Evaluation of Antimicrobial Efficacy and Clinical Outcomes of Triphala and 2.5% Sodium Hypochlorite as Intraradicular Irrigants in Pulpectomy of Primary Teeth.

A natural irrigation solution with a broad spectrum of antimicrobial coverage, triphala was selected for the pulpectomy procedure. Because of its natural ingredients, it is well-known for promoting tissue healing. It also supposedly has certain additional qualities as compared to usual irrigation solutions that are made chemically. Although 2.5% NaOCl is thought to be perfect since it meets most of the requirements for an irrigation solution but it cannot be optimized for pulpectomy procedure. Primary teeth that were recommended for pulpectomy underwent this randomized controlled experiment. Two groups of eighty-four primary teeth were randomly assigned to receive irrigations: triphala in Group A; 2.5% Sodium hypochlorite in Group B. Sample were taken from infected primary root canals. A sterile test tube with bhi broth as the transport media was used to collect pre- and post-irrigation samples using sterile absorbent paper tips. On agar media, microorganisms were cultivated and their mean colony count was assessed. Following the procedure, the patient's follow-up visits at one, two and three months were used to evaluate the clinical result. The post-microbial colony count was dramatically reduced (p<0.001) by both irrigation treatments. Triphala in Group A is demonstrating desirable efficacy. Clinical success was found satisfactory in both the groups studied (p<0.001). But statistically significant difference was not found (p=0.175). Considering undesirable properties of sodium hypochlorite triphala can be a better alternative as a root canal irrigants in pulpectomy of primary teeth.

Event studies in international finance research.

Event studies are widely used in finance research to investigate the implications of announcements of corporate initiatives, regulatory changes, or macroeconomic shocks on stock prices. These studies are often used in a single-country setting (usually the U.S.), but little work has yet been conducted in an international context, perhaps due to the complexities inherent in implementing cross-country studies. This paper explores the methodological challenges of conducting event studies in international finance research. We emphasize how scholars should choose an event, select the study period (short vs. long term), estimate abnormal returns, infer statistically whether the event under consideration produces a reliable price reaction, and explore the role of formal and informal institutions in explaining cross-country differences in price reactions. We also provide an extension of event studies to an important but less studied asset class in an international setting - the fixed-income market. We conclude by offering practical recommendations for researchers conducting cross-country finance event studies and identifying opportunities for future research. Given the increasing number of global events, such as the COVID-19 pandemic, Brexit, and the Paris and Trans-Pacific Partnership agreements, we believe our paper is especially timely.

Les études d'événements sont largement utilisées dans la recherche financière pour étudier les implications des annonces d'initiatives d'entreprises, de changements réglementaires ou de chocs macroéconomiques sur les prix des actions. Ces études sont souvent utilisées dans le cadre d'un seul pays (généralement les États-Unis), mais peu de travaux ont encore été menés dans un contexte international, probablement en raison des complexités inhérentes à la mise en oeuvre d'études transnationales. Cet article explore les défis méthodologiques de la conduite d'études d'événements dans la recherche en finance internationale. Nous mettons l'accent sur la manière dont les chercheurs doivent choisir un événement, sélectionner la période d'étude (court ou long terme), estimer les rendements anormaux, déduire statistiquement si l'événement considéré produit une réaction fiable des prix, et explorer le rôle des institutions formelles et informelles dans l'explication des réactions des prix à travers les réactions des prix. Nous proposons également une extension des études d'événements à une classe d'actifs importante mais moins étudiée dans un contexte international - le marché des titres à revenu fixe. Nous concluons en offrant des recommandations pratiques aux chercheurs qui mènent des études d'événements financiers transnationaux et en identifiant les possibilités de recherches futures. Compte tenu du nombre croissant d'événements mondiaux, tels que la pandémie de COVID-19, le Brexit et les accords de Paris et de partenariat transpacifique, nous pensons que notre article est particulièrement opportun.

