Bedside physician led US-guided supra-clavicular lymph node biopsy and ROSE (rapid on-site evaluation): SVC obstruction swift management in lung cancer.

Superior vena cava obstruction (SVCO) is an oncological emergency and can often be linked to an underlying lung malignancy. Due to the potential life-threatening risks associated with SVCO, it necessitates urgent diagnosis and management. In this report, we discuss 3 case studies where the use of ultrasound-guided supraclavicular lymph node biopsy was used to obtain a biopsy from patients with SVCO, followed by rapid on-site evaluation (ROSE). The benefits of this technique ensure a more rapid histological diagnosis, while also involving a less invasive procedure for the patient. The histological diagnosis is essential in improving patient outcomes when treating those with SVCO as the recommended treatments vary depending on the underlying type of lung malignancy. Having this information can help the clinician swiftly employ the optimal treatment pathway for the patient.

Sero-epidemiology and risk factor analysis of human brucellosis in Punjab, Pakistan: a cross sectional study.

Human brucellosis is a neglected zoonotic problem worldwide with a high degree of morbidity in humans and is mostly overlooked due to other febrile conditions. The aim of this study was to evaluate the sero-prevalence and risk factors of human brucellosis among subjects living in Punjab, Pakistan. In this cross-sectional study, human blood samples were collected from seven districts of Punjab, Pakistan. Information regarding personal data, demographic data and potential risk factors was collected through a structured questionnaire. Detection of anti-Brucella antibodies was done through Rose Bengal Plate Test (RBPT) and Enzyme Linked Immunosorbent Assay (ELISA). Descriptive analysis, Chi square test and Odds ratio was applied using STATA software version 12. The sero-prevalence of human brucellosis was 13.13% with significantly higher percentage in males 17.23% and age group 25-40 years 16.50% (P=< 0.001). The demographic factors positively associated with human brucellosis were lack of education (P = 0.003; OR = 1.85) and farming as an occupation (P =<0.001; OR = 2.50) Similarly, among the risk factors studied, keeping animals at home (P =<0.001; OR = 2.03), slaughtering of animals (P =<0.001; OR = 15.87) and consuming raw milk (P =<0.001; OR = 5.42) were the factors strongly connected with human brucellosis. A massive awareness should be given to livestock farmers and individuals directly linked to animals regarding risk factors and transmission of brucellosis. Consumption of unpasteurized milk and its products should be condemned to curtail this neglected disease.

The anaerobic biodegradation of emerging organic contaminants by horizontal subsurface flow constructed wetlands.

The horizontal subsurface flow constructed wetland (HFCW) is widely studied for the treatment of wastewater containing emerging organic contaminants (EOCs): pharmaceuticals, personal care products, and steroidal hormones. This study evaluates the performance of HFCW for the removal of these types of EOCs based on the data collected from peer-reviewed journal publications. In HFCW, anaerobic biodegradation is an important removal mechanism of EOCs besides their removal by the filter media (through sedimentation, adsorption, and precipitation) and plant uptake. The average removal efficiency of 18 selected EOCs ranged from 39% to 98%. The moderate to higher removal efficiency of 12 out of 18 selected EOCs in HFCW indicates the suitability of this type of constructed wetland (CW) for the treatment of wastewater containing these EOCs. The reasonably good removal (>50% in most of the cases) of these EOCs in HFCW might be due to the occurrence of anaerobic biodegradation as one of their major removal mechanisms in CWs. Although the effluent concentration of EOCs was substantially decreased after the treatment, the environmental risk posed by them was not fully reduced in most of the cases. For instance, estimated risk quotient of 11 out of 18 examined EOCs was extremely high for the effluent of HFCW.

Sero-epidemiology and risk factor analysis of human brucellosis in Punjab, Pakistan: a cross sectional study

@#Human brucellosis is a neglected zoonotic problem worldwide with a high degree of morbidity in humans and is mostly overlooked due to other febrile conditions. The aim of this study was to evaluate the sero-prevalence and risk factors of human brucellosis among subjects living in Punjab, Pakistan. In this cross-sectional study, human blood samples were collected from seven districts of Punjab, Pakistan. Information regarding personal data, demographic data and potential risk factors was collected through a structured questionnaire. Detection of anti-Brucella antibodies was done through Rose Bengal Plate Test (RBPT) and Enzyme Linked Immunosorbent Assay (ELISA). Descriptive analysis, Chi square test and Odds ratio was applied using STATA software version 12. The sero-prevalence of human brucellosis was 13.13% with significantly higher percentage in males 17.23% and age group 25-40 years 16.50% (P=< 0.001). The demographic factors positively associated with human brucellosis were lack of education (P = 0.003; OR = 1.85) and farming as an occupation (P =<0.001; OR = 2.50) Similarly, among the risk factors studied, keeping animals at home (P =<0.001; OR = 2.03), slaughtering of animals (P =<0.001; OR = 15.87) and consuming raw milk (P =<0.001; OR = 5.42) were the factors strongly connected with human brucellosis. A massive awareness should be given to livestock farmers and individuals directly linked to animals regarding risk factors and transmission of brucellosis. Consumption of unpasteurized milk and its products should be condemned to curtail this neglected disease.

