COVID-19 infection was first described in Wuhan, China after an increasing spread of atypical pneumonia of unknown pathogen. Unfortunately, this novel virus continues spreading causing a pandemic. Thalassemia considered one of the most common hemoglobinopathies. Beta thalassemia is the commonest type with a variety in clinical picture due to the deference in homozygous. A lot of vulnerable categories were at high risk of getting infected with the coronavirus and more even its complication. Despite the conflicting data and ongoing research on this topic, thalassemia patients were categorized among the high-risk population. Here we present a case series describing the clinical progression of two splenectomised patients who has transfusion dependent beta thalassemia major.
Psychosocial support for families of persons with dementia through home based care programme from a developing country: Process of intervention development and pilot testing
In India, person with dementia continue to live with their families all through their illness period. It is common in India that because of the family relationships and cultural values the caregiving process is a joint effort made by the adult members in the family. Thus understanding the psychosocial issues of the caregivers of persons with dementia in the Indian context and providing appropriate psychosocial support for the caregivers is essential in the holistic approach for the care for persons with dementia.The current paper shares the process of development of psychosocial intervention for the families of persons with dementia and findings from the pilot study in urban Bangalore. The findings were helpful in systematically developing the content for the proposed homebased care programme for caregivers of persons with dementia. The pilot results show that the psychosocial support through home based programme for the family caregivers of persons with dementia is feasible and effective.
Takotsubo syndrome (TTS) is characterised by transient regional wall motion abnormalities of the left or right ventricles often associated with new ECG changes (including ST-segment elevations, ST-segment depressions, T-wave inversions and QTc prolongation) in the absence of a culprit atherosclerotic artery which could explain the ventricular dysfunction. In this article we present an unusual case of recurrent TTS following electrical cardioversion in a 61 year old female patient who was admitted to our unit.
Metastatic pancreatic adenocarcinoma to the urinary bladder is extremely rare and has only been reported 4 cases worldwide. We describe such a case presented with hematuria and dysuria after ten months of the initial diagnosis. Immunohistochemistry helped to confirm the diagnosis of metachronous metastasis. Six months after being diagnosed with the bladder metastasis, progression with severe right hydronephrosis and mild dilatation of the left pyelocaliceal system palliated with an UventaTM metallic ureteral stent and a double J ureteric catheter.
Macaronesia islands’ invasive plant use in animal feed or composting may bring economic and environmental benefits to the region. Arundo donax, Pennisetum setaceum, Agave americana, and Ricinus communis, present in the three archipelagos (Canary, Azores and Madeira), were characterized chemically and biologically. A. donax and P. setaceum showed elevated crude protein (CP) content, 13.25 and 16.33 DM%, respectively, and extremely high NDF values, 75.87 and 80.83 DM%, with a DM digestibility of 55.02 to 59.77%. A. americana showed a low NDF value (22.78 to 27.94 DM%) and a very low CP value (4.24 to 5.61 DM%). However, its DM digestibility was high (79.89 to 86.33%). R. communis presented the best values for CP (24.62%) and NDF (26.56 DM%), however, due to the presence of toxic substances (ricin), it cannot be easily used in animal feed. The P. setaceum and R. communis were found to be the least gas-producing forage, with A. americana being the major producer. To increase these plants’ value for animal feed, treatment with urea or NaOH to A. donax and P. setaceum, and enrichment with nitrogen to Agave is proposed. Due to its toxic properties, R. communis must be used in composting.
CML is a chronic myeloproliferative disorder associated with activating mutations in tyrosine kinases forming a BCR-ABL fusion gene, causing hyperproliferation of neoplastic myeloid progenitors [1,2]. The incidence of CML peaks in the fourth and fifth decades of life . In the United States, nearly 4,500 cases are diagnosed annually . The onset of the disease is insidious due to the nonspecific initial “B symptoms,” such as increased fatigability, weight loss and weakness. The natural history of CML is slow with a median survival of three years if untreated [3,4]. The current treatment is targeted therapies to the BCR-ABL tyrosine kinase using imatinib or nilotinib and hydroxyurea. Although B symptoms are common, priapism can be an initial presentation of CML in 1-5% of cases . Priapism is a urological emergency defined by a sustained erection of four or more hours. Hyperviscous blood in leukemias, such as CML, prevents appropriate venous drainage of the corpora cavernosa, resulting in failure of detumescence . This case reports highlights priapism as a presenting sign of CML and reviews the pathophysiology between the association.