Los estudios de eventos son ampliamente usados en la investigación financiera para indagar las implicaciones de los anuncios de iniciativas empresariales, cambios regulatorios o choques macroeconómicos en los precios de las acciones. Estos estudios se utilizan a menudo en el marco de un solo país (normalmente EE.UU.), pero todavía se han realizado pocos trabajos en un contexto internacional, quizá debido a las complejidades inherentes a la realización de estudios transfronterizos. Este artículo explora los retos metodológicos de llevar a cabo estudios de eventos en la investigación financiera internacional. Enfatizamos cómo los académicos deben elegir un evento, seleccionar el período de estudio (corto frente a largo plazo), estimar los rendimientos anormales, inferir estadísticamente si el evento en cuestión produce una reacción fiable de los precios, y explorar el papel de las instituciones formales e informales para explicar las diferencias entre países en las reacciones de los precios. También ofrecemos una extensión de los estudios de eventos a una clase de activos importante pero menos estudiada en un entorno internacional: el mercado de renta fija. Concluimos ofreciendo recomendaciones prácticas para los investigadores que realizan estudios de eventos financieros entre países e identificando oportunidades para futuras investigaciones. Dado el creciente número de eventos mundiales, como la pandemia del COVID-19, el Brexit y el Acuerdo de París y el Acuerdo de Asociación Transpacífico, creemos que nuestro artículo es especialmente oportuno.

Estudos de eventos são amplamente utilizados em pesquisas sobre finanças para investigar as implicações de anúncios de iniciativas corporativas, mudanças regulatórias ou choques macroeconômicos nos preços das ações. Esses estudos são frequentemente usados em um único país (geralmente os EUA), mas pouco trabalho foi realizado em um contexto internacional, talvez devido às complexidades inerentes à implementação de estudos entre países. Este artigo explora os desafios metodológicos na condução de estudos de eventos na pesquisa de finanças internacionais. Enfatizamos como acadêmicos devem escolher um evento, selecionar o período de estudo (curto prazo versus longo prazo), estimar retornos anormais, inferir estatisticamente se o evento em análise produz uma reação de preço confiável e explorar o papel de instituições formais e informais na explicação de diferenças entre países nas reações de preços. Também fornecemos uma extensão dos estudos de eventos para uma classe de ativos importante, mas menos estudada em um cenário internacional ­ o mercado de renda fixa. Concluímos oferecendo recomendações práticas para pesquisadores que realizam estudos de eventos em finanças entre países e identificando oportunidades para pesquisas futuras. Dado o número crescente de eventos globais, como a pandemia de COVID-19, Brexit e os acordos de Paris e parceria Trans-Pacific, acreditamos que nosso artigo é especialmente oportuno.

Morphological and molecular evidences of Ascaridia galli in migratory quail Coturnix coturnix japonica from Baluchistan Pakistan.

The current study was conducted to examine the point prevalence of gastrointestinal parasites of migratory quails. Due to its economic importance, the control of ascaridiosis is critical. Migration of birds is considered to enhance the global spread and cross-species transmission of pathogens. The current study was aimed to detect A.galli in migratory quails, a potential contributory risk factor for transmission of this parasite to local birds. A total of 230 migratory quails were trapped using nets from migratory routes in Balochistan and examined under the compound microscope for the presence of A. galli. Conventionally, A. galli was identified by its morphology with the presence of three large lips and absence of posterior esophageal bulb. Results revealed that out of 230, 120 (52.17%) quails were positive for A. galli by targeting COX1 gene (533 bp) by using conventional PCR. Further, the amplicon was sequenced which showed 99% similarity with A. galli publically available in NCBI Gen Bank. Phylogenetic analysis of sequences of our isolated parasite indicated the close relationship with A.galli isolated from chickens. In conclusion migratory quails and other migratory birds may play a key role in spreading and transmission of these parasites and other pathogens to domestic chicken. Therefore, strict biosecurity measures should be adopted especially for commercial poultry farms.

A massive rock and ice avalanche caused the 2021 disaster at Chamoli, Indian Himalaya.