Mirizzi's syndrome: a diagnostic dilemma.

A 62-year-old male presented with a history of upper abdominal discomfort. Past history included asymptomatic gallstones. Abdominal ultrasound and CT demonstrated gallstones within a thick-walled gallbladder, and intra and extrahepatic duct dilatation. Endoscopic retrograde cholangiopancreatography (ERCP) revealed a stricture within the mid-portion of the common bile duct. At laparotomy, a single large stone was found causing external compression of the common bile duct causing a Mirizzi's-type stricture. At repeat ERCP, cholangiogram showed no evidence of stricture. Clinicians should be aware that no definite clinical signs distinguish Mirizzi's syndrome and surgical exploration is often required for diagnosis.

Varicella pneumonitis in an immunocompetent patient.

Varicella zoster virus is known by many different names, including chickenpox virus, varicella virus, zoster virus and human herpes virus type 3, and it causes chickenpox. Primary chickenpox skin involvement is a benign and self-limiting condition. The incidence in the Western world is on the rise. Varicella pneumonitis is a potentially fatal complication. Immunocompromised patients develop aggressive lung disease, but immunocompetent can have serious pulmonary compromise. Timely ICU support, respiratory intervention and antiviral therapy play a key role in improving outcomes. Aciclovir is an established therapy for treating varicella-related illnesses and early commencement in patients with or at risk of complications can be beneficial. This case demonstrates, healthy individuals with chickenpox can develop varicella pneumonitis. Despite being immunocompetent, the patient had significant radiologic changes.

Primary adenoid cystic carcinoma of the bronchus in a female teenager.

Primary adenoid cystic carcinoma (ACC) of the lung is an extremely rare malignant lung neoplasm. ACC of salivary glands of the head and neck, lachrymal glands, breast, skin, vulva and trachea have been frequently reported disease patterns in the literature, but it is unique to see this rare lung tumour in a patient as young as 14 years old. No double blind placebo, multicentre treatment data are available. Surgery is considered as the cornerstone of the treatment. Prognosis is variable and adjuvant radiotherapy has been found beneficial for prolonged survival. Our report of primary lung ACC in a young girl is a complex case due to young age, a different way of presentation and staging on diagnosis. It has been a quite challenging clinical scenario for the multidisciplinary lung cancer treating team involved in the clinical care. Prognosis remains unpredictable and uncertain despite the best present day evidence-based treatment.

ITS1 region of the nuclear ribosomal DNA of the mycoparasite Pythium periplocum, its taxonomy, and its comparison with related species.

Pythium periplocum Drechsler was isolated from some soil samples taken in the botanical garden of Tenerife, Canary Islands. This fungus has been found to be an aggressive mycoparasite of Botrytis cinerea. It is unique amongst the members of the genus Pythium because of the character combination of inflated filamentous type of sporangia and ornamented oogonia. The taxonomic description of this fungus and its comparison with related species, together with the polymerase chain reaction of the internal transcribed spacer of its nuclear ribosomal DNA, are discussed in this article.

Pythium prolatum isolated from soil in the Burgundy region: a new record for Europe.

Pythium prolatum Hendrix and Campbell has been isolated from a soil sample taken in the Burgundy region in France. The fungus is easily recognisable by its heavily ornamented oogonia with conical to mammiform spines, elongated sporangia, and its diclinous antheridia forming or originating from a tangled mass of hyphae. Descriptions of the morphological and reproductive aspects of Pythium prolatum, the polymerase chain reaction of the internal transcribed spacer (ITS1) of the ribosomal nuclear DNA as well as the nucleotide sequences of ITS1 coding for 5.8S rRNA are given.

Occurrence of resveratrol and pterostilbene in age-old darakchasava, an ayurvedic medicine from India.

'Darakchasava' is a well known Indian herbal preparation of which the main ingredient is Vitis vinifera L. This 'ayurvedic' medicine is prescribed as a cardiotonic and also given for other disorders. HPLC analysis of this age old formulation revealed the presence of polyphenols like resveratrol and pterostilbene. These phenolic compounds are now known as antioxidants, cancer chemopreventive agents, and also known to reduce mortality from coronary heart disease by increasing high density lipoproteins like cholesterol and inhibiting platelet aggregation (Soleas, J.S., Diamandis, E.P., Goldberg, D.M., 1997. Resveratrol: a molecule whose time has come? and gone? Clin. Biochem. 30 (2), 91-113). The study of darakchasava becomes interesting in the light of these findings. A brief introduction of this medicinal preparation, its formulation, its analysis by HPLC, and some of its properties are discussed in this article.