This study reviewed 50 inflammatory soft tissue lesions surgically removed and diagnosed histologically over a 30-year period from 1978-2007 at the University of Calabar Teaching Hospital in Nigeria. Onchocerciasis accounted for 60% of the lesions, followed by histoplasmosis at 20%. Other identified conditions included mycetoma, molluscum contagiosum, tuberculosis, leishmaniasis, rhinoscleroma, and blastomycosis. The lesions presented most commonly in children and young adults aged 5-15 years. Onchocercal nodules were widely distributed but predominantly in the chest wall. Histoplasmosis lesions were found in the clavicle, shoulder, ankle,
Skin Cancer Patient Ulcer Study by OC Skin Institute's Dr. Tony NakhlaOC Institute
OC Skin Institute's lead dermatologist Dr. Tony Nakhla, investigates the condition of a male patient with several skin cancer instances, some which required Mohs surgery, and the discovery of an ulcer located behind the right ear. Dr. Nakhla practices medical dermatology, as well as cosmetic dermatology, regularly in Orange County California alongside an experienced staff that offers treatments such as skin cancer detection, Mohs surgery, acne treatment, skin cancer removal, mole removal, spider vein therapy and more.
Citrobacter frendii infections in ReptilesCelise Taylor
This document summarizes information about Citrobacter frendii infections in humans and reptiles. It discusses the bacterium's history, associated diseases like pneumonia and meningitis, modes of transmission including person-to-person and through animal hosts like turtles, current treatment approaches using antimicrobial agents, and prevalence based on various studies showing it has infected many humans and captive reptiles. Personal experience is also shared treating infected sliders with topical antimicrobial treatments.
This document provides a historical overview of the classification of nasopharyngeal carcinoma (NPC) from the early 20th century to the present. Early schemes divided NPC into epitheliomas and lymphosarcomas. In the 1920s, the entity of lymphoepithelioma was described based on the mixture of epithelial and lymphoid cells. Through the mid-20th century, NPC was further classified into lymphoepithelioma, transitional cell carcinoma, and squamous cell carcinoma, though distinguishing between types was difficult. Current WHO classification divides NPC into keratinizing and nonkeratinizing types, but histological gradations exist and prognostic significance is unclear. Future classifications may be based
Abdominal tuberculosis: a surgical perplexityKETAN VAGHOLKAR
Abdominal tuberculosis is one of the most challenging forms of extra pulmonary tuberculosis. The diagnosis of the disease itself poses the greatest challenge due to the variability of presentation. Clinical presentations in various forms with conflicting results on a multitude of haematological, immunological and radiological tests causes a lot of confusion in interpreting and correlating the symptoms to arrive at a diagnosis. This adds to the perplexity in surgical management of this complex disease especially in an era where AIDS has added to the problems. Having arrived at a diagnosis, chemotherapy is the mainstay of treatment. Surgery is indicated when the response to medical therapy is poor or complications supervene. Deciding the optimum procedure is again a major issue. Understanding the pathophysiology therefore is pivotal in making a value decision. The article briefly outlines the approach to this surgical perplexity.
This document describes a study analyzing an epidermoid cyst and ridged warts that developed on a patient's feet. Histological and DNA analysis found human papillomavirus 60 (HPV 60) in the cysts, warts, and a connected eccrine duct. Immunohistochemical staining found the cyst expressed markers identical to epidermis layers, not eccrine ducts. A 3D reconstruction from serial sections showed the smallest cyst connected to an eccrine duct. This supports the idea that palmoplantar epidermoid cysts can develop from epidermoid metaplasia of eccrine ducts infected with HPV 60.
Type specific persistence of high risk human papillomavirus (HPV) as indicato...Alberto Cuadrado
Objectives To investigate the role of human
papillomavirus (HPV) in the development of cervical
neoplasia in women with no previous cervical
cytological abnormalities; whether the presence of
virus DNA predicts development of squamous
intraepithelial lesion; and whether the risk of incident
squamous intraepithelial lesions differs with repeated
detection of the same HPV type versus repeated
detection of different types.
Design Population based prospective cohort study.
Setting General population in Copenhagen,
Denmark.
Participants 10 758 women aged 2029 years
followed up for development of cervical cytological
abnormalities; 370 incident cases were detected (40
with atypical squamous cells of undetermined
significance, 165 with low grade squamous
intraepithelial lesions, 165 with high grade squamous
intraepithelial lesions).
Main outcome measures Results of cervical smear
tests and cervical swabs at enrolment and at the
second examination about two years later.
Results Compared with women who were negative
for human papillomavirus at enrolment, those with
positive results had a significantly increased risk at
follow up of having atypical cells (odds ratio 3.2, 95%
confidence interval 1.3 to 7.9), low grade lesions (7.5,
4.8 to 11.7), or high grade lesions (25.8, 15.3 to 43.6).
Similarly, women who were positive for HPV at the
second examination had a strongly increased risk of
low (34.3, 17.6 to 67.0) and high grade lesions (60.7,
25.5 to 144.0). For high grade lesions the risk was
strongly increased if the same virus type was present
at both examinations (813.0, 168.2 to 3229.2).
Conclusions Infection with human papillomavirus
precedes the development of low and high grade
squamous intraepithelial lesions. For high grade
lesions the risk is greatest in women positive for the
same type of HPV on repeated testing.
This document provides an overview of necrotizing gangrene of the genitalia and perineum, a life-threatening soft tissue infection. The infection spreads along fascial planes and can be caused by anorectal, genitourinary, or cutaneous infections. Despite treatment including aggressive debridement and antibiotics, patients experience significant morbidity and mortality. Early diagnosis and complete removal of all necrotic tissue are essential for improved outcomes.
Epidemiologic Classification of Human Papillomavirus Types Associated with Ce...Alberto Cuadrado
background
Infection with human papilloma virus (HPV) is the main cause of cervical cancer, but
the risk associated with the various HPV types has not been adequately assessed.
methods
We pooled data from 11 case–control studies from nine countries involving 1918 women
with histologically confirmed squamous-cell cervical cancer and 1928 control women.
A common protocol and questionnaire were used. Information on risk factors was
obtained by personal interviews, and cervical cells were collected for detection of HPV
DNA and typing in a central laboratory by polymerase-chain-reaction–based assays
(with MY09/MY11 and GP5+/6+ primers).
results
HPV DNA was detected in 1739 of the 1918 patients with cervical cancer (90.7 percent)
and in 259 of the 1928 control women (13.4 percent). With the GP5+/6+ primer, HPV
DNA was detected in 96.6 percent of the patients and 15.6 percent of the controls. The
most common HPV types in patients, in descending order of frequency, were types 16,
18, 45, 31, 33, 52, 58, and 35. Among control women, types 16, 18, 45, 31, 6, 58, 35, and
33 were the most common. For studies using the GP5+/6+ primer, the pooled odds ratio
for cervical cancer associated with the presence of any HPV was 158.2 (95 percent
confidence interval, 113.4 to 220.6). The odds ratios were over 45 for the most common
and least common HPV types. Fifteen HPV types were classified as high-risk types
(16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 68, 73, and 82); 3 were classified as probable
high-risk types (26, 53, and 66); and 12 were classified as low-risk types (6, 11, 40,
42, 43, 44, 54, 61, 70, 72, 81, and CP6108). There was good agreement between our epidemiologic
classification and the classification based on phylogenetic grouping.
conclusions
In addition to HPV types 16 and 18, types 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 68, 73,
and 82 should be considered carcinogenic, or high-risk, types, and types 26, 53, and 66
should be considered probably carcinogenic.
Skin Cancer Patient Ulcer Study by OC Skin Institute's Dr. Tony NakhlaOC Institute
OC Skin Institute's lead dermatologist Dr. Tony Nakhla, investigates the condition of a male patient with several skin cancer instances, some which required Mohs surgery, and the discovery of an ulcer located behind the right ear. Dr. Nakhla practices medical dermatology, as well as cosmetic dermatology, regularly in Orange County California alongside an experienced staff that offers treatments such as skin cancer detection, Mohs surgery, acne treatment, skin cancer removal, mole removal, spider vein therapy and more.
Citrobacter frendii infections in ReptilesCelise Taylor
This document summarizes information about Citrobacter frendii infections in humans and reptiles. It discusses the bacterium's history, associated diseases like pneumonia and meningitis, modes of transmission including person-to-person and through animal hosts like turtles, current treatment approaches using antimicrobial agents, and prevalence based on various studies showing it has infected many humans and captive reptiles. Personal experience is also shared treating infected sliders with topical antimicrobial treatments.
This document provides a historical overview of the classification of nasopharyngeal carcinoma (NPC) from the early 20th century to the present. Early schemes divided NPC into epitheliomas and lymphosarcomas. In the 1920s, the entity of lymphoepithelioma was described based on the mixture of epithelial and lymphoid cells. Through the mid-20th century, NPC was further classified into lymphoepithelioma, transitional cell carcinoma, and squamous cell carcinoma, though distinguishing between types was difficult. Current WHO classification divides NPC into keratinizing and nonkeratinizing types, but histological gradations exist and prognostic significance is unclear. Future classifications may be based
Abdominal tuberculosis: a surgical perplexityKETAN VAGHOLKAR
Abdominal tuberculosis is one of the most challenging forms of extra pulmonary tuberculosis. The diagnosis of the disease itself poses the greatest challenge due to the variability of presentation. Clinical presentations in various forms with conflicting results on a multitude of haematological, immunological and radiological tests causes a lot of confusion in interpreting and correlating the symptoms to arrive at a diagnosis. This adds to the perplexity in surgical management of this complex disease especially in an era where AIDS has added to the problems. Having arrived at a diagnosis, chemotherapy is the mainstay of treatment. Surgery is indicated when the response to medical therapy is poor or complications supervene. Deciding the optimum procedure is again a major issue. Understanding the pathophysiology therefore is pivotal in making a value decision. The article briefly outlines the approach to this surgical perplexity.
This document describes a study analyzing an epidermoid cyst and ridged warts that developed on a patient's feet. Histological and DNA analysis found human papillomavirus 60 (HPV 60) in the cysts, warts, and a connected eccrine duct. Immunohistochemical staining found the cyst expressed markers identical to epidermis layers, not eccrine ducts. A 3D reconstruction from serial sections showed the smallest cyst connected to an eccrine duct. This supports the idea that palmoplantar epidermoid cysts can develop from epidermoid metaplasia of eccrine ducts infected with HPV 60.
Type specific persistence of high risk human papillomavirus (HPV) as indicato...Alberto Cuadrado
Objectives To investigate the role of human
papillomavirus (HPV) in the development of cervical
neoplasia in women with no previous cervical
cytological abnormalities; whether the presence of
virus DNA predicts development of squamous
intraepithelial lesion; and whether the risk of incident
squamous intraepithelial lesions differs with repeated
detection of the same HPV type versus repeated
detection of different types.
Design Population based prospective cohort study.
Setting General population in Copenhagen,
Denmark.
Participants 10 758 women aged 2029 years
followed up for development of cervical cytological
abnormalities; 370 incident cases were detected (40
with atypical squamous cells of undetermined
significance, 165 with low grade squamous
intraepithelial lesions, 165 with high grade squamous
intraepithelial lesions).
Main outcome measures Results of cervical smear
tests and cervical swabs at enrolment and at the
second examination about two years later.
Results Compared with women who were negative
for human papillomavirus at enrolment, those with
positive results had a significantly increased risk at
follow up of having atypical cells (odds ratio 3.2, 95%
confidence interval 1.3 to 7.9), low grade lesions (7.5,
4.8 to 11.7), or high grade lesions (25.8, 15.3 to 43.6).
Similarly, women who were positive for HPV at the
second examination had a strongly increased risk of
low (34.3, 17.6 to 67.0) and high grade lesions (60.7,
25.5 to 144.0). For high grade lesions the risk was
strongly increased if the same virus type was present
at both examinations (813.0, 168.2 to 3229.2).
Conclusions Infection with human papillomavirus
precedes the development of low and high grade
squamous intraepithelial lesions. For high grade
lesions the risk is greatest in women positive for the
same type of HPV on repeated testing.