On 7 February 2021, a catastrophic mass flow descended the Ronti Gad, Rishiganga, and Dhauliganga valleys in Chamoli, Uttarakhand, India, causing widespread devastation and severely damaging two hydropower projects. More than 200 people were killed or are missing. Our analysis of satellite imagery, seismic records, numerical model results, and eyewitness videos reveals that ~27 × 106 cubic meters of rock and glacier ice collapsed from the steep north face of Ronti Peak. The rock and ice avalanche rapidly transformed into an extraordinarily large and mobile debris flow that transported boulders greater than 20 meters in diameter and scoured the valley walls up to 220 meters above the valley floor. The intersection of the hazard cascade with downvalley infrastructure resulted in a disaster, which highlights key questions about adequate monitoring and sustainable development in the Himalaya as well as other remote, high-mountain environments.

Workplace mistreatment and mental health in female surgeons in Pakistan.

BACKGROUND: Despite workplace mistreatment, which includes harassment, bullying and gender discrimination(GD)/bias, being serious problems for female surgeons, there are limited data from lower-middle-income countries like Pakistan. This study explored harassment and GD/bias experienced by female surgeons in Pakistan, and the effects of these experiences on mental health and well-being. METHODS: A nationwide survey was conducted between July and September 2019 in collaboration with the Association of Women Surgeons of Pakistan, an organization consisting of female surgeons and trainees in Pakistan. An anonymous online survey was emailed directly, disseminated via social media platforms (such as Facebook, Twitter and Instagram), and sent to surgical programmes in Pakistan. RESULTS: A total of 146 women surgeons responded to the survey; 67.1 per cent were trainees and the rest attending surgeons. Overall, 57.5 per cent of surgeons reported experiencing harassment, most common being verbal (64.0 per cent) and mental (45.9 per cent), but this mostly went unreported (91.5 per cent). On multivariable analysis adjusted for age and specialty, workplace harassment (odds ratio 2.02 (95 per cent c.i. 1.09 to 4.45)) and bullying (odds ratio 5.14 (95 per cent c.i. 2.00-13.17)) were significantly associated with severe self-perceived burnout, while having a support system was protective against feelings of depression (odds ratio 0.35 (95 per cent c.i. 0.16 to 0.74)). The overwhelming majority (91.3 per cent) believed that more institutional support groups were needed to help surgeons with stress reduction (78.8 per cent), receiving mentorship (74.7 per cent) and work-life balance (67.8 per cent). CONCLUSION: Workplace mistreatment, in particular harassment and bullying, has a damaging impact on the mental well-being of female surgeons, particularly trainees. The absence of support groups in Pakistan should be urgently addressed so that surgeons, especially trainees, may cope better with potentially harmful workplace stressors.

Insulin resistance and intestinal integrity in children with and without HIV infection in Uganda.

OBJECTIVES: The risk of cardiometabolic complications in children with perinatally acquired HIV infection (PHIVs) and in perinatally HIV-exposed but uninfected children (HEUs) and its relationship to systemic inflammation and markers of gut integrity are not well established. In this current study, we assed insulin resitance in PHIV compared to HEUs and HIV unexposed uninfected children and explored potential association with intestinal damage biomarkers. METHODS: This was a cross-sectional study in PHIVs, HEUs and HIV-unexposed, uninfected children (HUUs) aged 2-10 years enrolled in Uganda. PHIVs were on stable antiretroviral therapy (ART) with HIV viral load  < 400 HIV-1 RNA copies/mL. Insulin resistance was estimated using the homeostasis model assessment of insulin resistance (HOMA-IR). We measured markers of systemic inflammation, monocyte activation and gut integrity. Kruskal-Wallis tests were used to compare markers by HIV status; Pearson correlation and multiple linear regressions were used to assess associations of the HOMA-IR index with biomarkers of intestinal damage and translocation. RESULTS: Overall, 172 participants were enrolled in the study (57 PHIVs, 59 HEUs and 56 HUUs). The median age was 7.8 [interquartile range (IQR) 6.39, 8.84] years, 55% were female and the median body mass index (BMI) was 15 (IQR 14.3, 15.8) kg/m2 . Among PHIVs, the median CD4% was 37%, and 93% had viral load ≤ 20 copies/mL. PHIVs had higher waist:hip ratio, high-density lipoprotein (HDL) cholesterol, triglycerides and HOMA-IR index than the other groups (P ≤ 0.02). Factors correlated with insulin resistance included higher BMI and HDL cholesterol and lower soluble tumour necrosis factor receptor I (sTNFRI) (P ≤ 0.02). There was no correlation between any of the other inflammatory or gut biomarkers and HOMA-IR index (P ≥ 0.05). After adjusting for age and sTNFRI, BMI remained independently associated with the HOMA-IR index (ß = 0.16; P < 0.01). CONCLUSIONS: Despite viral suppression, Ugandan PHIVs have disturbances in glucose metabolism. Higher BMI, and not immune activation or alteration of gut integrity, was associated with insulin resistance in this population.

