (HPMCP) and HPMC acetyl succinate (HPMCAS) were selected as carriers to prepare solid dispersions using hot melt extrusion because of their relatively low glass transition temperatures. The solid dispersions were compared for their ease of manufacturing, physical stability such as recrystallization potential, phase separation, molecular mobility and enhancement of drug dissolution. Two different drug loads of 20 and 50% (w/w) were studied in each polymer system. It was interesting to note that solid dispersions with 50% (w/w) drug load were easier to process in the melt extruder compared to 20% (w/w) drug load in all three carriers, which was attributed to the plasticizing behavior of the drug substance. Upon storage at accelerated stability conditions, no phase separation was observed in HPMC 3cps and HPMCAS solid dispersions at the lower and higher drug load, whereas for HPMCP, phase separation was observed at higher drug load after 3 months. The pharmaceutical performance of these solid dispersions was evaluated by studying drug dissolution in pH 6.8 phosphate buffer. Drug release from solid dispersion prepared from polymers used for enteric coating, i.e. HPMCP and HPMCAS was faster compared with the water soluble polymer HPMC 3cps. In conclusion, of the 3 polymers studied for preparing solid dispersions of thermally sensitive compound using hot melt extrusion, HPMCAS was found to be the most promising as it was easily processible and provided stable solid dispersions with enhanced dissolution., (Copyright © 2011 Elsevier B.V. All rights reserved.)

Background: As the size of the known human interactome grows, biologists increasingly rely on computational tools to identify patterns that represent protein complexes and pathways. Previous studies have shown that densely connected network components frequently correspond to community structure and functionally related modules. In this work, we present a novel method to identify densely connected and bipartite network modules based on a log odds score for shared neighbours., Results: To evaluate the performance of our method (NeMo), we compare it to other widely used tools for community detection including kMetis, MCODE, and spectral clustering. We test these methods on a collection of synthetically constructed networks and the set of MIPS human complexes. We apply our method to the CXC chemokine pathway and find a high scoring functional module of 12 disconnected phospholipase isoforms., Conclusion: We present a novel method that combines a unique neighbour-sharing score with hierarchical agglomerative clustering to identify diverse network communities. The approach is unique in that we identify both dense network and dense bipartite network structures in a single approach. Our results suggest that the performance of NeMo is better than or competitive with leading approaches on both real and synthetic datasets. We minimize model complexity and generalization error in the Bayesian spirit by integrating out nuisance parameters. An implementation of our method is freely available for download as a plugin to Cytoscape through our website and through Cytoscape itself.

The primary goal of this study was to evaluate the use of specific surface area as a measurable physical property of materials for understanding the batch-to-batch variation in the flow behavior. The specific surface area measurements provide information about the nature of the surface making up the solid, which may include defects or void space on the surface. These void spaces are often present in the crystalline material due to varying degrees of disorderness and can be considered as amorphous regions. In the present work, the specific surface area for 10 batches of the same active pharmaceutical ingredient (compound 1) with varying quantity of amorphous content was investigated. Some of these batches showed different flow behavior when processed using roller compaction. The surface area value was found to increase in the presence of low amorphous content, and decrease with high amorphous content as compared to crystalline material. To complement the information obtained from the above study, physical blends of another crystalline active pharmaceutical ingredient (compound 2) and its amorphous form were prepared in known proportions. Similar trend in specific surface area value was found. Tablets prepared from known formulation with varying amorphous content of the active ingredient (compound 3) also exhibited the same trend. A hypothesis to explain the correlation between the amorphous content and specific surface area has been proposed. The results strongly support the use of specific surface area as a measurable tool for investigation of source of batch to batch variation in processability.