This document provides an overview of necrotizing gangrene of the genitalia and perineum, a life-threatening soft tissue infection. The infection spreads along fascial planes and can be caused by anorectal, genitourinary, or cutaneous infections. Despite treatment including aggressive debridement and antibiotics, patients experience significant morbidity and mortality. Early diagnosis and complete removal of all necrotic tissue are essential for improved outcomes.
Epidemiologic Classification of Human Papillomavirus Types Associated with Ce...Alberto Cuadrado
background
Infection with human papilloma virus (HPV) is the main cause of cervical cancer, but
the risk associated with the various HPV types has not been adequately assessed.
methods
We pooled data from 11 case–control studies from nine countries involving 1918 women
with histologically confirmed squamous-cell cervical cancer and 1928 control women.
A common protocol and questionnaire were used. Information on risk factors was
obtained by personal interviews, and cervical cells were collected for detection of HPV
DNA and typing in a central laboratory by polymerase-chain-reaction–based assays
(with MY09/MY11 and GP5+/6+ primers).
results
HPV DNA was detected in 1739 of the 1918 patients with cervical cancer (90.7 percent)
and in 259 of the 1928 control women (13.4 percent). With the GP5+/6+ primer, HPV
DNA was detected in 96.6 percent of the patients and 15.6 percent of the controls. The
most common HPV types in patients, in descending order of frequency, were types 16,
18, 45, 31, 33, 52, 58, and 35. Among control women, types 16, 18, 45, 31, 6, 58, 35, and
33 were the most common. For studies using the GP5+/6+ primer, the pooled odds ratio
for cervical cancer associated with the presence of any HPV was 158.2 (95 percent
confidence interval, 113.4 to 220.6). The odds ratios were over 45 for the most common
and least common HPV types. Fifteen HPV types were classified as high-risk types
(16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 68, 73, and 82); 3 were classified as probable
high-risk types (26, 53, and 66); and 12 were classified as low-risk types (6, 11, 40,
42, 43, 44, 54, 61, 70, 72, 81, and CP6108). There was good agreement between our epidemiologic
classification and the classification based on phylogenetic grouping.
conclusions
In addition to HPV types 16 and 18, types 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 68, 73,
and 82 should be considered carcinogenic, or high-risk, types, and types 26, 53, and 66
should be considered probably carcinogenic.
frequency of cryptococcus species and varieties in méxicoIPN
This study analyzed 211 Cryptococcus strains isolated from patients in Mexico City hospitals between 1989-1998. C. neoformans was the dominant species isolated (97.15%), followed by C. albidus and C. uniguttulatus. Most strains were isolated from cerebral spinal fluid (92.5%) and AIDS was the main predisposing factor (85%). The disease was found to predominantly affect males (87.3%) in their third (33.8%) and fourth (37.5%) decades of life. When compared to other Latin American countries, the isolation frequency of C. neoformans var. neoformans and var. gattii in Mexico was most similar to Brazil.
Papillomavirus research update: highlights of the Barcelona HPV 2000 internat...Alberto Cuadrado
This document summarizes highlights from the 18th International Papillomavirus Conference held in Barcelona, Spain in July 2000. It discusses several key topics:
1) Epidemiological studies presented data on HPV prevalence by age and risk factors like oral contraceptive use.
2) Studies of HPV serology found correlations between antibody levels and sexual behavior or HPV infection status.
3) Research on potential cofactors in cervical cancer like chlamydia infection presented both supporting and non-supporting evidence for their role in carcinogenesis.
The Natural History of Type-specific Human Papillomavirus Infections in Femal...Alberto Cuadrado
This study examined the natural history of type-specific HPV infections in female university students over 24 months. Key findings include:
- The incidence rates of acquiring high-risk or low-risk HPV infections were similar at around 14 and 12 cases per 1000 women-months, respectively.
- HPV-16, -51, and -84 had the highest rates of new acquisition at around 5, 3, and 4 cases per 1000 women-months, respectively.
- HPV-16 infections persisted the longest on average at 18 months, followed by HPV-31 and HPV-53 at around 14-15 months. HPV-6 and HPV-84 cleared fastest on average in under 10 months.
- After
Prospects for primary prevention of cervical cancer in developing countriesAlberto Cuadrado
This document discusses prospects for primary prevention of cervical cancer in developing countries through HPV vaccination. It notes that HPV types 16 and 18 cause the majority of cervical cancers worldwide. Vaccines against HPV, particularly virus-like particle vaccines, show promise in preventing HPV infection and progression to cervical cancer. While efficacy trials of HPV vaccines are underway, effectiveness trials under field conditions in developing countries are also needed to demonstrate the real-world impact of HPV vaccination programs in reducing cervical cancer incidence and mortality over prolonged follow-up periods of 20 years or more. Such effectiveness trials could help accelerate adoption of HPV vaccination in populations that bear the greatest cervical cancer burden.
Genotyping of 27 Human Papillomavirus Types by Using L1 Consensus PCR Product...Alberto Cuadrado
Amplification of human papillomavirus (HPV) DNA by L1 consensus primer systems (e.g., MY09/11 or
GP51/61) can detect as few as 10 to 100 molecules of HPV targets from a genital sample. However, genotype
determination by dot blot hybridization is laborious and requires at least 27 separate hybridizations for
substantive HPV-type discrimination. A reverse blot method was developed which employs a biotin-labeled
PCR product hybridized to an array of immobilized oligonucleotide probes. By the reverse blot strip analysis,
genotype discrimination of multiple HPV types can be accomplished in a single hybridization and wash cycle.
Twenty-seven HPV probe mixes, two control probe concentrations, and a single reference line were immobilized
to 75- by 6-mm nylon strips. Each individual probe line contained a mixture of two bovine serum albuminconjugated
oligonucleotide probes specific to a unique HPV genotype. The genotype spectrum discriminated on
this strip includes the high-risk, or cancer-associated, HPV genotypes 16, 18, 26, 31, 33, 35, 39, 45, 51, 52, 55,
56, 58, 59, 68 (ME180), MM4 (W13B), MM7 (P291), and MM9 (P238A) and the low-risk, or non-cancerassociated,
genotypes 6, 11, 40, 42, 53, 54, 57, 66, and MM8 (P155). In addition, two concentrations of b-globin
probes allowed for assessment of individual specimen adequacy following amplification. We have evaluated the
performance of the strip method relative to that of a previously reported dot blot format (H. M. Bauer et al.,
p. 132–152, in C. S. Herrington and J. O. D. McGee (ed.), Diagnostic Molecular Pathology: a Practical Approach,
(1992), by testing 328 cervical swab samples collected in Digene specimen transport medium (Digene Diagnostics,
Silver Spring, Md.). We show excellent agreement between the two detection formats, with 92%
concordance for HPV positivity (kappa 5 0.78, P < 0.001). Nearly all of the discrepant HPV-positive samples
resulted from weak signals and can be attributed to sampling error from specimens with low concentrations
(<1 copy/ml) of HPV DNA. The primary advantage of the strip-based detection system is the ability to rapidly
genotype HPVs present in genital samples with high sensitivity and specificity, minimizing the likelihood of
misclassification.
This document provides an overview of fascial space infections, including their classification, stages, microbiology, and management. It discusses various fascial spaces of the head and neck region that can become infected, including the maxillary spaces (canine, palatal, infratemporal), mandibular spaces (submental, submandibular, sublingual), and secondary spaces (lateral pharyngeal, retropharyngeal). It also outlines the progression of odontogenic infections and signs of cellulitis versus abscess formation. The principles of treatment involve determining infection severity, surgical drainage, medical support, and antibiotic selection.
Epidemiology of Onychomycosis in Pernambuco, Northeastern of Brazil: Results ...CrimsonpublishersCJMI
Epidemiology of Onychomycosis in Pernambuco, Northeastern of Brazil: Results of a Laboratory-Based Survey by Gonçalves de Lima Neto in Cohesive Journal of Microbiology & Infectious Disease
This study summarizes the parasitic polymorphism of Coccidioides spp. observed in clinical specimens from patients with coccidioidomycosis. The following parasitic forms were observed: 1) spherules/endospores at different maturation stages; 2) pleomorphic mycelial cells like septate hyphae and arthroconidia; and 3) fungal ball formations containing mycelia and arthroconidia. This parasitic polymorphism had not been fully documented previously and recognizing these diverse forms is important for accurate diagnosis of coccidioidomycosis.
This editorial summarizes recent research on oncolytic viruses for cancer therapy. It discusses how oncolytic viruses can directly kill tumor cells and induce immune responses. Clinical trials have explored various naturally occurring and engineered viruses to treat cancers like melanoma, hepatocellular carcinoma, and glioblastoma. Recent FDA approval of the first oncolytic virus therapy for melanoma marks progress in the field. However, many questions remain regarding optimal viruses, combinations, dosages and administration methods. The role of the immune system is complex, with barriers and opportunities to leverage. Future work is needed to address challenges and maximize the potential of this innovative cancer treatment approach.
Surgical Infection. Acute purulent infection of skin & cellular spasesEneutron
The document discusses various types of acute and chronic surgical infections, including their causes, classifications, and treatments. It describes purulent surgical infections as inflammatory processes of different localizations caused by purulent microorganisms. Surgical infections are classified based on factors like progression, etiology, and localization. Treatment involves both conservative methods like antibiotics in early stages and surgical drainage and debridement of pus or necrotic tissues in later stages. Specific infections discussed include furuncles, carbuncles, abscesses, phlegmons, erysipelas, lymphangitis, and various types of panaritium.
This study analyzed 182 pediatric patients under 14 years old with Staphylococcus aureus infections from 3 hospitals in Medellin, Colombia between 2008-2010. 41.4% of patients were under 1 year old. The most common infections were skin and soft tissue infections. Patients with methicillin-resistant S. aureus infections were more likely to have attended daycare centers or taken previous antibiotics. Sixteen different clonal complexes were identified among the isolates, with methicillin-susceptible S. aureus strains showing more diversity. The most common staphylococcal cassette chromosome mec type was IVc, which was linked to Panton-Valentine leukocidin genes. This prevalence of S. aureus infections in
1) The document discusses research on oral cancer stem cells (CSCs) and their role in oral cancer invasion and metastasis.
2) It describes experiments showing that oral CSCs express markers like CD44 and sLeX that increase their ability to migrate and metastasize.
3) The research aims to better understand the relationship between CD44 and sLeX expression and their role in oral squamous cell carcinoma progression and metastasis. Preliminary studies indicate these markers correlate with and play a critical role in the metastatic process.
Crohn's disease is a chronic inflammatory bowel disease that can involve any part of the gastrointestinal tract. Metastatic Crohn's disease (MCD) is a rare cutaneous manifestation where noncaseating granulomatous skin lesions occur at sites separate from the GI tract in patients with Crohn's. MCD most often presents as papules, plaques or nodules on the arms, legs, genitalia and face. Histopathology of MCD shows granulomatous inflammation in the dermis. Treatment options include steroids, antibiotics, immunosuppressants, infliximab and surgery.
This document summarizes the results of sequencing and analyzing genomes of Mycobacterium tuberculosis isolates from 5 patients with extra-pulmonary tuberculosis. Key findings include:
1. The isolates showed genetic heterogeneity, with variations in single nucleotide polymorphisms and presence/absence of genes compared to the reference genome.
2. One isolate (LN8) showed the highest number of unique single nucleotide variations and gene deletions, indicating it had diverged more than the others.
3. Several genes missing or disrupted in the isolates are involved in important processes like cell wall biosynthesis and membrane transport, which may influence pathogenesis.
4. The variations identified suggest next-generation sequencing can effectively detect small genomic changes in M
Comparison of tzanck smear with viral serology in varicellaEva Yustiana
This document summarizes a study comparing the Tzanck smear test to viral serology for diagnosing varicella (chickenpox). The study analyzed 50 patients with symptoms of varicella. The Tzanck smear, which examines skin scrapings for multinucleated giant cells, was positive in 66% of patients. Viral serology, which detects antibodies against the varicella virus, was positive in 90% of patients. Both tests showed matching positive results in 62% of patients. The study concludes that the Tzanck smear provides a quick diagnosis of varicella but may miss some cases, while viral serology confirms diagnosis but requires longer for results.
This document provides information on autoimmune disorders, including:
- Causes of autoimmunity include sequestered antigens, altered antigens, loss of immunoregulation, and loss of self-tolerance.