Effect of cholesterol-loaded cyclodextrins on cryosurvival of dog spermatozoa.

Cryopreservation affects integrity of cholesterol and phospholipids in the plasma membrane of sperm leading to decreased fertility of frozen-thawed semen. Cholesterol-loaded cyclodextrins (CLC) have been shown to improve post-thaw semen quality in various species. The aim of this study was to investigate the optimal concentration of CLC for better post-thaw semen quality in dogs. Semen collection, through digital manipulation, was conducted once a week in four adult German shepherd dogs (n = 20 ejaculates; five ejaculates/dog). Semen samples with mass motility>3 (0: without movement; 5: fast progressive movement), motility >70% and concentration >200 × 106 /ml were pooled and processed in Tris-citrate extender containing 0, 1, 2 or 3 mg of CLC. The post-thaw quality was assessed on the basis of percentage motility, morphological abnormalities, live/dead ratio and plasma membrane, acrosome and DNA integrity, evaluated using anova and further analysed by Tukey's range test, if applicable. The addition of CLC showed an overall improvement in post-thaw semen quality. Among various treatment groups, and when compared to the control, the percentages of motile (55.5%), viable (65%), plasma membrane intact (56.7%), acrosome intact (49.2%) and DNA intact (98%) spermatozoa were significantly higher in 2 mg/ml CLC group (p < .05). It is concluded that incorporation of cholesterol in semen extender results in a beneficial increase in post-thaw semen quality in dogs.

Determination of concentrations of Fe, Mg, and Zn in some ferrite samples using neutron activation analysis and X-ray fluorescence techniques.

Mg-Zn ferrite is considered as one of the important materials with potential uses in many applications. In this work, samples of ferrite Mg(1-x)ZnxFe2O4 (where x=0.0, 0.2, 0.4, 0.6, 0.8 and 1) were synthesized by the sol-gel method for use in some hyperthermia applications. The composition and purity of the prepared samples hardly affected their properties. Therefore, the elemental concentration of these samples was measured by the X-ray fluorescence technique and thermal neutron activation analysis to check the quality of the prepared samples. The results of both methods were compared with each other and with the molecular ratios of the as-prepared samples. In addition, no existing elemental impurity, with considerable concentration, was measured.

Alcohol and dietary factors associate with gut integrity and inflammation in HIV-infected adults.

OBJECTIVES: HIV-infected adults have heightened monocyte activation and inflammation, at least partially as a consequence of altered gut integrity. The role of dietary factors in microbial translocation and inflammation and their downstream effect on markers of cardiovascular disease (CVD) have not been explored. Our purpose was to describe the longitudinal dietary patterns of HIV-infected adults, and to examine the relationship between dietary intake, gut integrity, inflammation and subclinical markers of CVD in HIV-infected adults. METHODS: We conducted a secondary analysis of 147 HIV-infected participants in a 96-week randomized clinical trial of rosuvastatin as primary CVD prevention. Dietary intake was assessed using dietary recall; plasma gut integrity, monocyte activation and inflammation markers were measured using an enzyme-linked immunosorbent assay (ELISA); and CVD risk was assessed using carotid ultrasound and the coronary artery calcium score. Linear mixed models were used to analyse longitudinally measured biomarkers. RESULTS: The median age was 45 years and 78% of patients were male. At baseline, participants consumed a mean (standard deviation) of 108 (70) g of fat daily, 19 (15.6) g of fibre, 266 (186) g of carbohydrates and 15.6 (5.9) g of protein; 45% of the sample consumed alcohol. Over time, alcohol consumption was associated with several markers of gut integrity and inflammation (all P < 0.05). CONCLUSIONS: HIV-infected adults in a contemporary, high-resource setting have poor dietary patterns. Alcohol use was associated with worse gut integrity and increased inflammation, while other aspects of diet (fibre, carbohydrates and fat) were not. These data add to growing evidence illustrating the need for a better understanding of the effect of lifestyle factors on comorbidities in HIV-infected adults.