It is well known in the literature that adult ptosis can be induced or worsen by cataract surgery even with modern sutureless clear cornea phacoemulsification. [1, 2, 3, 4,5,6,7,8] We are presenting this unusual case was the opposite. The ptosis resolved after cataract surgery. A possible effect from the successful management of dry eye disease before cataract surgery is explained. Drooping of the unilateral upper eyelid is unilateral ptosis. Ptosis may be myogenic, neurogenic, and aponeurotic from healthy aging, injury, eye diseases. [9, 10] Ptosis also can be associated with hard contact lens wear, immunological, degenerative, or hereditary disorders, tumors, or infections.  Patients with ptosis often present with a lower position of the upper eyelid, complain of a tired appearance, and defect in their superior visual field even blurred vision. The levator muscle controls the position of the eyelid and is innervated by the oculomotor nerve. The Mueller muscle also controls partially by providing sympathetic innervation. The deficiency of these two muscles may cause ptosis.  Hering’s law of motor correspondence of a ptosis lid can affect the contralateral lid position [5, 7] as the levator muscles work in synchrony with each other. Therefore, unilateral ptosis can induce a retraction of the contralateral lid or a pseudo retraction. When ptosis is causing visual field defects, the innervation input to both eyelids will increase to reduce the ptosis. There will be a compensatory elevation of eyebrow to reduce the amount of ptosis.  These phenomena need to be considered in the evaluation of unilateral ptosis for surgery. Another essential examination, such as Margin Reflex Distance 1 (MRD1), is the crucial measurement for ptosis besides levator function and palpebral fissure. MRD1 is the distance from the margin of the upper lid to the central corneal reflex (normal is between 4.0-4.5 mm)….
The Pandemic of SARS COV 2 popularly known as ‘Corona Virus19’ has affected 213 countries and territories around the world since the beginning of year 2020. All the countries have focused their attention acutely on the higher fatality rate the virus has caused among the elderly and launched a scientific enquiry on why children have emerged relatively unaffected. This pandemic has already amplified existing social fractures and inequalities and it is expected that all most all countries may take 5-10 years to return to their socio-economic status of 2019. Most importantly people are losing trust in healthcare system. As the Global tally of cases crosses 28 million cases and nearly 0.9 million deaths on 10th September 2020, with the highest daily case of 300,683 on 4 September 2020 and deaths of 8513 on 17 April 2020. However, the proportion or absolute number of cases and deaths in children is not readily available at Global, National, or even at local levels. In the beginning it was estimated that the children under 14 years contributed less than 0.5% and therefore the Children were not the face of this pandemic. The sub-national data in states reporting desegregated data in USA and India indicate that the children contribute between 0.1% to 10% in the recent weeks. The pandemic of COVID-19 initially appeared to cause only a mild illness in children and immediate health impact, or mortality rates were not alarming. A few weeks following the peak of COVID-19 epidemic in the US and the European Union, a novel systemic illness called Multisystem inflammatory syndrome in children (MIS-C) has been reported with devastating effect. Most importantly children’s risk being among its biggest victims, their lives are being changed in profound ways. What has escaped our attention is the long-term damage the cascading effect of COVID-19…
Sedative, hypothermic, anxiolytic effects and rapid radical scavenging property of aqueous leaf extract of Vitex doniana (Lamiaceae) in mice
Vitex doniana is used ethnomedicinally for the management of madness, insanity, and epilepsy. This study was undertaken to evaluate the sedative, hypothermic and anxiolytic effects of crude aqueous leaf extract of Vitex doniana (AVD) in mice, as well as its rapid radical scavenging property. Doses of 250, 500, and 1000 mg/kg AVD were adopted for the pharmacological testing in mice of both sexes (n=6). The behavioural effects of the extract in the open field apparatus were determined. AVD was evaluated for its anxiolytic effect, using elevated T- maze, staircase, and hole-board models. While the sedative and hypothermic effects of the extract in mice were determined by assessments of ketamine-induced sleeping time and rectal temperature respectively. AVD was subjected to rapid radical scavenging test using thin-layer chromatography (TLC)-bioautography. The results showed AVD to have an inhibitory effect on CNS in the open field test. AVD demonstrated anxiolytic effect at 250 mg/kg, and sedative effect at 500 and 1000 mg/kg. The sedative effect of AVD at 500 and 1000 mg/kg was further revealed in ketamine-induced sleeping time and rectal temperature. AVD also showed strong free radical scavenging property attributed to the presence of fatty acid esters, terpenes, phenolics, and phenolic glycosides. AVD is acutely non-toxic and it possesses significant sedative, hypothermic and anxiolytic effects, which could in part be due to the presence of rapid free radical scavenging compounds, thus, providing pharmacological justification for its ethnomedicinal uses as a curative for madness and insanity.
In the film and television texts, the spiritual growth and changes of male characters are always accompanied by pains, that is, the Oedipus-style of killing the father and marrying the mother, which has also become a way for male characters to grow up. When the male characters cannot correctly deal with the order of these two desires in the process of self-construction, it will bring a devastating hit to the male characters. The male characters in Wen Jiang’s films often have a strong Oedipus complex, and this complex will ultimately affect the growth of the characters.