- Common autoimmune diseases discussed include systemic lupus erythematosus and systemic sclerosis.
- For systemic lupus erythematosus, clinical manifestations, etiology, pathology, and treatment are summarized. Oral manifestations including bleeding and ulcers are also noted.
- Systemic sclerosis causes fibrosis of the skin, subcutaneous tissue, muscles and internal organs. Its etiology is unclear but involves genetic and environmental factors.
This document discusses necrotizing fasciitis and gas gangrene. It defines them as necrotizing soft tissue infections caused by bacteria. For necrotizing fasciitis, it lists risk factors like diabetes and clinical signs like disproportionate pain. Evaluation involves labs, cultures, and imaging. Treatment is emergent debridement and broad-spectrum antibiotics. Gas gangrene is caused by Clostridium bacteria following trauma. It presents with pain, swelling and a sweet odor, and is treated with surgery and antibiotics against Clostridium like penicillin and clindamycin.
Species distribution and virulence factors of coagulase negative staphylococc...Alexander Decker
This document summarizes a study on coagulase-negative staphylococci (CoNS) isolated from clinical samples in Nigeria. The most common CoNS species isolated were S. haemolyticus (28.3%), S. epidermidis (26.7%), and S. saprophyticus (18.3%). Many of the CoNS isolates produced virulence factors like hemolysins and biofilms. Hemolysis was observed in 34.2% of isolates, most frequently in S. haemolyticus (58.8%). Slime production, an indicator of biofilm formation, was detected in 75.95% of isolates, with high rates in S. epidermidis (93.
Measuring the impact of schistosomiasis infection on different blood parametersAlexander Decker
This study assessed the impact of Schistosoma mansoni infection on various blood parameters in 100 infected patients in Sudan. The results showed reductions in hemoglobin, red blood cell count, hematocrit, and other measures in infected individuals compared to a control group. Additionally, higher parasite densities were associated with greater reductions in most blood parameters, indicating more severe infection leads to more pronounced anemia and other blood abnormalities. The study concluded S. mansoni infection negatively impacts blood parameters important for assessing anemia and other health issues.
This document provides an overview of mucormycosis, a fungal infection caused by certain mold species. It discusses the risk factors, pathogenesis, clinical presentation, diagnosis and treatment of mucormycosis. The main treatment involves antifungal drugs like amphotericin B and posaconazole, surgical debridement of infected tissues, and controlling underlying risk factors like diabetes.
Efficient design of feedforward network for pattern classificationIOSR Journals
This document compares the performance of radial basis function (RBF) networks and multi-layer perceptron (MLP) networks for pattern classification tasks. It analyzes the training time of RBF and MLP networks on two datasets: a below poverty line (BPL) dataset with 293 samples and 13 features, and a breast cancer dataset with 699 samples and 9 features. For both datasets, RBF networks trained significantly faster than MLP networks using the same number of hidden neurons, without affecting classification performance. The document concludes that RBF networks perform training faster than MLP networks for these pattern classification problems.
The document analyzes and designs a multi-cell post-tensioned pre-stressed concrete box girder bridge with a 35m span. Two different duct materials, HDPE and corrugated bright metal, are considered to determine the most economical design. Finite element modeling and analysis of the box girder is performed using CSI Bridge software. The design is done according to Indian code specifications, considering aspects such as section properties, load calculations, stress limits, prestressing calculations and loss estimates, and serviceability checks. Results for bending moments, shear forces, displacements and stresses are obtained and compared for both duct options.
frequency of cryptococcus species and varieties in méxicoIPN
This study analyzed 211 Cryptococcus strains isolated from patients in Mexico City hospitals between 1989-1998. C. neoformans was the dominant species isolated (97.15%), followed by C. albidus and C. uniguttulatus. Most strains were isolated from cerebral spinal fluid (92.5%) and AIDS was the main predisposing factor (85%). The disease was found to predominantly affect males (87.3%) in their third (33.8%) and fourth (37.5%) decades of life. When compared to other Latin American countries, the isolation frequency of C. neoformans var. neoformans and var. gattii in Mexico was most similar to Brazil.
Papillomavirus research update: highlights of the Barcelona HPV 2000 internat...Alberto Cuadrado
This document summarizes highlights from the 18th International Papillomavirus Conference held in Barcelona, Spain in July 2000. It discusses several key topics:
1) Epidemiological studies presented data on HPV prevalence by age and risk factors like oral contraceptive use.
2) Studies of HPV serology found correlations between antibody levels and sexual behavior or HPV infection status.
3) Research on potential cofactors in cervical cancer like chlamydia infection presented both supporting and non-supporting evidence for their role in carcinogenesis.
The Natural History of Type-specific Human Papillomavirus Infections in Femal...Alberto Cuadrado
This study examined the natural history of type-specific HPV infections in female university students over 24 months. Key findings include:
- The incidence rates of acquiring high-risk or low-risk HPV infections were similar at around 14 and 12 cases per 1000 women-months, respectively.
- HPV-16, -51, and -84 had the highest rates of new acquisition at around 5, 3, and 4 cases per 1000 women-months, respectively.
- HPV-16 infections persisted the longest on average at 18 months, followed by HPV-31 and HPV-53 at around 14-15 months. HPV-6 and HPV-84 cleared fastest on average in under 10 months.
- After
Prospects for primary prevention of cervical cancer in developing countriesAlberto Cuadrado
This document discusses prospects for primary prevention of cervical cancer in developing countries through HPV vaccination. It notes that HPV types 16 and 18 cause the majority of cervical cancers worldwide. Vaccines against HPV, particularly virus-like particle vaccines, show promise in preventing HPV infection and progression to cervical cancer. While efficacy trials of HPV vaccines are underway, effectiveness trials under field conditions in developing countries are also needed to demonstrate the real-world impact of HPV vaccination programs in reducing cervical cancer incidence and mortality over prolonged follow-up periods of 20 years or more. Such effectiveness trials could help accelerate adoption of HPV vaccination in populations that bear the greatest cervical cancer burden.
Genotyping of 27 Human Papillomavirus Types by Using L1 Consensus PCR Product...Alberto Cuadrado
Amplification of human papillomavirus (HPV) DNA by L1 consensus primer systems (e.g., MY09/11 or
GP51/61) can detect as few as 10 to 100 molecules of HPV targets from a genital sample. However, genotype
determination by dot blot hybridization is laborious and requires at least 27 separate hybridizations for
substantive HPV-type discrimination. A reverse blot method was developed which employs a biotin-labeled
PCR product hybridized to an array of immobilized oligonucleotide probes. By the reverse blot strip analysis,
genotype discrimination of multiple HPV types can be accomplished in a single hybridization and wash cycle.
Twenty-seven HPV probe mixes, two control probe concentrations, and a single reference line were immobilized
to 75- by 6-mm nylon strips. Each individual probe line contained a mixture of two bovine serum albuminconjugated
oligonucleotide probes specific to a unique HPV genotype. The genotype spectrum discriminated on
this strip includes the high-risk, or cancer-associated, HPV genotypes 16, 18, 26, 31, 33, 35, 39, 45, 51, 52, 55,
56, 58, 59, 68 (ME180), MM4 (W13B), MM7 (P291), and MM9 (P238A) and the low-risk, or non-cancerassociated,
genotypes 6, 11, 40, 42, 53, 54, 57, 66, and MM8 (P155). In addition, two concentrations of b-globin
probes allowed for assessment of individual specimen adequacy following amplification. We have evaluated the
performance of the strip method relative to that of a previously reported dot blot format (H. M. Bauer et al.,
p. 132–152, in C. S. Herrington and J. O. D. McGee (ed.), Diagnostic Molecular Pathology: a Practical Approach,
(1992), by testing 328 cervical swab samples collected in Digene specimen transport medium (Digene Diagnostics,
Silver Spring, Md.). We show excellent agreement between the two detection formats, with 92%
concordance for HPV positivity (kappa 5 0.78, P < 0.001). Nearly all of the discrepant HPV-positive samples
resulted from weak signals and can be attributed to sampling error from specimens with low concentrations
(<1 copy/ml) of HPV DNA. The primary advantage of the strip-based detection system is the ability to rapidly
genotype HPVs present in genital samples with high sensitivity and specificity, minimizing the likelihood of
misclassification.
This document provides an overview of fascial space infections, including their classification, stages, microbiology, and management. It discusses various fascial spaces of the head and neck region that can become infected, including the maxillary spaces (canine, palatal, infratemporal), mandibular spaces (submental, submandibular, sublingual), and secondary spaces (lateral pharyngeal, retropharyngeal). It also outlines the progression of odontogenic infections and signs of cellulitis versus abscess formation. The principles of treatment involve determining infection severity, surgical drainage, medical support, and antibiotic selection.
Epidemiology of Onychomycosis in Pernambuco, Northeastern of Brazil: Results ...CrimsonpublishersCJMI
Epidemiology of Onychomycosis in Pernambuco, Northeastern of Brazil: Results of a Laboratory-Based Survey by Gonçalves de Lima Neto in Cohesive Journal of Microbiology & Infectious Disease
This study summarizes the parasitic polymorphism of Coccidioides spp. observed in clinical specimens from patients with coccidioidomycosis. The following parasitic forms were observed: 1) spherules/endospores at different maturation stages; 2) pleomorphic mycelial cells like septate hyphae and arthroconidia; and 3) fungal ball formations containing mycelia and arthroconidia. This parasitic polymorphism had not been fully documented previously and recognizing these diverse forms is important for accurate diagnosis of coccidioidomycosis.
This editorial summarizes recent research on oncolytic viruses for cancer therapy. It discusses how oncolytic viruses can directly kill tumor cells and induce immune responses. Clinical trials have explored various naturally occurring and engineered viruses to treat cancers like melanoma, hepatocellular carcinoma, and glioblastoma. Recent FDA approval of the first oncolytic virus therapy for melanoma marks progress in the field. However, many questions remain regarding optimal viruses, combinations, dosages and administration methods. The role of the immune system is complex, with barriers and opportunities to leverage. Future work is needed to address challenges and maximize the potential of this innovative cancer treatment approach.
Surgical Infection. Acute purulent infection of skin & cellular spasesEneutron
The document discusses various types of acute and chronic surgical infections, including their causes, classifications, and treatments. It describes purulent surgical infections as inflammatory processes of different localizations caused by purulent microorganisms. Surgical infections are classified based on factors like progression, etiology, and localization. Treatment involves both conservative methods like antibiotics in early stages and surgical drainage and debridement of pus or necrotic tissues in later stages. Specific infections discussed include furuncles, carbuncles, abscesses, phlegmons, erysipelas, lymphangitis, and various types of panaritium.
This study analyzed 182 pediatric patients under 14 years old with Staphylococcus aureus infections from 3 hospitals in Medellin, Colombia between 2008-2010. 41.4% of patients were under 1 year old. The most common infections were skin and soft tissue infections. Patients with methicillin-resistant S. aureus infections were more likely to have attended daycare centers or taken previous antibiotics. Sixteen different clonal complexes were identified among the isolates, with methicillin-susceptible S. aureus strains showing more diversity. The most common staphylococcal cassette chromosome mec type was IVc, which was linked to Panton-Valentine leukocidin genes. This prevalence of S. aureus infections in
1) The document discusses research on oral cancer stem cells (CSCs) and their role in oral cancer invasion and metastasis.
2) It describes experiments showing that oral CSCs express markers like CD44 and sLeX that increase their ability to migrate and metastasize.
3) The research aims to better understand the relationship between CD44 and sLeX expression and their role in oral squamous cell carcinoma progression and metastasis. Preliminary studies indicate these markers correlate with and play a critical role in the metastatic process.
Crohn's disease is a chronic inflammatory bowel disease that can involve any part of the gastrointestinal tract. Metastatic Crohn's disease (MCD) is a rare cutaneous manifestation where noncaseating granulomatous skin lesions occur at sites separate from the GI tract in patients with Crohn's. MCD most often presents as papules, plaques or nodules on the arms, legs, genitalia and face. Histopathology of MCD shows granulomatous inflammation in the dermis. Treatment options include steroids, antibiotics, immunosuppressants, infliximab and surgery.