Comparative efficacy of G6G and Ovsynch protocols on synchronization and pregnancy rate in Nili-Ravi buffalo.

The aim of this work was to evaluate the efficacy of G6G and Ovsynch protocols on synchronization and pregnancy rate in Nili-Ravi buffalo. For this, a total of fifty buffalo were assigned into two treatment groups: (1) G6G (n=25) and (2) Ovsynch (n=25). The blood samples were collected from all the treated buffalo on day (D) 7 (PGF2α injection of Ovsynch) to measure the progesterone (P4). All the buffalo were fixed time inseminated (FTAI) following last GnRH of Ovsynch. Ultrasonography was performed for follicular, corpus luteum (CL) dynamics and pregnancy diagnosis. The results revealed that synchronization rate and response to final PGF2α were significantly (P<0.05) higher in G6G compared to Ovsynch. The ovulation to first GnRH of Ovsynch was higher (P<0.05) in G6G (84%) than Ovsynch (56%). The mean dominant follicle size following last GnRH of Ovsynch showed significantly larger diameter in G6G (11.7±0.2mm) compared to Ovsynch (10.9±0.2mm). Moreover, the higher (P<0.05) P4 concentration was observed in G6G than Ovsynch. The presence of double CL on D 7 was higher (P<0.05) in G6G (64%) than Ovsynch (24%) group. The pregnancy rate (P=0.08) tended to be greater in G6G compared to Ovsynch. In conclusion, G6G treatment showed better ovulatory and luteolytic response to first GnRH and PGF2α compared to Ovsynch treatment. Moreover, the addition of GnRH and PGF2α prior to Ovsynch is helpful to improve synchronization application of Ovsynch protocol in Nili-Ravi buffalo.

A Probabilistic Approach to Mitigate Composition Attacks on Privacy in Non-Coordinated Environments.

Organizations share data about individuals to drive business and comply with law and regulation. However, an adversary may expose confidential information by tracking an individual across disparate data publications using quasi-identifying attributes (e.g., age, geocode and sex) associated with the records. Various studies have shown that well-established privacy protection models (e.g., k-anonymity and its extensions) fail to protect an individual's privacy against this "composition attack". This type of attack can be thwarted when organizations coordinate prior to data publication, but such a practice is not always feasible. In this paper, we introduce a probabilistic model called (d, α)-linkable, which mitigates composition attack without coordination. The model ensures that d confidential values are associated with a quasi-identifying group with a likelihood of α. We realize this model through an efficient extension to k-anonymization and use extensive experiments to show our strategy significantly reduces the likelihood of a successful composition attack and can preserve more utility than alternative privacy models, such as differential privacy.

Comparison of transvaginal and transabdominal ultrasonography in the diagnosis of ectopic pregnancy.

This cross sectional study was carried out in the department of Radiology and Imaging, Dhaka Medical College Hospital from July 2008 to June 2010 to compare the accuracy of transvaginal ultrasonography and transabdominal ultrasonography in the diagnosis of clinically suspected cases of ectopic pregnancy. Initially 60 patients with clinical suspicion of ectopic pregnancy were included in this study after analyzing selection criteria 30 patients underwent both transvaginal and transabdominal ultrasonography. 'Histopathological diagnosis' was considered gold standard against which accuracies of two diagnostic modalities were compared. Sensitivity, specificity, positive predictive value, negative predictive value and accuracy of transabdominal ultrasonography as a diagnostic modality in evaluation of suspected ectopic pregnancy were 73.1%, 75%, 95%, 30% and 73.3% respectively where as transvaginal ultrasonography was found to have 92.3% sensitivity, 75% specificity, 96% positive predictive value, 60% negative predictive value and 90% accuracy. Transvaginal ultrasonography was superior to transabdominal ultrasonography in the evaluation of suspected ectopic pregnancies so, transvaginal ultrasonography is important for early and accurate diagnosis of ectopic pregnancy.