Purpose: Rapamycin and 5-fluorocytosine (5-FC) are antifungal agents with unique mechanisms of activity, with potential for cooperative interaction with AmB. Combination antifungal therapy involving conventional AmB has been restricted by poor physical stability and compatibility with antifungal drugs and vehicles., Methods: AmB and rapamycin were encapsulated in 1,2-distearoyl-sn-glycero-3-phosphoethanolamine-N-methoxy poly(ethylene glycol) (PEG-DSPE) micelles using a solvent evaporation method. The physical stability of micelle encapsulated AmB and rapamycin with 5-FC and saline was evaluated using dynamic light scattering (DLS). In vitro susceptibility of Candida albicans isolates to 5-FC and PEG-DSPE micelle solubilized AmB and rapamycin has been evaluated. Interactive effects have been quantified using a checkerboard layout., Results: In contrast with conventional AmB, PEG-DSPE micelles encapsulating AmB and rapamycin are compatible with saline and 5-FC over 12 h. The solubilized drugs retain high level of potency in vitro. The combination of solubilized AmB and rapamycin was indifferent, as fractional inhibitory concentration (FIC) index and combination index (CI) values were approximately 1. Combinations of solubilized AmB or rapamycin with 5-FC, and the three-drug combination were moderately synergistic since the FIC index and CI values were consistent less than 1., Conclusions: These results indicate that AmB solubilized in PEG-DSPE micelles is compatible with solubilized rapamycin and 5-FC. The indifferent or moderately synergistic activity of combinations is encouraging and warrants further investigation in appropriate rodent models.

Micelles formed from PEG-DSPE solubilize high levels of the poorly water-soluble antifungal amphotericin B (AmB). AmB release from PEG-DSPE micelles is slow in buffer but remarkably rapid in the presence of bovine serum albumin (BSA). Sequential changes in the absorbance spectrum of AmB in PEG-DSPE micelles point to a rapid dissociation of incorporated drug in the presence of BSA. In this context, we have studied micelles formed from PEG-DSPE which coincorporate cholesterol (PEG-DSPE|cholesterol). (1)H NMR measurements point to a lower mobility of lipid in PEG-DSPE|cholesterol micelles compared to PEG-DSPE micelles. The absorbance spectrum of AmB incorporated in PEG-DSPE|cholesterol micelles is distinct from that in PEG-DSPE micelles, which may point to differences in the drug-micelle interaction. AmB release from PEG-DSPE|cholesterol micelles is slow in buffer and in the presence of BSA. The absorption spectrum of AmB in PEG-DSPE|cholesterol micelles remained unchanged in BSA, further supporting stable incorporation and the slow release from the carrier.

Novel mixed polymeric micelles formed from biocompatible polymers, poly(ethylene glycol)-b-poly(epsilon-caprolactone) (PEG(5000)-b-PCL(x)) and 1,2-distearoyl-sn-glycero-3-phosphoethanolamine-N-methoxy poly(ethylene glycol) (PEG-DSPE), possess small size and high thermodynamic stability, raising their potential as long circulating carriers in the context of delivery of antineoplastic and antibiotic drugs. Formation of mixed polymeric micelles was confirmed using size exclusion chromatography and 1H NMR NOESY. Steady-state fluorescence measurements revealed depressed critical micellar concentrations indicative of a cooperative interaction between component hydrophobic blocks, which was quantified using the pseudophase model for micellization. Steady-state fluorescence measurements indicated that the mixed polymeric micelle cores possess intermediate micropolarity and high microviscosity. Pulsed field gradient spin-echo measurements were used to characterize micellar diffusion coefficients, which agree well with those obtained using dynamic light scattering. NOE spectra suggested that the hydrophobic polymer segments from individual components are in close proximity, giving evidence for the formation of a relatively homogeneous core. Contrary to one-component PEG(5000)-b-PCL(x) micelles, the mixed polymeric micelles could incorporate clinically relevant levels of the poorly water soluble antibiotic, amphotericin B (AmB). AmB encapsulation and release studies revealed an interesting composition-dependent interaction of the drug with the mixed polymeric micelle core.

Postsynaptic effects of dimethylsulfoxide (DMSO) were studied at the frog cutaneous pectoris neuromuscular junction using electrophysiological techniques and computer assisted analysis. It was found that the average amplitude of extracellularly recorded miniature end-plate potentials (meppse) as well as the time constant of their monoexponential decay (tau) were both elevated in the presence of DMSO. In spite of increased scatter of individual values, amplitude and tau of meppse highly correlated with each other. These results imply that DMSO partially blocked the activity of acetylcholine esterase in addition to its already known presynaptic action of acetylcholine release enhancement. Inhibitory action of DMSO on activity of isolated acetylcholine esterase was previously demonstrated by biochemical methods.