Association of Facial Wrinkles With Different Facial Forms in the Population of Maharashtra: A Prospective Observational Study.

INTRODUCTION: Wrinkles commonly manifest in various areas of the face as individuals age. This study aimed to assess the association between facial wrinkles and different facial forms. MATERIALS AND METHODS: An observational, prospective study was conducted on the facial photographs of 400 subjects aged 40-60 years, which were divided into four groups of 100 subjects each: Group 1, square facial form; Group 2, ovoid facial form; Group 3, square tapered facial form; and Group 4, tapered facial form. All groups had almost equal distributions of males and females. Six types of facial wrinkles were studied, namely, forehead, glabellar, canthal, nasolabial, wrinkles at the corner of the mouth, and perioral wrinkles. Analysis of variance (ANOVA) was used for intergroup comparison, and an independent Student's t-test was used to assess gender differences in facial wrinkles. RESULTS: Significant gender differences were observed for forehead wrinkles in Groups 1 and 3, canthal wrinkles in Groups 1 and 2, and right perioral wrinkles in Group 1 (p<0.05). There were non-significant gender differences between right and left-side facial wrinkles (p>0.05). Significant differences between the groups were observed for all facial wrinkles between the right and left sides of the face (p<0.05). There was a significant difference between the groups for the presence of glabellar, corner of the mouth, and perioral wrinkles, with the presence of higher wrinkles in ovoid and tapered facial forms compared to square and square tapered facial forms (p<0.05). CONCLUSIONS: Females had more facial wrinkles than males, predominantly in the forehead region. The least prominent wrinkles were observed in the perioral region of the face. Glabellar, corner of the mouth, and perioral wrinkles were predominantly observed in ovoid and tapered facial forms.

Knowledge, Attitude, and Practice Survey of Gastroparesis in Asia by Asian Neurogastroenterology and Motility Association

Background/Aims@#Gastroparesis is identified as a subject that is understudied in Asia. The scientific committee of the Asian Neurogastroenterology and Motility Association performed a Knowledge, Attitude, and Practices survey on gastroparesis among doctors in Asia. @*Methods@#The questionnaire was created and developed through a literature review of current gastroparesis works of literature by the scientific committee of Asian Neurogastroenterology and Motility Association. @*Results@#A total of 490 doctors from across Asia (including Bangladesh, China, Hong Kong, Indonesia, Japan, Malaysia, Myanmar, the Philippines, Singapore, South Korea, Taiwan, Thailand, and Vietnam) participated in the survey. Gastroparesis is a significant gastrointestinal condition. However, a substantial proportion of respondents was unable to give the correct definition and accurate diagnostic test. The main reason for lack of interest in diagnosing gastroparesis was “the lack of reliable diagnostic tests” (46.8%) or “a lack of effective treatment” (41.5%). Only 41.7% of respondents had access to gastric emptying scintigraphy. Most doctors had never diagnosed gastroparesis at all (25.2%) or diagnosed fewer than 5 patients a year (52.1%). @*Conclusions@#Gastroparesis can be challenging to diagnose due to the lack of instrument, standardized method, and paucity of research data on normative value, risk factors, and treatment studies in Asian patients. Future strategies should concentrate on how to disseminate the latest knowledge of gastroparesis in Asia. In particular, there is an urgent need to estimate the magnitude of the problems in high risk and idiopathic patients as well as a standardized diagnostic procedure in Asia.

Second Asian Consensus on Irritable Bowel Syndrome

BACKGROUND/AIMS: There has been major progress in our understanding of the irritable bowel syndrome (IBS), and novel treatment classes have emerged. The Rome IV guidelines were published in 2016 and together with the growing body of Asian data on IBS, we felt it is timely to update the Asian IBS Consensus. METHODS: Key opinion leaders from Asian countries were organized into 4 teams to review 4 themes: symptoms and epidemiology, pathophysiology, diagnosis and investigations, and lifestyle modifications and treatments. The consensus development process was carried out by using a modified Delphi method. RESULTS: Thirty-seven statements were developed. Asian data substantiate the current global viewpoint that IBS is a disorder of gut-brain interaction. Socio-cultural and environmental factors in Asia appear to influence the greater overlap between IBS and upper gastrointestinal symptoms. New classes of treatments comprising low fermentable oligo-, di-, monosacharides, and polyols diet, probiotics, non-absorbable antibiotics, and secretagogues have good evidence base for their efficacy. CONCLUSIONS: Our consensus is that all patients with functional gastrointestinal disorders should be evaluated comprehensively with a view to holistic management. Physicians should be encouraged to take a positive attitude to the treatment outcomes for IBS patients.