The influence of gamete co-incubation length on the in vitro fertility and sex ratio of bovine bulls with different penetration speed.

The objectives of this work were to evaluate whether the sperm penetration speed is correlated to the in vitro fertility and whether adapting the gamete co-incubation length to the kinetics of the bull improves in vitro fertility and affects the sex ratio. In vitro matured oocytes were co-incubated with spermatozoa from four different bulls (A-D). At various post-insemination (p.i.) times (4, 8, 12, 16 and 20 h), samples of oocytes were fixed and stained with DAPI for nuclei examination, while the remaining ones were transferred into culture to evaluate embryo development. The blastocysts produced were sexed by PCR. Two bulls (A and B) had faster kinetics than the others (C and D), as shown by the higher penetration rates recorded at 4 h p.i. (43%, 30%, 11% and 6%, respectively for bulls A, B, C and D; p<0.01). The differences in the kinetics among bulls did not reflect their in vitro fertility. The incidence of polyspermy was higher for faster penetrating bulls (36%, 24%, 16% and 4%, respectively for bulls A, B, C and D; p<0.01) and at longer co-incubation times (0%, 16%, 19%, 30% and 34%, respectively at 4, 8, 12, 16 and 20 h p.i.; p<0.01). The fertilizing ability of individual bulls may be improved by adapting the co-incubation length to their penetration speed. A sperm-oocyte co-incubation length of 8 h ensured the greatest blastocyst yields for the two faster penetrating bulls. On the contrary, 16 h co-incubation was required to increase (p<0.01) cleavage rate of the two slower bulls. Bulls with a faster kinetics did not alter the embryo sex ratio towards males. The female/male (F/M) ratios recorded were 2.1, 1.4, 1.2, 1.3 and 1.6, respectively at 4, 8, 12, 16 and 20 h p.i.

Oman's progress towards reaching "Ultimate Intervention Goals" for the surgery "S" component of SAFE strategy for the elimination of blinding trachoma in 2008.

BACKGROUND: A community based survey for Trachomatous Trichiasis (TT) was conducted in the high (TT >5% in 1997) and meso endemic areas (TT 1% to 5% in 1997) of Oman during 2008-09. METHODS: Investigators examined Omanis 40 age years and older from randomly selected villages. Eyes were examined for TT and vision. The medical history of surgery and advice given for TT surgery were recorded. The TT cases that were unadvised by health staff were defined as un-approached cases. Cluster adjusted prevalence of TT and risk of TT by gender were estimated. RESULT: We examined 4,951 of 5,268 persons in high-endemic areas and 965 of 993 (97.2%) persons in meso-endemic areas. The cluster adjusted prevalence of TT in the high and meso endemic areas were 7.54% (95% Confidence Interval [CI] 6.78-8.30) and 1.69% (95% CI 0.88-2.50) respectively. There were 5 TT patients in high endemic areas and none in meso-endemic areas who were not approached or managed in the past. The prevalence of TT across all ages was less than 1 per 1,000 of the population in all wilayats of Oman. Females had a significantly higher risk of cluster adjusted TT compared to males (Odds Ratio = 1.87 [95% CI 1.85-1.89]). The prevalence of blindness was 0.5% among TT cases in high endemic areas. CONCLUSION: Oman seems to have reached the Ultimate Intervention Goals (UIGs) of the "S" (Surgery) component in 2008 in high and meso-endemic areas. The efforts of existing eye services could be better evaluated if un-approached TT cases are used to calculate the TT prevalence. Oman needs to focus more on females with TT to reach the UIGs.

Regulation of the cell-specific calcitonin/calcitonin gene-related peptide enhancer by USF and the Foxa2 forkhead protein.