This document summarizes the results of sequencing and analyzing genomes of Mycobacterium tuberculosis isolates from 5 patients with extra-pulmonary tuberculosis. Key findings include:
1. The isolates showed genetic heterogeneity, with variations in single nucleotide polymorphisms and presence/absence of genes compared to the reference genome.
2. One isolate (LN8) showed the highest number of unique single nucleotide variations and gene deletions, indicating it had diverged more than the others.
3. Several genes missing or disrupted in the isolates are involved in important processes like cell wall biosynthesis and membrane transport, which may influence pathogenesis.
4. The variations identified suggest next-generation sequencing can effectively detect small genomic changes in M
Comparison of tzanck smear with viral serology in varicellaEva Yustiana
This document summarizes a study comparing the Tzanck smear test to viral serology for diagnosing varicella (chickenpox). The study analyzed 50 patients with symptoms of varicella. The Tzanck smear, which examines skin scrapings for multinucleated giant cells, was positive in 66% of patients. Viral serology, which detects antibodies against the varicella virus, was positive in 90% of patients. Both tests showed matching positive results in 62% of patients. The study concludes that the Tzanck smear provides a quick diagnosis of varicella but may miss some cases, while viral serology confirms diagnosis but requires longer for results.
This document provides information on autoimmune disorders, including:
- Causes of autoimmunity include sequestered antigens, altered antigens, loss of immunoregulation, and loss of self-tolerance.
- Common autoimmune diseases discussed include systemic lupus erythematosus and systemic sclerosis.
- For systemic lupus erythematosus, clinical manifestations, etiology, pathology, and treatment are summarized. Oral manifestations including bleeding and ulcers are also noted.
- Systemic sclerosis causes fibrosis of the skin, subcutaneous tissue, muscles and internal organs. Its etiology is unclear but involves genetic and environmental factors.
This document discusses necrotizing fasciitis and gas gangrene. It defines them as necrotizing soft tissue infections caused by bacteria. For necrotizing fasciitis, it lists risk factors like diabetes and clinical signs like disproportionate pain. Evaluation involves labs, cultures, and imaging. Treatment is emergent debridement and broad-spectrum antibiotics. Gas gangrene is caused by Clostridium bacteria following trauma. It presents with pain, swelling and a sweet odor, and is treated with surgery and antibiotics against Clostridium like penicillin and clindamycin.
Species distribution and virulence factors of coagulase negative staphylococc...Alexander Decker
This document summarizes a study on coagulase-negative staphylococci (CoNS) isolated from clinical samples in Nigeria. The most common CoNS species isolated were S. haemolyticus (28.3%), S. epidermidis (26.7%), and S. saprophyticus (18.3%). Many of the CoNS isolates produced virulence factors like hemolysins and biofilms. Hemolysis was observed in 34.2% of isolates, most frequently in S. haemolyticus (58.8%). Slime production, an indicator of biofilm formation, was detected in 75.95% of isolates, with high rates in S. epidermidis (93.
Measuring the impact of schistosomiasis infection on different blood parametersAlexander Decker
This study assessed the impact of Schistosoma mansoni infection on various blood parameters in 100 infected patients in Sudan. The results showed reductions in hemoglobin, red blood cell count, hematocrit, and other measures in infected individuals compared to a control group. Additionally, higher parasite densities were associated with greater reductions in most blood parameters, indicating more severe infection leads to more pronounced anemia and other blood abnormalities. The study concluded S. mansoni infection negatively impacts blood parameters important for assessing anemia and other health issues.
This document provides an overview of mucormycosis, a fungal infection caused by certain mold species. It discusses the risk factors, pathogenesis, clinical presentation, diagnosis and treatment of mucormycosis. The main treatment involves antifungal drugs like amphotericin B and posaconazole, surgical debridement of infected tissues, and controlling underlying risk factors like diabetes.
Efficient design of feedforward network for pattern classificationIOSR Journals
This document compares the performance of radial basis function (RBF) networks and multi-layer perceptron (MLP) networks for pattern classification tasks. It analyzes the training time of RBF and MLP networks on two datasets: a below poverty line (BPL) dataset with 293 samples and 13 features, and a breast cancer dataset with 699 samples and 9 features. For both datasets, RBF networks trained significantly faster than MLP networks using the same number of hidden neurons, without affecting classification performance. The document concludes that RBF networks perform training faster than MLP networks for these pattern classification problems.
The document analyzes and designs a multi-cell post-tensioned pre-stressed concrete box girder bridge with a 35m span. Two different duct materials, HDPE and corrugated bright metal, are considered to determine the most economical design. Finite element modeling and analysis of the box girder is performed using CSI Bridge software. The design is done according to Indian code specifications, considering aspects such as section properties, load calculations, stress limits, prestressing calculations and loss estimates, and serviceability checks. Results for bending moments, shear forces, displacements and stresses are obtained and compared for both duct options.
Efficient Design of Transceiver for Wireless Body Area NetworksIOSR Journals
This document describes the efficient design of a transceiver for wireless body area networks (WBANs). It proposes a low-power and low-complexity baseband transceiver specification with a digital timing synchronization scheme. The transceiver uses frequency-shift keying modulation and includes transmitter and receiver baseband modules. The transmitter module encodes and processes data for transmission, while the receiver module recovers timing and data from the received signal. Simulation results show the transceiver achieves ultra-low power consumption of 58mW for transmission and 59mW for reception at 4MHz operation.
Performance of Phase Congruency and Linear Feature Extraction for Satellite I...IOSR Journals
This document summarizes research on extracting linear features from satellite images. It introduces using a phase congruency and linear feature extraction model combined with an adaptive smoothing algorithm. The paper aims to evaluate the advantages and limitations of this approach when applied to satellite image feature extraction. It also describes other common feature extraction methods, such as using mathematical morphology operations like dilation and erosion. Overall, the document reviews techniques for automated linear feature extraction from satellite imagery.
1. The document proposes an efficient algorithm to retrieve videos from a database using a video clip as a query.
2. Key features like color, texture, edges and motion are extracted from video shots and clusters are created using these features to reduce search time complexity.
3. When a query video is given, its features are used to search the closest cluster. Then sequential matching of additional features and shot lengths is done to find the most similar matching videos from the database.
An Improved Phase Disposition Pulse Width Modulation (PDPWM) For a Modular Mu...IOSR Journals
1) The document proposes an improved phase disposition pulse width modulation (PDPWM) method for a modular multilevel inverter used for photovoltaic grid connection.
2) The method, called selective virtual loop mapping (SVLM), aims to achieve dynamic capacitor voltage balance without adding an extra compensation signal.
3) It establishes the concept of virtual submodules and balances voltages by changing the loop mapping relationships between virtual and real submodules, making it suitable for modular multilevel converters with a large number of submodules.
Wireless Sensor Network: an emerging entrant in HealthcareIOSR Journals
This document discusses the potential for wireless sensor networks in healthcare applications. It describes how wireless sensor networks can be used to monitor patients remotely by collecting physiological data from sensor devices. Some challenges to the adoption of this technology in healthcare include ensuring privacy and security of medical data transmitted over wireless networks. The document also provides examples of how wireless body area networks and wearable sensor devices can help monitor aspects of health and enable at-home health monitoring.
Increase In Electrical And Thermal Conductivities Of Doped Polymers Dependent...IOSR Journals
Most Polymers do not possess natural intrinsic properties that will be enough for them to be used as semi- conductors. In the world trend of industrial growth where polymers seem to be replacing all semi-conductors because of their availability, durability, recyclability and reduced cost, attention is being strongly given to their improvement them for this essential function hence the need for this research.Eight samples each of four polymers; polyethylene (PE), polystyrene (PS), poly propylene (PP),nylon 66 were prepared by doping with different concentrationsof graphite to enhance their electrical and thermal conductivities, considering the fact that they are of different intrinsic properties. The samples were testedfor their electrical and thermal conductivities.It was evident that as the concentration of the graphite dopantincreases, the electrical and thermal conductivities of all the polymers increased although not at the same rate.The most interesting fact is that all polymers that showed highly favorable results in electrical conductivity, showed the least for thermal conductivities which can be attributed to their intrinsic properties.
Implementation of PCI Target Controller Interfacing with Asynchronous SRAMIOSR Journals
Abstract: In this paper, we present design of a PCI (Peripheral Component Interconnect) target controller
which is interfacing with asynchronous SRAM 64kX8 memory. The target controller provides the control signals
to the SRAM for read and writes cycles. The master sends the address, data and other control signals. Based on
these signals the controller initiates the read and write cycles we have designed PCI block diagram which
represents how the master controls target and target interfaces with memory. We also designed state machine to
generate control signals for target controller by which the controller initiates the read and write cycles. PCI
implements a 32-bit multiplexed Address and Data bus (AD [31:0]).The simulation results presented in this
paper represents read and write transactions between slave and memory according to commands generated by
controller. We have been used Xilinx ISE project navigator 0.40d to simulate project code which is written in
Verilog Hardware Description Language. We have been tested our functionality by writing test bench and then
compared that results with actual functionality.
Keywords – Asynchronous SRAM, PCI, PCI connector
A Comparative Study on Dyeing of Cotton and Silk Fabric Using Madder as a Nat...IOSR Journals
This document presents a study comparing the dyeing of cotton and silk fabrics with madder, a natural red dye. Various mordanting techniques were tested, including pre-mordanting, post-mordanting, and simultaneous mordanting with alum and copper sulfate. The dyed fabrics were evaluated based on color characteristics and colorfastness properties. The results showed that silk fabrics dyed darker shades than cotton and exhibited better colorfastness to washing and rubbing when mordanted. Mordanted silk samples showed deeper colors and greater wash fastness compared to mordanted cotton samples. While mordanting improved some properties, the dyed fabrics generally displayed poor perspiration fastness.
Comparison of Psychological Variables within different positions of players o...IOSR Journals
This document discusses a study that compared psychological variables (competition anxiety, achievement motivation, and self-concept) among different playing positions (front, middle, back) of junior state boys' badminton players in Manipur, India. Sixty players participated in a tournament and completed questionnaires measuring the psychological variables. Results found no significant differences in competition anxiety, achievement motivation, or self-concept between the different playing positions.
Performance optimization of thermal systems in textile industriesIOSR Journals
Energy consumption has been growing very rapidly due to population growth, rapid urbanization
and industrial development. For future planning, it is important to know the current specific energy
consumption and the energy intensity in order to estimate future energy consumption. In the industrial sector
especially in textile units’ large amount of energy wasted due to improper working and lack of energy saving
measures. In this study, the various measures that causes the main energy losses are investigated .In the textile
dyeing sector, the main processes are associated with steam in various proportions. For the steam production,
steam boilers of different types are used for different applications. The efficiency of the boiler varies from one
industry to other based on various parameters such as quality of the water, fuel used, blow down quantity, etc.
Steam traps are also having influence on the boiler efficiency. In the case of steam leakage the performance of
the system decreases as the consumption of fuel increases to produce more steam. Thus by adopting various
recovery methods we can reduce the energy losses and fuel consumption.
Convolution Theorem for Canonical Cosine Transform and Their PropertiesIOSR Journals
The document discusses the convolution theorem for the generalized canonical cosine transform. It begins with an introduction to fractional Fourier transforms and linear canonical transforms. It then defines the generalized canonical cosine transform and introduces a special type of convolution for this transform. The main result is that the convolution theorem holds for the generalized canonical cosine transform: the transform of the convolution of two functions is equal to the convolution of the individual transforms of the two functions. The theorem is stated and a proof is provided. Finally, some properties of the canonical cosine transform are mentioned.
Surfactant-assisted Hydrothermal Synthesis of Ceria-Zirconia Nanostructured M...IOSR Journals
CeO2–ZrO2 oxides were prepared by the surfactant-templated method using cetyl trimethyl ammonium bromide (CTAB) as template and modified with chromium nitrate. These were characterized by XRD, FT-IR, TEM, SEM, BET and TPD-CO2. The XRD data showed that as prepared CeO2-ZrO2 powder particles have single phase cubic fluorite structure. HRTEM shows mesoscopic ordering. Average particle size is 12-13 nm as calculated from particle histogram. The nitrogen adsorption/desorption isotherm were classified to be type IV isotherm, typical of mesoporous material. The presence of uni-modal mesopores are confirmed by the pore size distribution which shows pore distribution at around 60 A°. Catalytic activity was studied towards liquid-phase oxidation of benzene.