NUT carcinoma of the sinonasal tract infiltrating the orbit in a man with birdshot chorioretinitis.

A 48-year-old man with a history of birdshot chorioretinitis presented with blurry vision, retro-bulbar pain and sinusitis. Though visual acuity was unaffected, he had left optic disc oedema and mild restriction of left eye abduction. His symptoms progressed quickly, with diplopia in primary gaze, epistaxis from his left nostril, and a left relative afferent pupillary defect (RAPD). On computed tomography, there was a mass in the nasal cavity that extended through the left cribriform plate and lamina papyracea and posteriorly into the optic canal. Pathological examination of biopsy specimens revealed sheets of undifferentiated cells with extensive areas of necrosis and islands of squamous differentiation. The tumour cells expressed monokeratin, p63, CD34, and p16. Molecular testing indicated rearrangement of the NUTM1 (15q14) locus and fusion of the NUTM1 and BRD4 (19p13.12) loci, confirming the diagnosis of NUT carcinoma of the sinonasal tract. This is the first reported case of NUT carcinoma in a patient with birdshot chorioretinitis. The onset of chorioretinitis may have been the earliest sign of the effects of the BRD4-NUTM1 fusion protein, resulting in expression of HLA-A29. There is evidence that bromodomain and extra terminal (BET) family proteins play a role in inflammatory marker expression.

Development, Translation and Validation of Enhanced Asian Rome III Questionnaires for Diagnosis of Functional Bowel Diseases in Major Asian Languages: A Rome Foundation-Asian Neurogastroenterology and Motility Association Working Team Report

BAome III criteria. METHODS: After EAR3Q was developed by Asian experts by cCKGROUND/AIMS: The development-processes by regional socio-cultural adaptation of an Enhanced Asian Rome III questionnaire (EAR3Q), a cultural adaptation of the Rome III diagnostic questionnaire (R3DQ), and its translation-validation in Asian languages are presented. As English is not the first language for most Asians, translation-validation of EAR3Q is essential. Hence, we aimed to culturally adapt the R3DQ to develop EAR3Q and linguistically validate it to show that the EAR3Q is able to allocate diagnosis according to Ronsensus, it was translated into Chinese, Hindi-Telugu, Indonesian, Korean, and Thai, following Rome Foundation guidelines; these were then validated on native subjects (healthy [n = 60], and patients with irritable bowel syndrome [n = 59], functional dyspepsia [n = 53] and functional constipation [n = 61]) diagnosed by clinicians using Rome III criteria, negative alarm features and investigations. RESULTS: Experts noted words for constipation, bloating, fullness and heartburn, posed difficulty. The English back-translated questionnaires demonstrated concordance with the original EAR3Q. Sensitivity and specificity of the questionnaires were high enough to diagnose respective functional gastrointestinal disorders (gold standard: clinical diagnoses) in most except Korean and Indonesian languages. Questionnaires often uncovered overlapping functional gastrointestinal disorders. Test-retest agreement (kappa) values of the translated questionnaires were high (0.700-1.000) except in Korean (0.300-0.500) and Indonesian (0.100-0.400) languages at the initial and 2-week follow-up visit. CONCLUSIONS: Though Chinese, Hindi and Telugu translations were performed well, Korean and Indonesian versions were not. Questionnaires often uncovered overlapping FGIDs, which were quite common.

Integrative and comparative analysis of coiled-coil based marine snail egg cases - a model for biomimetic elastomers.

Integrative and comparative analyses of biomaterials systems offer the potential to reveal conserved elements that are essential for mechanical function. The approach also affords the opportunity to identify variation in designs at multiple length scales, enabling the delineation of a range of parameters for creating precisely tuned biomimetic materials. We investigated the molecular design and structural hierarchy of elastomeric egg capsules from the marine snail Pugilina cochlidium (family Melongenidae) and compared these data with all available published studies in order to infer the structure-property relationships of the egg case from the molecular to the macroscopic scale. While mechanical similarities had previously been observed for two other marine melongenid snails, Busycotypus canaliculatus and Busycon carica, B. canaliculatus was the only species for which detailed molecular and nanostructural data were available. Egg capsules from P. cochlidium were found to exhibit mechanical properties and shock absorbing potential that was similar to B. canaliculatus. The two species also displayed similarity in hierarchical fibril bundling and a sub-micron staggering of 100-105 nm within filaments, as shown by atomic force microscopy and small angle X-ray diffraction. In situ Raman micro spectroscopy indicated that P. cochlidium egg cases undergo a stress-induced coiled-coil to extended ß-strand structural transformation that is very similar to that of B. canaliculatus. These observations supported the view that these structural and hierarchical elements are essential for egg case function. Comparative analysis of the primary amino acid sequences and structural predictions for all known egg case proteins suggested that while the proteins all contain sequences prone to adopt α-helical structures, the predicted location of coiled-coil domains and stutter perturbations varied within and between species. Despite these differences, mixtures of denatured native egg case proteins readily re-folded in citrate-phosphate assembly buffer into α-helix rich, coiled-coil based oligomers, as determined by attenuated total reflection Fourier transform infrared spectroscopy, circular dichroism and MALDI-TOF. It is concluded that both conserved and divergent designs in marine snail egg cases offer inspiration for the engineering of biomimetic elastomeric materials with a unique capability for mechanical energy absorption.

