Tuberculosis of the thyroid gland is an uncommon disease and primary involvement of thyroid is even more rare. It is a rare disease even in countries in which tuberculosis is endemic. The diagnosis is often difficult as the clinical presentation has no distinct characteristics. Clinical course of the disease may resemble toxic goiter or acute thyroiditis or may follow a subacute or chronic growth pattern without specific symptomatology. Histologically presence of necrotizing epithelioid cell granulomas along with langhans type giant cells are the hallmark of thyroid tuberculosis. Demonstration of acid fast bacilli by ZN staining confirms the diagnosis, but this stain is frequently negative in tissue sections.

Parkinsonism due to an isolated lesion of the substantia nigra following a febrile illness is a rare entity. Anecdotal reports in the literature implicate substantia nigra as peculiarly susceptible to flaviviruses. Here we report a case of isolated substantia nigra involvement in a probable Japanese encephalitis patient who presented with post-encephalitic parkinsonism

BACKGROUND: Valsalva maneuver reduces pain by activating sinoaortic baroreceptor reflex arc. We planned this study to evaluate the role of valsalva in attenuating spinal needle-puncture pain. METHODS: Ninety American Society of Anesthesiologists (ASA) grade I and II enrolled patients undergoing elective surgery were randomized into 3 groups of 30 each. Group I (Control): didn't blow; group II (Distraction): patients blew into rubber tube; Group III (Valsalva): blew into sphygmomanometer tube and raise mercury column up to 30 mmHg for at least 20 seconds. During above procedures, spinal puncture was performed with 25-gauge spinal needle. RESULTS: Eighty-two patient data were analyzed. Incidence of spinal puncture pain was reduced to 10% (3 of 27) in Valsalva group as compared to 100% (28 of 28 in control group and 27 of 27 in Distraction group) observed in other two groups (P < 0.05). Severity of lumbar puncture pain as assessed by visual analog scale (0-10; where 0 is no pain and 10 is the worst imaginable pain) presented as Median (Interquartile range) were significantly reduced in the Valsalva group (0.0 [0.0] as compared to other 2 groups 2.0 [0.0] in the Distraction group and 3.0 [0.8] in Control group) (P < 0.05). Regarding time taken by CSF to fill spinal needle hub, there was no difference among the three groups (P > 0.05). None patient of all groups had post dural puncture headache (P > 0.05). CONCLUSIONS: Valsalva can be performed routinely in ASA I and II patients undergoing spinal anesthesia as it is safe, painless and non-pharmacological method of pain attenuation.
Anesthesia, Spinal* ; Baroreflex ; Humans ; Incidence ; Needles ; Post-Dural Puncture Headache ; Punctures* ; Rubber ; Skin* ; Sphygmomanometers ; Spinal Puncture ; Valsalva Maneuver* ; Visual Analog Scale

Objective: The purpose of this study was to evaluate the essential oil composition as well as antibacterial activities of essential oil and leaves extracts of Lantana camara against five bacterial strains. Methods: Essential oil was obtained by hydro-distillation from the leaves and analyzed by GC and GC-MS. The antibacterial activities of essential oil and the leaves extracts were tested by using disk diffusion method against five bacterial strains. Results: Thirty seven compounds were identified representing 98.11% of the total oil, of which trans-caryophyllene (13.95%), bicyclogermacrene (9.77%), α-curcumene (8.57%), sabinene (8.28%), (E)-citral (6.90%), 1,8 cineole (5.06%), α-pinene (4.03%), γ-terpinene (3.83%) and germacrene D (3.13%) were detected as major components. In respect to the antibacterial activities, essential oil showed the high degree of sensitivity against Micrococcus luteus, Escherichia coli, Staphylococcus aureus and Bacillus cereus except Pseudomonas aeruginosa while extracts of leaves obtained through petroleum ether, benzene, methanol and water exhibited good to moderate antimicrobial activity against all tested bacterial strains. Conclusions: The present study suggested that M. luteus showed best zone of inhibition for the essential oil as well as aqueous extract among all the tested bacterial strains. The most active extract can be subjected to isolation of the therapeutic antimicrobials to carry out further pharmacological evaluation.

Japanese encephalitis (JE) is an important vector-borne viral disease of humans and horses in Asia. JE outbreaks occur regularly amongst humans in certain parts of India and sporadic cases occur among horses. In this study, JE seroprevalence and evidence of JE virus (JEV) infection among horses in Haryana (India) is described. Antibodies against JEV were detected in 67 out of 637 (10.5%) horses screened between 2006 and 2010. Two foals exhibiting neurological signs were positive for JEV RNA by RT-PCR; JEV was isolated from the serum of one of the foals collected on the second day of illness. This is the first report of JEV isolation from a horse in India. Furthermore, a pool of mosquitoes collected from the premises housing these foals was positive for JEV RNA by RT-PCR. Three structural genes, capsid (C), premembrane (prM), and envelope (E) of the isolated virus (JE/eq/India/H225/2009) spanning 2,500 nucleotides (from 134 to 2,633) were cloned and sequenced. BLAST results showed that these genes had a greater than 97% nucleotide sequence identity with different human JEV isolates from India. Phylogenetic analysis based on E- and C/prM genes indicated that the equine JEV isolate belonged to genotype III and was closely related to the Vellore group of JEV isolates from India.
Animals ; Antibodies, Monoclonal ; Cloning, Molecular ; Culex/virology ; Encephalitis Virus, Japanese/*genetics/*isolation & purification ; Encephalitis, Japanese/epidemiology/*veterinary/virology ; Enzyme-Linked Immunosorbent Assay/methods/veterinary ; Female ; Genes, Viral ; Genotype ; Horse Diseases/epidemiology/*virology ; Horses ; India/epidemiology ; RNA, Viral/genetics/isolation & purification ; Reverse Transcriptase Polymerase Chain Reaction/veterinary ; Seroepidemiologic Studies

Gastrointestinal mucormycosis is a rare disease with a significant mortality rate, even when promptly diagnosed and treated. An unusual complication was observed in India during the second wave of coronavirus disease 2019 (COVID-19). Two incidences of gastric mucormycosis were found. A 53-year-old male patient with a history of COVID-19 one month earlier came into the intensive care unit. After admission, the patient developed hematemesis, which was initially treated with blood transfusions and digital subtraction angiography embolization. Esophagogastroduodenoscopy (EGD) revealed a large ulcer with a clot in the stomach. During an exploratory laparotomy, the proximal stomach was necrotic. Histopathological examination confirmed mucormycosis. The patient was started on antifungals, but despite rigorous therapy, the patient died on the tenth postoperative day. Another patient, an 82-year-old male with a history of COVID-19, arrived with hematemesis two weeks earlier and was treated conservatively. EGD revealed a large white-based ulcer with abundant slough along the larger curvature of the body. Mucormycosis was verified by biopsy.He was treated with amphotericin B and isavuconazole. He was discharged after two weeks in a stable condition. Despite quick detection and aggressive treatment, the prognosis is poor. In the second case, prompt diagnosis and treatment saved the patient’s life.