The document proposes a new security method called Yours Advanced Security Hood (YASH) to prevent password cracking through brute force and dictionary attacks. YASH uses a two-level security approach:
1. It tracks the number of incorrect login attempts and activates a virtual machine crosschecking (VMC) process if the attempt threshold is exceeded, preventing the password from being matched to attempted passwords.
2. It allows the true user to initiate an unauthorised access control (UAC) using their mobile phone to signal that no attempts should be matched, protecting the account until the user deactivates UAC.
3. The system can then detect the true user by their ability to deactivate UAC through their
A* search is an algorithm that finds the shortest path between a starting node and a goal node. It uses a heuristic function to determine the order in which it explores nodes. The heuristic estimates the cost to get from each node to the goal. A* search explores nodes with the lowest total cost, which is the cost to reach the node plus the heuristic estimate to reach the goal from that node. A* search is admissible and optimal if the heuristic is admissible, meaning it never overestimates the actual cost. While efficient, A* search can require significant memory for large search problems. Future work could apply A* search techniques to pathfinding for robots.
Prevalence of Cleft Lip and Palate in Abuja Nigeria (From December2000 to Dec...IOSR Journals
The prevalence of cleft lip and palate in University of Abuja Teaching Hospital from December 2000 to December 2010 was investigated in this works and was found to be 3.2 in every 1,000 live birth. This is very high as compared to reports from earlier works but was suspected to be due to the smile Train Project which is a private sector driven initiative that takes up the burden of paying for cleft lip and palate repair. Left sides clefts of the lip and palate were found to be almost twice that of right sides cleft of the lip and palate. This was in keeping with reports from earlier works. This study shows there is need for further studies in the field of cleft lip palate in all regions of the country
This document analyzes the cryptographic security of an efficient unlinkable secret handshakes scheme proposed by Ryu, Yoo, and Ha. It summarizes the scheme and its goals of providing authentication and key agreement between group members while preserving unlinkability. The document then shows that the scheme is vulnerable to a key-compromise impersonation attack, allowing an adversary who learns a user's private key to impersonate other users within the same group. This violates an important security property for key agreement protocols. In conclusion, while the scheme aims to provide strong anonymity, it fails to achieve key-compromise impersonation resilience.
Improving Irrigation Water Management in Delta of EgyptIOSR Journals
This document discusses improving irrigation water management in the Delta region of Egypt. It does this in two stages: 1) irrigation scheduling through calculating evapotranspiration rates and studying the effects of irrigation depth on crop yield and revenue, and 2) examining the effects of mixing fresh and saline irrigation waters on crop productivity when applied through different irrigation systems. The key crops grown in the Delta region are discussed, along with water sources, costs, soil types and other relevant factors. Two models are presented for irrigation scheduling: one relating crop yield to evapotranspiration, and another identifying optimal crop rotations. The effects of saline water on crop yields when mixed with fresh water are also studied.
A New Approach for Improving Performance of Intrusion Detection System over M...IOSR Journals
This document discusses improving the performance of intrusion detection systems (IDS) in mobile ad hoc networks (MANETs). It proposes using an inverted table approach to track communication information and identify attacker nodes through data mining. The key approaches are:
1. Maintaining an inverted table to record network communication information for analysis.
2. Using data mining techniques like anomaly detection to identify attacker nodes based on patterns in the table.
3. Discovering preventative paths that avoid identified attacker nodes to improve network throughput and reduce data loss.
The approaches aim to improve IDS performance challenged by attacks that slow detection in MANETs. The work will be implemented in NS2 and evaluate performance based on throughput and
Spindle cell neoplasms usually occur in head, neck, orbit, soft tissues of scalp and along the upper aerodigestive tract. They are relatively uncommon in lower gastrointestinal tract and represent a distinct clinical entity. Increased awareness is required among colorectal surgeons and pathologists due to their benign nature & uncertain etiology, to avoid misdiagnosis of rectal cancer. Definitive diagnosis necessitates immunohistochemical analysis. We present an unusual case of spindle cell neoplasm of rectum in an asymptomatic elderly gentleman, detected on screening colonoscopy. Following thorough evaluation with MRI pelvis, CT scan thorax, abdomen, pelvis with contrast and multidisciplinary meeting discussion (MDT) at our institution, he was successfully treated with a specialized minimally invasive approach (TAMIS). Histopathology with immunohistochemistry confirmed the diagnosis of spindle cell neoplasm. As they are uncommon in colorectum & non-invasive, management and long-term follow-up is still under study. These lesions should be differentiated from other stromal tumours in GIT.
This document summarizes a case report of a congenital myofibroma tumor in a newborn male. Histopathological examination revealed a biphasic tumor composed of round and spindle-shaped cells. Immunohistochemistry showed the tumor cells were positive for CD34 and smooth muscle markers. Ultrastructural examination demonstrated cytoplasmic intermediate filaments, indicating smooth muscle differentiation. The findings support that this tumor is a true hemangiopericytoma, arising from pericytes and undergoing myofibroblastic differentiation, rather than a solitary fibrous tumor.
This document provides guidelines for managing opportunistic mycobacterial infections. It discusses the epidemiology, diagnosis, and treatment of these infections. For pulmonary disease caused by M. kansasii in HIV-negative patients, the guidelines recommend treatment with rifampicin and ethambutol for 9 months based on prospective studies showing high cure rates without relapse. For patients with compromised immunity, treatment should continue for 15-24 months or until sputum cultures are negative for 12 months. Relapses should be retreated with rifampicin and ethambutol for 15-24 months, adding prothionamide and streptomycin for non-responders.
(1) The document discusses various parasites that can infect the liver and biliary tree, including tapeworms (Echinococcus granulosus, E. multilocularis, E. vogeli), flukes (Fasciola hepatica), and trematodes (Schistosoma japonicum, S. mansoni).
(2) It provides details on the life cycles, symptoms, geographic distribution, diagnosis, and treatment of these parasites. For many species, it describes the eggs, adult worms, and larval stages as seen under microscopy.
(3) Imaging findings (e.g. CT, MRI) and serological tests are also discussed as important diagnostic tools for
Fibroma odontogeno del mascellare superiore: caso clinico e revisione della l...MerqurioEditore_redazione
This case report describes a 46-year-old male with an odontogenic fibromyxoma in the right maxilla. Odontogenic fibromyxomas are rare benign tumors that usually occur in the mandible. Radiological examination with CT revealed expansion of the right maxillary sinus walls and obstruction of the sinus cavity. Histopathological examination confirmed the diagnosis of fibromyxoma. The tumor was surgically removed via enucleation and curettage. A review of the literature found that maxillary fibromyxomas are rare, with this case being the 30th reported case in the maxilla. Complete surgical removal is important to prevent recurrence of these tumors.
3.) How to Diagnose Fungus Diseases.pptRashaAlNagar
Fungus diseases can be diagnosed through clinical clues, culture of the etiologic agent, and appearance in tissue. Clinical clues are often only suggestive. Culture of the agent is important to prove the etiology, with Sabouraud's medium most useful. Appearance in tissue can be seen through microscopy techniques like KOH examination, histopathology with stains like PAS, or GMS. The fungi may appear as yeasts, sporangia, hyphae, granules, sclerotic bodies, or a combination of yeast and hyphae depending on the disease. Definitive diagnosis relies on culture identification and correlating microscopic appearance in tissue.
FOURNIER’S GANGRENE: REVIEW OF 57 CASES IN TERTIARY INSTITUTIONAnil Haripriya
Fournier’s gangrene which is a rapidly progressive, fulminant polymicrobial synergistic infection of the perineum and genitals is now changing its pattern. Both genders can be affected and the mortality is still high (around10%). The clinical presentation in many patients in early stage may not be prominent. Thus rapid and accurate diagnosis is must for prompt treatment. Extensive surgical debridement and broad spectrum intravenous antibiotic remains the mainstay of treatment in order to reduce the morbidity and mortality.
We know that mesothelioma patients would rather stay local when receiving treatment,rnso we will review options for private medical centers, surgical consultants, clinical trials,rnand match you up with friendly, local physicians wherever we can.
We know that mesothelioma patients would rather stay local when receiving treatment,rnso we will review options for private medical centers, surgical consultants, clinical trials,rnand match you up with friendly, local physicians wherever we can.
mycelial forms of coccidiodes spp. in parasitic phaseIPN
1) The study examined 44 patients with pulmonary coccidioidomycosis in Mexico between 1991-2005 to analyze the association between mycelial parasitic forms of Coccidioides spp. and risk factors like diabetes.
2) Patients with type 2 diabetes were 4 times more likely than non-diabetics to develop mycelial parasitic forms. Mycelial forms took longer than 8 months to develop and were associated with cough, hemoptysis, cavitary lesions on x-ray, and type 2 diabetes.
3) Based on the results, the study proposes incorporating mycelial forms into the parasitic phase definition for Coccidioides spp. in patients with type 2
This document summarizes a case report of tularemia (Francisella tularensis infection) in British Columbia and reviews 16 other cases over 15 years. All cases were acquired rurally and presented most commonly with skin lesions and lymphadenopathy. Two severe cases of sepsis and pulmonary infection were also reported. Physicians and public health workers should be aware of this rare but potentially serious disease endemic to BC, especially for those exposed to wildlife.
Abstract—In Italy the hydatid disease is more prevalent and new cases are highlighted more frequently in Sicily, Sardinia, (Italy). Aim of this study is to put the indication in search of iaditea nature in both spleen swelling and muscle tendon.
Material and Method Patients observed during the period 2007-2009 at the Surgical Clinic III and Digestive Surgery, Policlinico G Rodolico were explored for Hydatid cyste at various sites. Diagnosis of cysts ecchinococcus occurred primarily for various four reasons either for compression of bodies involved or for eosinophilia or for instrumental investigation or for anaphylactic reaction to rupture of cysts. Biological diagnosis is based on serology rather than isolation of the parasite (indirect diagnosis);
Results Patients attended during the period 2007-2009 Hydatid cyst was found in 0.5% of all cases in liver along with 4 in the lung, 3 in splenic, 2 in the mammary and 2 in the chest wall No 2. The Surgical treatment with the complete removal of the cyst with a satisfactory postoperative course in the absence of cases of relapse of the disease and by following the therapeutic act, the assumption of mebendazole 50mg / kg / day for 3 weeks at a dose of 400mg for 4 months
Conclusions There is a need to define diagnostic methods with high specificity and sensitivity, which can provide a valid diagnostic aid for the cases clinically difficult to diagnose. And the final diagnosis must then also be based on the development of immunological methods that allow the determination of specific antibodies in the serum and their titration and / or the circulating antigen determination.
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
Desmoplastic Non-Infantile Ganglioglioma; An Incidental Finding with Unusual ...CrimsonPublishersTNN
Desmoplastic non-infantile ganglioglioma (DNIG) is a rare tumor entity and only a small number of cases have been published until now in the literature. Although its infantile counterpart (desmoplastic infantile ganglioglioma [DIG]) has been already recognized and included together with desmoplastic infantile astrocytoma (DIA) in the WHO Classification of CNS tumors, DNIG has not been accepted as a distinct tumor entity. The reason for this is obviously the scarcity of the neoplasm and subsequently the absence of substantial information regarding its pathogenesis and its association to the infantile form.
An exophytic lesion of the vagina cytological findingsMarceloPerazzoli
This document reports on a case of primary malignant melanoma of the vagina identified through cytological examination. A 74-year-old woman presented with a prolapsed anterior vaginal wall and exophytic lesions. A direct smear showed malignant cells that were initially misdiagnosed as squamous cell carcinoma. Biopsy revealed the presence of melanin pigment indicating malignant melanoma. Primary melanoma of the vagina is rare, accounting for less than 3% of vaginal malignancies. Accurate cytological diagnosis is challenging due to the rarity of this cancer and lack of overt pigmentation in some cases.
Histopathological patterns of cutaneous malignant melanoma in Sudaniosrjce
This study aimed to determine the histopathological patterns of cutaneous malignant melanoma in Sudanese patients. The study found that males represented 57.1% of cases and the majority of lesions (81.6%) were on the lower limbs. The most common clinic-pathological type was acral-lentiginous melanoma (75.5%). Microscopy showed epithelioid cell type in 61.2% of cases and deep invasion, ulceration, and lymphovascular invasion were common, indicating late stage at presentation. The findings were similar to previous studies in other African populations.