Chemical composition and ruminal nutrient degradability of fresh and ensiled amaranth forage.

BACKGROUND: Amaranth is a crop with potential as a source of forage for ruminants that has not been well characterized. A study was conducted to determine the impact of ensiling on the nutritional quality and ruminal degradability of forage from two amaranth cultivars adapted to North America (i.e. Plainsman and D136). In particular, quantification and some microscopic characterization of oxalate found in amaranth were performed as it is an antiquality compound of concern. RESULTS: There were limited interactions between cultivars and ensiling for most variables. Differences in chemical composition between amaranth cultivars were also limited. Ensiling reduced non-structural carbohydrate and true protein contents. The proportion of acid detergent protein was high in fresh and ensiled forages of both cultivars (average of 177 g kg(-1) crude protein). Total oxalate content averaged 30 and 25 g kg(-1) in fresh and ensiled forages respectively. Ensiling reduced soluble oxalate content. Crystals observed in amaranth were calcium oxalate druses found mostly in idioblast cells in leaf mesophyll and parenchyma of primary and secondary veins. In situ ruminal degradability data indicated that both fresh and ensiled amaranth are highly degradable in the rumen. CONCLUSION: This study confirms that amaranth is a suitable forage for ruminant animals. Its chemical composition is comparable, for most variables, to that of other commonly used forage species.

Fatalities in wild goats in Kurdistan associated with Peste des Petits Ruminants virus.

Between August 2010 and February 2011, over 750 deaths were recorded among wild goats (Capra aegagrus, the endangered progenitor of the domestic goat) in Kurdistan. Based on the clinical signs and post-mortem findings, the involvement of peste des petits ruminants virus (PPRV) was suspected. This was confirmed by laboratory analysis, and the virus was found to be closely related to a Turkish strain isolated in 2000. During the outbreak in wild goats, no disease in domestic animals was reported. Domestic ruminants in the region are routinely vaccinated with an attenuated vaccine based on the 'Nigeria/75/1' strain of PPRV. This is the first report of active PPRV infection in Kurdistan and most likely the immunity afforded by vaccination prevented spillover infections. It is therefore recommended to continue with the campaign. Conversely, there is no justification for the use of force to keep the endangered wild goats away from domestic flocks.

Chemical composition, dietary fibre, tannins and minerals of grain amaranth genotypes.

The objective of this study was to determine the chemical composition of 28 white and coloured grain amaranth (Amaranthus spp.) genotypes. Neutral detergent fibre (NDF) concentration was greater while strach concentration was lower for coloured seeds genotypes than white seeds genotypes. Total dietary fibre followed a similar trend to that observed for NDF. Total tannin concentrations ranged between 20.7 and 0 g/kg with total and hydrolysed tannin concentrations being higher for white than for coloured seeds genotypes. Coloured seeds genotypes contained higher Mg and Ca concentrations than white seeds genotypes. However, seed colour had no influence on K, Na and P concentrations. Copper and Fe were the most variable micro-minerals in the evaluated genotypes with no significant effect of seed colour on the concentration of either mineral.

Effect of serotonin on small intestinal contractility in healthy volunteers.

The physiological significance of serotonin released into the intestinal lumen for the regulation of motility is unknown in humans. The aim of this study was to evaluate the effect of serotonin infused into the lumen of the gastric antrum, duodenum or the jejunum, on antro-duodeno-jejunal contractility in healthy human volunteers. Manometric recordings were obtained and the effects of either a standard meal, continuous intravenous infusion of serotonin (20 nmol/kg/min) or intraluminal bolus infusions of graded doses of serotonin (2.5, 25 or 250 nmol) were compared. In addition, platelet-depleted plasma levels of serotonin, blood pressure, heart rate and electrocardiogram were evaluated. All subjects showed similar results. Intravenous serotonin increased migrating motor complex phase III frequency 3-fold and migrating velocity 2-fold. Intraluminal infusion of serotonin did not change contractile activity. Platelet-depleted-plasma levels of serotonin increased 2-fold following both intravenous and high doses of intraluminal infusions of serotonin. All subjects reported minor short-lived adverse effects following intravenous serotonin stimulation, while only half of the subjects reported minor short-lived adverse effects following intraluminal serotonin stimulations. We conclude that exogenous serotonin in the lumen of the upper part of the small intestine does not seem to change antro-duodeno-jejunal contractility significantly in healthy adult volunteers.

