Endocrine Prehabilitation.

We conceptualize and define endocrine and metabolic prehabilitation as enhancement of physical, psychosocial and social health, prior to a planned medical, surgical or radiotherapeutic endocrine/metabolic intervention, in order to ensure optimal therapeutic outcomes during and after the procedure. This is similar to, but different from the process of endocrine rehabilitation, which follows endocrine therapy. All health care professionals, working as a team, should take responsibility of endocrine prehabilitation.

Early onset unilateral Terrien's marginal degeneration.

A young man in his first decade of life presented with insidious onset, gradually progressive diminution of vision in right eye since 2 months associated with foreign body sensation. Slit-lamp examination revealed superior arcuate band of corneal stromal thinning extending from 9-3 o' clock. There was associated corneal vascularisation and presence of lipid deposition at the leading edge of the furrow formation with intact epithelium without any apparent signs of inflammation. There was no previous history of ocular or systemic disease, trauma, ocular surgery, collagen vascular disease or contact lens wear. Serological tests for rheumatic diseases did not show any abnormalities. Scheimpflug imaging showed high against the rule astigmatism with a 'reverse crab claw' pattern. A provisional diagnosis of right eye Terrien's marginal corneal degeneration was made. On a 1-month follow-up visit, there was significant symptomatic relief with lubricants alone and with spectacles the visual acuity improved to 20/60 in the right eye.

Incidence, short-term outcome, and spatial distribution of stroke patients in Ludhiana, India.

OBJECTIVE: To estimate the incidence, short-term outcome, and spatial distribution of stroke patients and to evaluate the completeness of case ascertainment in Ludhiana. METHODS: This population-based prospective cohort study was conducted in Ludhiana, Punjab, Northwest India. All first-ever stroke patients (≥18 years) were included between March 2010 and March 2013 using WHO Stepwise Approach Surveillance methodology from the city. Stroke patient data were obtained from hospitals, scan centers, and general practitioners, and details of deaths from the Municipal Corporation. RESULTS: Out of 7,199 stroke patients recruited, 3,441 were included in final analysis. The mean age was 59 ± 15 years. The annual incidence rate was 140/100,000 (95% confidence interval [CI] 133-147) and age-adjusted incidence rate was 130/100,000 (95% CI 123-137). The annual incidence rate for stroke in the young (18-49 years) was 46/100,000 (95% CI 41-51). The case fatality at 28 days was 22%. Patients above 60 years of age (p = 0.03) and patients who were managed in public hospitals had poor survival (p = 0.01). Hot spots for cumulative incidence were seen in central and southern parts of the city, and hot spots for poor outcome were seen in the outskirts of the city. CONCLUSIONS: The incidence rates are similar to other studies from India. Stroke patient survival is poor in public hospitals. The finding of spatial analysis is of public health significance for stroke prevention and strengthening of stroke services.

SPAAN: a software program for prediction of adhesins and adhesin-like proteins using neural networks.

MOTIVATION: The adhesion of microbial pathogens to host cells is mediated by adhesins. Experimental methods used for characterizing adhesins are time-consuming and demand large resources. The availability of specialized software can rapidly aid experimenters in simplifying this problem. We have employed 105 compositional properties and artificial neural networks to develop SPAAN, which predicts the probability of a protein being an adhesin (Pad). RESULTS: SPAAN had optimal sensitivity of 89% and specificity of 100% on a defined test set and could identify 97.4% of known adhesins at high Pad value from a wide range of bacteria. Furthermore, SPAAN facilitated improved annotation of several proteins as adhesins. Novel adhesins were identified in 17 pathogenic organisms causing diseases in humans and plants. In the severe acute respiratory syndrome (SARS) associated human corona virus, the spike glycoprotein and nsps (nsp2, nsp5, nsp6 and nsp7) were identified as having adhesin-like characteristics. These results offer new lead for rapid experimental testing. AVAILABILITY: SPAAN is freely available through ftp://203.195.151.45 CONTACT: ramu@igib.res.in.