IOSR Journal of Pharmacy (IOSRPHR), www.iosrphr.org, call for paper, research...iosrphr_editor
IOSR Journal of Pharmacy (IOSRPHR), www.iosrphr.org, call for paper, research paper publishing, where to publish research paper, journal publishing, how to publish research paper, Call for research paper, international journal, publishing a paper, call for paper 2012, journal of pharmacy, how to get a research paper published, publishing a paper, publishing of journal, research and review articles, Pharmacy journal, International Journal of Pharmacy, hard copy of journal, hard copy of certificates, online Submission, where to publish research paper, journal publishing, international journal, publishing a paper
in this ppt slide you study about oncogene and related viruses. they are very fatal because it responsible for tumor/cancer disease. so, all you read this
—India constitutes about one fourth of the Global TB burden. Cutaneous TB is less common clinical form of tuberculosis accounting for 1-2 % of the total extra-pulmonary cases. Objective of this study was to describe the clinical and epidemiological pattern of Cutaneous TB presenting in the Skin Outpatient Department (OPD). Patients presenting with clinically suspected skin lesions of Cutaneous TB from January 2015 to August 2016 were included in the study. Dermatological and systemic examination was carried out and histopathogical examination of skin punch biopsy was done. It was observed that out of a total of sixty patients, 45 (75%) patients were found to have features of Cutaneous TB on histopathology. Lupus vulgaris (42.2%) was the most common form of Cutaneous TB. Most patients were in age group of 11-30 years. Male to female ratio was 1.6:1. Most common sites of involvement were lower limbs and neck. Mantoux test was positive(≥15 mm induration) in 66.7% cases. Typical tuberculoid histology was found in 91.1% cases. No cases of tuberculids were seen and non-specific chronic inflammation was seen in six cases. It was concluded that Cutaneous TB may present with different morphological patterns resembling other inflammatory, infective and neoplastic conditions. Proper and thorough investigations are necessary for detection of Cutaneous TB as the annual incidence of total TB cases in India is high.
This case report describes a 73-year-old man with prostate cancer that metastasized to a pelvic lymph node. During pathological examination after prostatectomy, it was discovered that this same lymph node was also affected by Hodgkin's lymphoma. Immunohistochemical staining confirmed the presence of both prostate adenocarcinoma and classical Hodgkin's lymphoma in the lymph node. This represents the first reported case of a urological cancer (prostate adenocarcinoma) metastasizing to a lymph node simultaneously involved by Hodgkin's disease. Synchronous occurrence of two or more tumors is rare, but histopathological identification is important for treatment decisions and prognosis.
This document provides a technical review of secure banking using RSA and AES encryption methodologies. It discusses how RSA and AES are commonly used encryption standards for secure data transmission between ATMs and bank servers. The document first provides background on ATM security measures and risks of attacks. It then reviews related work analyzing encryption techniques. The document proposes using a one-time password in addition to a PIN for ATM authentication. It concludes that implementing encryption standards like RSA and AES can make transactions more secure and build trust in online banking.
This document analyzes the performance of various modulation schemes for achieving energy efficient communication over fading channels in wireless sensor networks. It finds that for long transmission distances, low-order modulations like BPSK are optimal due to their lower SNR requirements. However, as transmission distance decreases, higher-order modulations like 16-QAM and 64-QAM become more optimal since they can transmit more bits per symbol, outweighing their higher SNR needs. Simulations show lifetime extensions up to 550% are possible in short-range networks by using higher-order modulations instead of just BPSK. The optimal modulation depends on transmission distance and balancing the energy used by electronic components versus power amplifiers.
This document provides a review of mobility management techniques in vehicular ad hoc networks (VANETs). It discusses three modes of communication in VANETs: vehicle-to-infrastructure (V2I), vehicle-to-vehicle (V2V), and hybrid vehicle (HV) communication. For each communication mode, different mobility management schemes are required due to their unique characteristics. The document also discusses mobility management challenges in VANETs and outlines some open research issues in improving mobility management for seamless communication in these dynamic networks.
This document provides a review of different techniques for segmenting brain MRI images to detect tumors. It compares the K-means and Fuzzy C-means clustering algorithms. K-means is an exclusive clustering algorithm that groups data points into distinct clusters, while Fuzzy C-means is an overlapping clustering algorithm that allows data points to belong to multiple clusters. The document finds that Fuzzy C-means requires more time for brain tumor detection compared to other methods like hierarchical clustering or K-means. It also reviews related work applying these clustering algorithms to segment brain MRI images.
1) The document simulates and compares the performance of AODV and DSDV routing protocols in a mobile ad hoc network under three conditions: when users are fixed, when users move towards the base station, and when users move away from the base station.
2) The results show that both protocols have higher packet delivery and lower packet loss when users are either fixed or moving towards the base station, since signal strength is better in those scenarios. Performance degrades when users move away from the base station due to weaker signals.
3) AODV generally has better performance than DSDV, with higher throughput and packet delivery rates observed across the different user mobility conditions.
This document describes the design and implementation of 4-bit QPSK and 256-bit QAM modulation techniques using MATLAB. It compares the two techniques based on SNR, BER, and efficiency. The key steps of implementing each technique in MATLAB are outlined, including generating random bits, modulation, adding noise, and measuring BER. Simulation results show scatter plots and eye diagrams of the modulated signals. A table compares the results, showing that 256-bit QAM provides better performance than 4-bit QPSK. The document concludes that QAM modulation is more effective for digital transmission systems.
The document proposes a hybrid technique using Anisotropic Scale Invariant Feature Transform (A-SIFT) and Robust Ensemble Support Vector Machine (RESVM) to accurately identify faces in images. A-SIFT improves upon traditional SIFT by applying anisotropic scaling to extract richer directional keypoints. Keypoints are processed with RESVM and hypothesis testing to increase accuracy above 95% by repeatedly reprocessing images until the threshold is met. The technique was tested on similar and different facial images and achieved better results than SIFT in retrieval time and reduced keypoints.
This document studies the effects of dielectric superstrate thickness on microstrip patch antenna parameters. Three types of probes-fed patch antennas (rectangular, circular, and square) were designed to operate at 2.4 GHz using Arlondiclad 880 substrate. The antennas were tested with and without an Arlondiclad 880 superstrate of varying thicknesses. It was found that adding a superstrate slightly degraded performance by lowering the resonant frequency and increasing return loss and VSWR, while decreasing bandwidth and gain. Specifically, increasing the superstrate thickness or dielectric constant resulted in greater changes to the antenna parameters.
This document describes a wireless environment monitoring system that utilizes soil energy as a sustainable power source for wireless sensors. The system uses a microbial fuel cell to generate electricity from the microbial activity in soil. Two microbial fuel cells were created using different soil types and various additives to produce different current and voltage outputs. An electronic circuit was designed on a printed circuit board with components like a microcontroller and ZigBee transceiver. Sensors for temperature and humidity were connected to the circuit to monitor the environment wirelessly. The system provides a low-cost way to power remote sensors without needing battery replacement and avoids the high costs of wiring a power source.
1) The document proposes a model for a frequency tunable inverted-F antenna that uses ferrite material.
2) The resonant frequency of the antenna can be significantly shifted from 2.41GHz to 3.15GHz, a 31% shift, by increasing the static magnetic field placed on the ferrite material.
3) Altering the permeability of the ferrite allows tuning of the antenna's resonant frequency without changing the physical dimensions, providing flexibility to operate over a wide frequency range.
This document summarizes a research paper that presents a speech enhancement method using stationary wavelet transform. The method first classifies speech into voiced, unvoiced, and silence regions based on short-time energy. It then applies different thresholding techniques to the wavelet coefficients of each region - modified hard thresholding for voiced speech, semi-soft thresholding for unvoiced speech, and setting coefficients to zero for silence. Experimental results using speech from the TIMIT database corrupted with white Gaussian noise at various SNR levels show improved performance over other popular denoising methods.
This document reviews the design of an energy-optimized wireless sensor node that encrypts data for transmission. It discusses how sensing schemes that group nodes into clusters and transmit aggregated data can reduce energy consumption compared to individual node transmissions. The proposed node design calculates the minimum transmission power needed based on received signal strength and uses a periodic sleep/wake cycle to optimize energy when not sensing or transmitting. It aims to encrypt data at both the node and network level to further optimize energy usage for wireless communication.
This document discusses group consumption modes. It analyzes factors that impact group consumption, including external environmental factors like technological developments enabling new forms of online and offline interactions, as well as internal motivational factors at both the group and individual level. The document then proposes that group consumption modes can be divided into four types based on two dimensions: vertical (group relationship intensity) and horizontal (consumption action period). These four types are instrument-oriented, information-oriented, enjoyment-oriented, and relationship-oriented consumption modes. Finally, the document notes that consumption modes are dynamic and can evolve over time.
The document summarizes a study of different microstrip patch antenna configurations with slotted ground planes. Three antenna designs were proposed and their performance evaluated through simulation: a conventional square patch, an elliptical patch, and a star-shaped patch. All antennas were mounted on an FR4 substrate. The effects of adding different slot patterns to the ground plane on resonance frequency, bandwidth, gain and efficiency were analyzed parametrically. Key findings were that reshaping the patch and adding slots increased bandwidth and shifted resonance frequency. The elliptical and star patches in particular performed better than the conventional design. Three antenna configurations were selected for fabrication and measurement based on the simulations: a conventional patch with a slot under the patch, an elliptical patch with slots
1) The document describes a study conducted to improve call drop rates in a GSM network through RF optimization.
2) Drive testing was performed before and after optimization using TEMS software to record network parameters like RxLevel, RxQuality, and events.
3) Analysis found call drops were occurring due to issues like handover failures between sectors, interference from adjacent channels, and overshooting due to antenna tilt.
4) Corrective actions taken included defining neighbors between sectors, adjusting frequencies to reduce interference, and lowering the mechanical tilt of an antenna.
5) Post-optimization drive testing showed improvements in RxLevel, RxQuality, and a reduction in dropped calls.
This document describes the design of an intelligent autonomous wheeled robot that uses RF transmission for communication. The robot has two modes - automatic mode where it can make its own decisions, and user control mode where a user can control it remotely. It is designed using a microcontroller and can perform tasks like object recognition using computer vision and color detection in MATLAB, as well as wall painting using pneumatic systems. The robot's movement is controlled by DC motors and it uses sensors like ultrasonic sensors and gas sensors to navigate autonomously. RF transmission allows communication between the robot and a remote control unit. The overall aim is to develop a low-cost robotic system for industrial applications like material handling.
This document reviews cryptography techniques to secure the Ad-hoc On-Demand Distance Vector (AODV) routing protocol in mobile ad-hoc networks. It discusses various types of attacks on AODV like impersonation, denial of service, eavesdropping, black hole attacks, wormhole attacks, and Sybil attacks. It then proposes using the RC6 cryptography algorithm to secure AODV by encrypting data packets and detecting and removing malicious nodes launching black hole attacks. Simulation results show that after applying RC6, the packet delivery ratio and throughput of AODV increase while delay decreases, improving the security and performance of the network under attack.
The document describes a proposed modification to the conventional Booth multiplier that aims to increase its speed by applying concepts from Vedic mathematics. Specifically, it utilizes the Urdhva Tiryakbhyam formula to generate all partial products concurrently rather than sequentially. The proposed 8x8 bit multiplier was coded in VHDL, simulated, and found to have a path delay 44.35% lower than a conventional Booth multiplier, demonstrating its potential for higher speed.
This document discusses image deblurring techniques. It begins by introducing image restoration and focusing on image deblurring. It then discusses challenges with image deblurring being an ill-posed problem. It reviews existing approaches to screen image deconvolution including estimating point spread functions and iteratively estimating blur kernels and sharp images. The document also discusses handling spatially variant blur and summarizes the relationship between the proposed method and previous work for different blur types. It proposes using color filters in the aperture to exploit parallax cues for segmentation and blur estimation. Finally, it proposes moving the image sensor circularly during exposure to prevent high frequency attenuation from motion blur.