An 18-bp enhancer controls cell-specific expression of the calcitonin/calcitonin gene-related peptide gene. The enhancer is bound by a heterodimer of the bHLH-Zip protein USF-1 and -2 and a cell-specific factor from thyroid C cell lines. In this report we have identified the cell-specific factor as the forkhead protein Foxa2 (previously HNF-3beta). Binding of Foxa2 to the 18-bp enhancer was demonstrated using electrophoretic mobility shift assays. The cell-specific DNA-protein complex was selectively competed by a series of Foxa2 DNA binding sites, and the addition of Foxa2 antiserum supershifted the complex. Likewise, a complex similar to that seen with extracts from thyroid C cell lines was generated using an extract from heterologous cells expressing recombinant Foxa2. Interestingly, overexpression of Foxa2 activated the 18-bp enhancer in heterologous cells but only in the presence of the adjacent helix-loop-helix motif. Likewise, coexpression of USF proteins with Foxa2 yielded greater activation than by Foxa2 alone. Unexpectedly, Foxa2 overexpression repressed activity in the CA77 thyroid C cell line, suggesting that Foxa2 may interact with additional cofactors. The stimulatory role of Foxa2 at the calcitonin/calcitonin gene-related peptide gene enhancer was confirmed by short interfering RNA-mediated knockdown of Foxa2. As seen with Foxa2 overexpression, the effect of Foxa2 knockdown also required the adjacent helix-loop-helix motif. These results provide the first evidence for combinatorial control of gene expression by bHLH-Zip and forkhead proteins.

An alarming rate of drug-resistant tuberculosis at Ngwelezane Hospital in northern KwaZulu Natal, South Africa.

OBJECTIVE: To obtain a profile of tuberculosis (TB) cases caused by Mycobacterium tuberculosis in northern KwaZulu Natal (KZN) for 2001. METHOD: The demographic and drug resistance characteristics were determined. A total of 251 smear and culture confirmed cases was obtained and the resistance of three major anti-tuberculosis drugs was tested using the proportion method. RESULTS: The patients were mainly from Ngwelezane (57.8%), Stanger (23.5%) and Manguzi (18.7%); 59.0% were male; 54.2% of the isolates were obtained from new TB patients. The mean age of the TB patients was 29.6 years, with the maximum notification age range at 25-34 years. A high prevalence of drug-resistant and multiresistant TB was observed in this region. At least 55% of previously treated and 19% of new cases from all areas were resistant to at least one of the drugs tested. New patients from Ngwelezane and Manguzi area had a high prevalence of any rifampicin resistance (11.0%) and ethambutol resistance (3.9%), respectively. CONCLUSION: Our results indicate that the TB epidemic in northern KZN, especially in Ngwelezane, is severe. An infrastructure to educate stakeholders about the need to ensure consistency in treatment is needed.

Recurrent Rapunzel syndrome - a case report.

BACKGROUND: Rapunzel syndrome is a rare condition and occurs when gastric trichobezoar extends beyond the pylorus into the bowel. Till to date, only thirteen such cases have been reported in literature in paediatric age group. We present an additional case and also report the first recurrence of the Rapunzel syndrome in a child. CASE REPORT: Rapunzel syndrome in a 12-year-old girl is presented who also had the recurrence. The pathogenesis, clinical features, diagnosis, treatment and literature are reviewed briefly. CONCLUSIONS: Recurrence of Rapunzel Syndrome is very uncommon, and does occur only if the patients are left untreated for their underlying problem. Therefore, to prevent this, a comprehensive management should always be considered.

Lipoprotein (a) and glycaemic control in Pakistani subjects with diabetes mellitus.

AIMS: To measure lipoprotein (Lp)(a) levels in people with diabetes mellitus (DM) and to see if there is any difference in Lp(a) levels between diabetics with good glycaemic control and those with poor glycaemic control. METHODS: Sixty subjects with DM and thirty healthy individuals were studied. Fasting blood samples were analyzed for glucose, glycosylated hemoglobin, Serum total cholesterol, triglycerides, low density lipoproteins, high density lipoproteins and Lp(a). RESULTS: A non significant difference was found between the lipid profile of normal individuals and subjects with DM with a good glycemic control. Lp(a) levels were significantly raised in diabetics. The difference in Lp(a) levels between well controlled and poorly controlled diabetics was non significant. In the control group 23.4% of individuals had high risk levels of Lp(a) while it was 46.7 % for people with DM. CONCLUSION: Glycaemic control improves lipid profile positively in diabetics and may even lead to near normalization of lipoprotein concentrations. Diabetics have elevated levels of Lp(a) and the difference in Lp(a) levels between well controlled and poorly controlled diabeticsts is non-significant.