Serotonin and superior mesenteric artery resistance index.

OBJECTIVE: Serotonin is a vasoactive neuroendocrine substance and serotonergic drugs are promising agents for the treatment of functional gastrointestinal disorders. The effect of serotonin on superior mesenteric blood flow in humans is unknown. The aim of this study was to examine the effect of exogenous serotonin on superior mesenteric artery blood flow, as estimated by the resistance index with Doppler ultrasound, in healthy human volunteers. MATERIAL AND METHODS: Six fasting healthy adult volunteers of both genders were studied. Transabdominal Doppler ultrasound was used to evaluate the effects of either a standard meal or intravenous infusion of serotonin (2.5-20 nmol kg-1 min-1) on the superior mesenteric artery resistance index, platelet-depleted plasma levels of serotonin, blood pressure, heart rate and electrocardiogram. RESULTS: All subjects had the same patterns of response to meal and serotonin stimulation. Meal stimulation decreased the mean resistance index from 0.84+/-0.04 to 0.72+/-0.02 (p = 0.0004) and increased platelet-depleted-plasma levels of serotonin from 50+/-36 to 61+/-46 nmol L-1 (p = 0.04). Serotonin stimulation increased the mean resistance index from 0.82+/-0.04 to 0.88+/-0.03 (p = 0.006) and mean platelet-depleted-plasma levels of serotonin from 44+/-24 to 83+/-37 nmol L-1 (p = 0.03). Most subjects reported minor short-lived adverse effects. Electrocardiogram results were unchanged during all examinations. CONCLUSIONS: We conclude that intravenous infusion of serotonin increases the resistance index of the superior mesenteric artery (increases downstream resistance) in healthy adult volunteers.

Ensiling characteristics, nutrient composition, and in situ ruminal and whole tract degradability of brown midrib and leafy corn silage.

A study was conducted to compare the ensiling characteristics, chemical composition, and the ruminal and total tract nutrient degradabilities of leafy (Cargill F227) and brown midrib (Mycogen TMF94) corn silage hybrids. Corn was grown in Saint-Jean-sur-Richelieu, Quebec, Canada, harvested at a target 350 g kg(-1) dry matter (DM) content, and ensiled in mini-silos for 0, 2, 4, 8, 16, and 45 d. Two non-lactating Holstein cows fitted with ruminal and proximal duodenal cannulae were used to determine ruminal and whole tract nutrient degradability. Forage from both hybrids went through a rapid fermentation with a sharp decline in pH during the first 2 d of ensiling, pH in both silage being less than 4.0 after 45 d. Lactic acid concentration was however greater for leafy than brown midrib corn. Chemical analysis of silage after 45 d of ensiling revealed that hybrids differed in their composition. Compared to leafy corn, brown midrib corn had lower neutral detergent fiber (NDF), acid detergent fiber (ADF), acid detergent lignin (ADL), crude protein (CP), and neutral detergent and acid detergent insoluble proteins, but higher starch and net energy of lactation (NEL) values. Results of the in situ incubation experiment indicated that compared to leafy corn brown midrib corn had greater ruminal DM (64 vs. 54%), CP (73 vs. 71%), and NDF (32 vs. 24%) degradabilities. Brown midrib corn silage also had greater DM ruminal (53 vs. 48%) and total tract (67 vs. 61%) digestibilities, as well as greater NDF ruminal (34 vs. 25%), intestinal (10 vs. 8%), and total tract (43 vs. 33%) digestibilities. Type of corn hybrid will thus greatly affect silage chemical composition and nutrient digestibility.

IgA-dominant glomerulonephritis associated with hepatitis A.

Unlike hepatitis B and C, renal involvement has been extremely uncommon in patients with hepatitis Avirus (HAV) infection. Nephrotic syndrome has been documented as a rare complication in association with HAV infection. In this report, we describe a patient with serologically documented HAV infection, who presented with nephrotic syndrome. The renal biopsy showed an immunoglobulin A- (IgA) dominant glomerulonephritis (GN) with subendothelial immune deposits. This is the second biopsy-proven case report of a patient with acute HAV associated with IgA-dominant immune complex glomerulonephritis and nephrotic syndrome. This is perhaps the first case in which a patient experienced both IgA-dominant glomerulonephritis and cutaneous cryoglobulinemic vasculitis.