This document describes modeling an adaptive controller for an aircraft roll control system using PID, fuzzy-PID, and genetic algorithm. It begins by introducing the aircraft roll control system and motivation for developing an adaptive controller to minimize errors from noisy analog sensor signals. It then provides the mathematical model of aircraft roll dynamics and describes modeling the real-time flight control system in MATLAB/Simulink. The document evaluates PID, fuzzy-PID, and PID-GA (genetic algorithm) controllers for aircraft roll control and finds that the PID-GA controller delivers the best performance.
DECLARATION OF HELSINKI - History and principlesanaghabharat01
This SlideShare presentation provides a comprehensive overview of the Declaration of Helsinki, a foundational document outlining ethical guidelines for conducting medical research involving human subjects.
Computer in pharmaceutical research and development-Mpharm(Pharmaceutics)MuskanShingari
Statistics- Statistics is the science of collecting, organizing, presenting, analyzing and interpreting numerical data to assist in making more effective decisions.
A statistics is a measure which is used to estimate the population parameter
Parameters-It is used to describe the properties of an entire population.
Examples-Measures of central tendency Dispersion, Variance, Standard Deviation (SD), Absolute Error, Mean Absolute Error (MAE), Eigen Value
Lecture 6 -- Memory 2015.pptlearning occurs when a stimulus (unconditioned st...AyushGadhvi1
learning occurs when a stimulus (unconditioned stimulus) eliciting a response (unconditioned response) • is paired with another stimulus (conditioned stimulus)
Travel Clinic Cardiff: Health Advice for International TravelersNX Healthcare
Travel Clinic Cardiff offers comprehensive travel health services, including vaccinations, travel advice, and preventive care for international travelers. Our expert team ensures you are well-prepared and protected for your journey, providing personalized consultations tailored to your destination. Conveniently located in Cardiff, we help you travel with confidence and peace of mind. Visit us: www.nxhealthcare.co.uk
- Video recording of this lecture in English language: https://youtu.be/Pt1nA32sdHQ
- Video recording of this lecture in Arabic language: https://youtu.be/uFdc9F0rlP0
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Promoting Wellbeing - Applied Social Psychology - Psychology SuperNotesPsychoTech Services
A proprietary approach developed by bringing together the best of learning theories from Psychology, design principles from the world of visualization, and pedagogical methods from over a decade of training experience, that enables you to: Learn better, faster!
These lecture slides, by Dr Sidra Arshad, offer a simplified look into the mechanisms involved in the regulation of respiration:
Learning objectives:
1. Describe the organisation of respiratory center
2. Describe the nervous control of inspiration and respiratory rhythm
3. Describe the functions of the dorsal and respiratory groups of neurons
4. Describe the influences of the Pneumotaxic and Apneustic centers
5. Explain the role of Hering-Breur inflation reflex in regulation of inspiration
6. Explain the role of central chemoreceptors in regulation of respiration
7. Explain the role of peripheral chemoreceptors in regulation of respiration
8. Explain the regulation of respiration during exercise
9. Integrate the respiratory regulatory mechanisms
10. Describe the Cheyne-Stokes breathing
Study Resources:
1. Chapter 42, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 36, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 13, Human Physiology by Lauralee Sherwood, 9th edition
Know the difference between Endodontics and Orthodontics.Gokuldas Hospital
Your smile is beautiful.
Let’s be honest. Maintaining that beautiful smile is not an easy task. It is more than brushing and flossing. Sometimes, you might encounter dental issues that need special dental care. These issues can range anywhere from misalignment of the jaw to pain in the root of teeth.
The skin is the largest organ and its health plays a vital role among the other sense organs. The skin concerns like acne breakout, psoriasis, or anything similar along the lines, finding a qualified and experienced dermatologist becomes paramount.
Test bank for karp s cell and molecular biology 9th edition by gerald karp.pdfrightmanforbloodline
Test bank for karp s cell and molecular biology 9th edition by gerald karp.pdf
Test bank for karp s cell and molecular biology 9th edition by gerald karp.pdf
Test bank for karp s cell and molecular biology 9th edition by gerald karp.pdf
Test bank for karp s cell and molecular biology 9th edition by gerald karp.pdf
G0153743
1. IOSR Journal of VLSI and Signal Processing (IOSR-JVSP)
ISSN: 2319 – 4200, ISBN No. : 2319 – 4197 Volume 1, Issue 5 (Jan. - Feb 2013), PP 37-43
www.iosrjournals.org
www.iosrjournals.org 37 | Page
Inflammatory Conditions Mimicking Tumours In Calabar: A 30
Year Study (1978-2007).
Omotoso AJ1
, Emanghe UE 2
, Nnoli MA1
, Ekanem AI1
Departments of 1
Pathology and 2
Medical Microbiology &Parasitology,
University of Calabar Teaching Hospital, Calabar.
Abstract: Background: Several lesions in the body present as soft tumor mass which often necessitate an
incision or excision biopsy for proper histologic diagnosis. It has been noted that several soft tissue tumours
turn out to be primarily infective inflammatory conditions. This study is aimed at reviewing these inflammatory
soft tissue masses with a view of understanding their aetiology, histologic morphology and anatomic locations.
Methodology: The records of the Department of Pathology, UCTH, were accessed to retrieve relevant clinical
information for reviewing all the histologically confirmed inflammatory tumours seen through the period of
1978 and 2007.
Resut: The study shows that onchocerciasis is the highest soft tissue inflammatory lesion in Calabar,
constituting 60% of the total lesions presenting as tumours over the period of study. Histoplasmosis caused by
histoplasms capsulatum is also responsible for the tumour lesions seen and was responsible for approximately
20% of the cases. Other infective conditions include mycetoma, molluscum contagiosum and tuberculosis. All
these lesions present as chronic granulomatous/inflammatory lesions with a palpable mass.
Conclusion: A significant number of microbial agents present a diagnostic challenge in the microbiology
laboratory which has been seen to account for the surgically removed soft tissue masses in our hospital.
Keywords: Granulomatous, Necrotizing, Non-Necrotizing, Onchocerciasis, Molluscum Contagiosum.
I. Introduction:
Chronic granulomatous lesions may resemble deep seated tumours resulting from both infectious and
non-infectious agents. An organized inflammatory process made up of tissue macrophages or histiocytes which
fuse to form multinucleated giant cells define granulomas.
Difficulties in diagnosis encountered both on clinical and laboratory basis often necessitate surgical
excision or biopsy of operable lesions for pathological diagnoses.
Granulomata, irrespective of the putative causative agent occur as a result of host response to the
antigen. The antigen may be an infectious pathogen, a foreign substance or an unknown agent which fails to
respond to the early inflammatory cells such as neutrophils and eosinophils.
The mass of granulation tissue consists of a collection of modified macrophages or epitheloid cells,
surrounding lymphocytes, actively growing fibroblasts and giant cells, all organized into a circumscribed
formation.
The granuloma may be necrotizing or non-necrotizing in nature. Although necrotizing granuloma
denotes an infectious aetiology, non-necrotizing granuloma may not exclude a non-infectious background.
The range of diseases with granulomatous appearance includes tuberculosis, leprosy, leishmaniasis,
cryptococcosis, sarcoidosis, rheumatoid arthritis, and berylliosis among others1
.
Objective:
To review the surgically removed inflammatory lesions that presented as soft tissue masses and to
determine the aetiology, morphology and location of the tumours.
II. Methods:
Between January 1978 and December 2007 (a 30 year period), we reviewed all soft tissue tumours sent
for histological diagnosis in the Department of Pathology of the University of Calabar. Relevant information
such as subjects’ biometric data, anatomic body sites where the lesions presented and their histological data
were extracted and reviewed. The granuloma was classified by their aetiologies into bacterial, parasitic, fungal
and viral types.
III. Results:
A total of fifty histologically confirmed chronic inflammatory soft tissue masses were seen at the
Pathology Department of the University of Calabar Teaching Hospital during the study period. Thirty of the
2. Inflammatory Conditions Mimicking Tumours In Calabar: A 30 Year Study (1978-2007).
www.iosrjournals.org 38 | Page
tumours were onchocercal masses accounting for 60% formed the majority with ten tumours due to
Histoplasmosis. Table 1 shows the distribution of all the clinical diagnoses.
The tumours were all of infective origin, namely bacterial, parasitic, fungal and viral aetiology. The
two bacterial tumours were each a tuberculous and rhinoscleroma granulomas. Thirty tumours were caused by
parasites (onchocerciasis and leishmaniasis) while fifteen were of fungal aetiology, namely histoplasmosis,
mycetoma and blastomycosis. There were two viral cases caused by molluscum contagiosum.
All subjects of age groups between 0-5 to 66-70years were affected. The 11-15 year age group had the
highest (13) number of tumours closely followed by the 6-10 and 0-5 years age groups, with 7 and 6 lesions,
respectively. Table 2 shows the age distribution by the aetiology of the tumours in this study.
The anatomic locations of the different granulomas varied widely. The distribution of onchocercal
granulomas, which represented the highest number of tumours, is shown by a pie chart.
The onchocercal nodules predominated the biopsied masses and were widely distributed mainly in chest wall
(5), two each in the anterior shoulder region, forehead, knee, anterior abdomen, popliteal fossa and one nodule
each presenting in the forearm, iliac crest, face, axilla, inguinal region, scapular, gluteus and intra orbital areas.
The sites of presentation of eleven nodules were however not indicated in the study.
The lesions found to be histoplasmosis had two masses presenting over the clavicle and the one tumour
each found in the shoulder, ankle, hand, periorbital region and anatomic sites were not indicated for four lesions.
All four lesions histologically confirmed as mycetoma presented in the feet while the single
tuberculous nodule was a wrist lesion.
While the rhinoscleroma was biopsied from the maxillary antrum, the leishmanal lesion was from the
trunk and the blastomycosis nodule was a skin lesion. Two cases of molluscum contagiosum were removed
from the foot and shoulder, respectively.
TABLE 1: DISTRIBUTION OF THE TUMOUR
Clinical Diagnosis Number Percentage
Onchocerciasis 30 60
Histoplasmosis 10 20
Mycetoma 4 8
Molluscum contagiosum 2 4
Tuberculous granuloma 1 2
Leishmaniasis 1 2
Rhinoscleroma 1 2
Blastomycosis 1 2
Total 50 100
TABLE 2: AGE DISTRIBUTION OF THE INFECTIOUS AGENTS MIMMICKING SOFT TISSUE
TUMOURS
Age Bacteria Parasite Fungi Virus Total
0-5 0 3 2 1 6
6 – 10 0 3 3 1 7
11 – 15 0 8 5 0 13
16 – 20 0 2 0 0 2
21 – 25 1 1 0 0 2
26 – 30 0 1 0 0 1
31 – 35 0 5 1 0 6
36 – 40 0 2 0 0 2
41 – 45 1 1 0 0 2
46 – 50 0 0 1 0 1
51 – 55 0 1 0 0 1
56 – 60 0 0 2 0 2
61 – 65 0 3 1 0 4
66 – 70 0 1 0 0 1
TOTAL 2 31 15 2 50
3. Inflammatory Conditions Mimicking Tumours In Calabar: A 30 Year Study (1978-2007).
www.iosrjournals.org 39 | Page
FIGURE 1: PIE CHART SHOWING PERCENTAGES DISTRIBUTION OF ANATOMIC LOCATION OF
ONCHOCERCIASIS
FIGURE 2: PIE CHART FOR ANATOMIC DISTRIBUTION FOR HISTOPLASMOSIS
IV. Discussion:
Inflammatory soft tissue tumours seen in this centre were mainly of infective origin. During the studied
period, thirty two thousand, four hundred and forty three (32,443) specimens were received in the Department of
Pathology, UCTH and only fifty (50) cases were inflammatory conditions accounting for 0.15 % of all tumours
seen within the 30 year study period.
Microbiologic diagnostics difficulties may warrant surgical biopsy for definitive histologic diagnosis.
This situation is common in resource-constrained areas with limited capacity for diagnosis of many microbial
infections.
Although we had no local studies to compare with respect to sites and age of the tumours, some of
them were found in commonly known sites while some were from unusual body sites.
Onchocercal nodules formed around adult worms and wolbachia-carrying microfilaria result in fibrosis
7
. Onchocercal lesions in our study were found below and above the waist with the chest wall dominating. This
4. Inflammatory Conditions Mimicking Tumours In Calabar: A 30 Year Study (1978-2007).
www.iosrjournals.org 40 | Page
distribution is at variance with the lower torso sites commonly seen in African patients 8
. Although Onchocercal
nodules occur more commonly in adults9
, 14 of the 31 lesions came from children. Similarly, the fungal lesions
tended to occur in the young age group of 5-15 years rather than adults.
The two bacterial lesions, tuberculosis and rhinoscleroma were found in adults of age groups 21-25
and 41-45 but it was difficult to assign their distribution. The ages of presentation are typical of the disease.
The two cases of molluscum contagiosum were expectedly from children 10 years and below and
occurred at nasal septum, a typical anatomic site 4,6
. Although there is usually a male preponderance of the
disease5
this study was unable to provide its sex distribution.
The study could not establish in which ages the lone cases of leishmaniasis and blastomycosis fall. For
the same reason, the mycetoma cases could not be distributed.
All eight diseases can occur commonly or as sporadic cases in a tropical area such as Nigeria. Also
infection with these different aetiologic agents are known to elicit chronic inflammatory reaction leading to the
formation of granulomas. 1, 9,10, 11
Clinical diagnosis is often a challenge because of the wide range of differential diagnoses for the
majority of the tumours in this study. In Nigeria, microbiological diagnoses of fungal and viral diseases is
rudimentary while capacity for some bacterial and parasitologic diagnosis of rhinoscleromatis and
mycobacterium tuberculosis in non-sputum samples is extremely limited.
Tuberculous Granuloma
Mycobacterium tuberculosis, a member of the Mycobacterium tuberculosis complex has a long
doubling time of between 16 and 20 hours, thus a slow grower. The organism also has intracellular location,
which ensures effective evasion of host immune defences.
The host response to eliminate the microbial pathogen results in a fibrotic reaction surrounded by
epithelial and chronic inflammatory cells. This lesion or tubercle granuloma consists of a central core of
caseating necrotic or non-necrotic tubercles and a peripheral of epithelial cells and histiocytes or macrophages1
.
The tuberculous granulomata have their nuclei arranged in a semi circle akin of a horse-shoe, called
Langhans giant cells.2,3
Granulomata are most commonly found in the cutaneous tissue of any part of the body, the pleura and
lung tissue.
In this study, one case of tuberculous granuloma presented as a soft tissue tumour in the wrist of the
subject, a rather unusual but not unlikely location.
FIGURE 3: H & E: Section showing central area of caseous necrosis interspersed with multinucleated
Langhans’ giant cells surrounded by rim of lymphocytes and epitheloid-cells.
Ziehl Neelsen stain, Auramine- Rhodamine stain are some of the common stains for confirmation of the
diagnosis of mycobacterium tuberculosis.
Rhinoscleroma
It is a chronic granulomatous disease almost exclusively limited to the nasal cavity.4
The disease is caused by Klebsiella rhinoscleromatis—subspecies of Klebsiella pneumoniae— a gram-
negative, encapsulated, nonmotile, rod-shaped bacillus (diplobacillus), member of the Enterobacteriaceae
family. It is sometimes referred to as the "Frisch bacillus," named for Anton von Frisch who identified the
5. Inflammatory Conditions Mimicking Tumours In Calabar: A 30 Year Study (1978-2007).
www.iosrjournals.org 41 | Page
organism in 1882. It is contracted directly by droplets or by contamination of material that is subsequently
inhaled.
Scleroma has an insidious and spontaneous onset but progresses through three distinct clinical stages. The
nodular or granulomatous stage consists of intranasal polyps. These nodules are painless and may occur at any
location between the nostrils and the lung hila.
The disease is seen commonly in young and middle aged adults and persons of lower economic and
nutritional levels. It occurs a little more in females than males.5
The location within the maxillary antrum in this study is in keeping with the common sites for
rhinoscleroma when the nodules spread to the floor, walls and septum of the nose.6
Onchocerciasis
A parasitic infection by the onchocerca volvolus nematode is transmitted by the female blackfly, simulium.
The onchocercal larvae develop in the ensymbiotic wolbachia pipiens worm which resides in the
dermis of the human host. The microfilariae develop and mature within nodules formed by the worms.
An inflammatory reaction occurs around the adult worm and that directed against the wolbachia carried
by the microfilariae results in tissue fibrosis.7
These fibrotic lesions occur as nodules involving skin or subcutaneous tissues. They are usually non-
tender and of varying sizes located in the pelvis, lower extremities, lower extremities, and lower torso
particularly in African patients.9
FIGURE 4: Section showing gravid Onchocercal volvulus with fibrosis and hyalinization of the stroma. The
stroma is infiltrated by chronic inflammatory cells mainly eosinophils and lymphocytes.
Leishmaniasis
Cutaneous Leishmaniasis is a chronic parasitic infection caused by different species of leishmania
related to the geographic location. In the old world of Asia and Africa, L. major, L. tropica and L. aethiopica
are responsible for infection while L. braziliensis, L. mexicana etc are responsible for infection in South
America.
Cutaneous leishmaniasis may induce chronic inflammation.10
Lesions manifest in skin as dry, crusted and spreading or may be moist and exudative with a red
granulating base. A mixture of acute and chronic inflammatory cells of infected and non-infected mononuclear
cells predominate with a granulomatous response of epitheloid and giant cells.1
Histoplasmosis
It is a common systemic fungal infection in some parts of North America (mid western and south
eastern USA). The disease is caused by Histoplasma capsulatum whose varants and virulence differ with
geographic location.14
H. capsulatum var dubosii is responsible for most of the disease in Africa with Nigeria,
Senegal, Zaire and Uganda accounting for most of the cases.
Infection is acquired by inhalation of fungal spores from the soil, making the lungs the site of primary
infection. The lung lesion is a concentric mass of caseating and noncaseating granuloma with a fibrotic thick
6. Inflammatory Conditions Mimicking Tumours In Calabar: A 30 Year Study (1978-2007).
www.iosrjournals.org 42 | Page
shell. A central calcium deposit within the granuloma differentiates it from a neoplastic mass. Histoplasmosis is
increasing in HIV-infected.
Definitive diagnosis is poor by mycological isolation on special media where available in addition to difficulty
in obtaining bronchoscopic specimen.
Lesions may be confined or enlarge to erode into airways. Common sites of location are the lung hila
or mediastinum, liver or spleen. Skin, bones and joints may be affected.
Histoplasmosis has no known sex or age predilection.
FIGURE 5: Section showing refractile spores of Histoplasma capsulatum within and outside the multinucleated
giant cells in the midst of chronic inflammatory cells mainly eosinophils.
Mycetoma
Mycetoma is a chronic granulomatous disease of the skin and subcutaneous tissue caused by bacteria,
actinomycetes or several fungal species.
It is commonly found in the tropic and subtropical regions especially in the Indian subcontinent from
where the names Madura foot or Maduromycosis came.
The bacterial and fungal species responsible for this disease vary according to region and the local
climate. These include Madurella spp, Pseudallescheria boydii, Acremonium spp, Fusarium spp for the
bacterial (Enmycetoma) agents and Actinomydurae madurae, A. pelletieri, Norcardia spp and Streptomyces
somaliensis for the Actinomycetoma.
The foot and lower leg are common sites of affectation following traumatic inoculation. However, any
part of the body can be affected.
Following inoculation, the organism grows to form masses of fungal mycelia or bacterial filaments.15
Mycetoma lesions are granulomatous and are associated with discharging sinuses and deformity of the part of
limb. Although it is localized, infection may extend to affect underlying bone.
Adults above 20 years and five times more men than women are commonly affected.
Blastomycosis
It is a systemic granulomatous lung disease caused by the inhalation of spore forms of the fungus, Blastomyces
dermatitidis in moist soil.
The disease is endemic in parts of North America, less commonly in Africa, India, Middle East and Central and
South America.
The lung is the primary site of disease from where it may be disseminated to other sites of the body. The skin is
the commonest extrapulmonary site, followed by the bone and genitourinary area.16
The lung lesion is a noncaseating granuloma of epitheloid and giant cells.
On the skin, lesions are characteristically verrucous, starting as papulopustular and later as heaped-up crusted
masses with micro abscesses in the margins.
The skin site of blastomycosis in this study agrees with known location of the extrapulmonary forms of the
disease.
V. Conclusion:
Microfilariasis caused by onchocerca volvolus and loa loa parasites are common in Cross River State.
However, it is onchocerciasis which is often characterized by fugitive swollen lumps in subcutaneous tissues
containing dead adult worms.
7. Inflammatory Conditions Mimicking Tumours In Calabar: A 30 Year Study (1978-2007).
www.iosrjournals.org 43 | Page
The study shows that onchocerciasis is still endemic in the study area with continued transmission of
infection from long term carriers. Other lesions seen are histoplamosis, mycetoma, molloscum contagiosum etc.
More study is required to ascertain the pathogenesis of the two infectious agents, histoplasma and
onchocerca. Importantly, the finding of high number of onchocerciasis is an indication that community infection
is still rife despite efforts of eradication with ivermectin. Also, control efforts may be waning for this parasitic
infection as more efforts are concentrated in the emerging public health infections such as HIV.
Reference
[1] Woodward B H, Rosenberg S I, Farnham R and Adams D O. Incidence and nature of primary granulomatous inflammation in
surgically removed material. Am Journal of Surgical Pathology. 1982; 6 (2): 119-129.
[2] Adams, D. O. ―The granulomatous inflammatory response. A review‖. Am J of Pathology. 1976; 84(1): 164-191.
[3] Granuloma. From Wikipedia, the free encyclopedia. Last modified 6 August, 2011 at 21.52.
[4] Andraea R., Edson RS, Kern EB. Rhinoscleroma: A growing concern in the United States? Mayo Clinic experience. Mayo
Clinic Proc. 1993; 68: 1151 – 1157.
[5] DiBartolomeo, Joseph R. Scleroma of the nose and pharynx. Western Journal of Medicine. 1976; vol. 124., pp 13-17.
[6] Palmer, PES and Reader MM. The imaging of tropical diseases. 2000. Heidelberg: Springer Verlachi; vols. 1 and 2 (ISBN 3 –
540 – 66219 – 7).
[7] Saint Andre A., Blackwell NM, Hall LR, et al. The role of endosymbiotic Wolbachia bacteria in the pathogenesis of river
blindness. Science. 2002; 295:1892 – 1895. In Mandell, Douglas and Bennett’s Principles and Practice of infectious Diseases:
6th
Ed, ELSEVIER Churchill Livingstone. Pp. 3273.
[8] American Academy of Paediatrics eBooks; accessed 22 July, 2011 on http: //aaparebook.apphblications.org.
[9] Taylor H R, Duke B O L, Munoz B. The selection of communities for treatment of onchocerciasis with ivermectin. Trop Med
Parasitol. 1992; 43:267.
[10] Elder D., Rosalie E., Christine J., Bernett J, Lever’s Histopathology of the skin. 1990; 60-61.
[11] John H, Arnold O, Neil P. Textbook of Paediatric dermatology. 2002; vol.1: 516-517.
[12] Rideley D.S. The pathogenesis of cutaneous leishmaniasis. Trans. R Soc Trop. Med Hyg. 1979; 73:150-160
[13] Mandell, Douglas and Bennett’s Principles and Practice of Infectious Diseases: 6th
Ed, ELSEVIER Churchill Livingstone. Pg
[14] Keath, E.J., Kobayashi G S, Medoff G. Classification of Histoplasma capsulatum by restriction fragrant length polymorphism in a
nuclear gene. J Clin Microbiol. 1992; 30:2104-2107.
[15] Manfredi R, Mazzoni A, Nanetti A, et al. Histoplasma capsulatum and duboisii in Europe: The impact of the HIV pandemic ,
travel, and immigration. Eur J Epidemiol. 1994; 10: 675-681.
[16] Mandell, Douglas and Bennett’s Principles and Practice of Infectious Diseases: 6th
Ed, ELSEVIER Churchill Livingstone. Pg
[17] Mercurio MG, Eleroski B E. Cutaneous blastomycosis. Cutic 1992; 50:422-424.