DIAGNOSING OVARIAN TORSION IN THE EMERGENCY DEPARTMENT: A CASE REPORT AND LITERATURE REVIEW Diagnosing acute abdomen in emergency department setting, especially in women of childbearing age, is challenging. The patient may present with non-specific complaints. We were presented with a case of a 28-year-old lady with no known medical illness complaining of sudden onset left-sided abdominal pain. Multiple analgesics were given, but her pain persisted. Bedside ultrasonography was performed and noted a multiloculated cyst over the left ovary, with the largest measuring 4 x 4 cm. She then underwent laparoscopic left salpingo-oophorectomy, revealing an engorged, gangrenous left fallopian tube and the left ovarian cyst was twisted three times. Histopathological examination confirmed a left ovarian haemorrhagic twisted ovarian cyst with a paratubal cyst. This case concludes that acute abdominal pain in women of childbearing age requires prompt and thorough investigation. Clinicians should consider several potential diagnoses, including ovarian torsion.

Recent studies have characterized the genomic structures of many eukaryotic cells,often focusing on their relation to gene expression.However,these studies have largely investigated cells grown in 2D cultures,although the transcriptomes of 3D-cultured cells are generally closer to their in vivo phenotypes.To examine the effects of spatial constraints on chromosome conformation,we investigated the genomic architecture of mouse hepatocytes grown in 2D and 3D cultures using in situ Hi-C.Our results reveal significant differences in higher-order genomic interactions,notably in compartment identity and strength as well as in topologically associating domain(TAD)-TAD interactions,but only minor differences are found at the TAD level.Our RNA-seq analysis reveals up-regulated expression of genes involved in physiological hepatocyte functions in the 3D-cultured cells.These genes are associated with a subset of structural changes,suggesting that differences in genomic structure are critically important for transcriptional regulation.However,there are also many structural differences that are not directly associated with changes in gene expression,whose cause remains to be determined.Overall,our results indicate that growth in 3D significantly alters higher-order genomic interactions,which may be consequential for a subset of genes that are impor-tant for the physiological functioning of the cell.

Introduction: The first five years of life constitute the foundations of the child's physical, mental growth and development. Mortality and morbidity are high during this age group. Early detection of danger signs is very crucial to prevent this. The objectives were to assess the knowledge of mothers regarding under-five danger signs and explore the association between the effects of knowledge with selected factors. Method: A descriptivestudy was conducted in a rural community of West Bengal from Jan’2018 to Sept’2018. Total study sample was 110 mothers having under five children. Door to door data collection was done through interview and data was analyzed both manually and by computer feeding. Results: Out of total study sample, majority (60%) belongs to age group 18-25 years followed by 31% among 26-33 age group, then 16% were more than 33 years. Out of total mothers, majority (40%) belongs to higher educated group, (37%) secondary group, followed by 10% with primary education and 13%were illiterate. Knowledge score was more than 50% among higher educated group (64%). Out of total respondents 61 (55.5%) mothers were not able to identify any danger signs whereas, 35.5 % mothers identified 1-2 danger signs and 9% mothers were able to identify 3-4 danger signs. Knowledge score about danger signs was more who visited antenatal clinic more than 4 times (61%). Conclusion: Awareness regarding under five danger signs are more among higher educated mothers. Number of antenatal visits also influences knowledge score.

The human respiratory tract hosts both pathogenic and commensal bacteria. The development of well-conserved 16S rRNA sequencing and culture-independent techniques has enabled many achievements in the study of the human microbiome. Microbial composition of the respiratory tract in early childhood has been shown to correlate to respiratory health in later stages of life. This review highlights current understandings of respiratory microbiota development in healthy children, examples of microbial interactions, impacts on the host immune system, and the relationship between respiratory tract microbiome and respiratory health.
Bacteria ; Child ; Humans ; Immune System ; Microbial Interactions ; Microbiota ; Respiratory System ; Respiratory Tract Infections

BACKGROUND: Musculoskeletal disorders (MSDs) in the health industry are quite common, however, there have only been a few studies regarding physiotherapists, while in Greece, there is an apparent lack of research and data. The aim of this study is to investigate MSDs experienced by physiotherapists in Greece, their causes and specific measures, and good practices followed. Additional emerging risk factors will be examined. METHODS: A questionnaire of MSDs followed by individual and workplace characteristics was completed by 252 physiotherapists. It covered the major workplace categories such as public hospitals, private rehabilitation centers, and private practices. RESULTS: Analysis indicated that 89% of the respondents had experienced a work-related MSD; 32.2% of those injuries occurred within the first 5 years of working. The most lumbered physiotherapists were those working as private practitioners and almost half of the injured respondents chose to work while injured. The most common measure taken to tackle work related MSDs was found to be physical therapy sessions. Job satisfaction and psychosocial issues were also identified as side-effects of the economic slowdown. CONCLUSION: Physiotherapists in Greece were found to suffer from MSDs; workplace musculoskeletal injuries were quite common but under-reported. The body parts most affected were the lower back, the upper back, the shoulders, and the neck. There was a strong correlation between the workplace setting and the number of MSDs. A well-defined occupational safety and health management system and strict administration steering were found to reduce MSDs. The economic slowdown experienced in Greece during the execution of this study placed additional pressure on physiotherapists.
Greece ; Hospitals, Public ; Human Body ; Humans ; Job Satisfaction ; Neck ; Occupational Health ; Physical Therapists* ; Private Practice ; Rehabilitation Centers ; Risk Factors* ; Shoulder ; Surveys and Questionnaires

It is common to find a nose with a hump, lower nasal tip and a radix among Koreans. A common procedure as an aesthetical improvement for such feature, involves rasping of the hump, while lifting the tip and the bridge at the same time. As for the hump, en bloc resection is a well-known, traditional surgical method, but it may cause an open roof deformity, which leads to a high possibility of infection if dorsal augmentation using silicone was performed through it as it connects the nasal cavity and dorsum. To overcome this complication, the hump on the bony portion and cartilaginous has been improved by a modified autospreader graft. Also, the graft can also be used for tip-plasty in dorsal augmentation using silicone, septal extension graft, strut and onlay graft. As a result of constant monitoring for a year, the reformation of the hump and infection was not found.
Congenital Abnormalities ; Inlays ; Lifting ; Methods ; Nasal Cavity ; Nose ; Rhinoplasty ; Silicon ; Silicones ; Transplants*

PURPOSE: To fight animal rabies, Moroccan veterinary authorities organize annual dog mass vaccination campaigns using Rabivac vaccine, an inactivated adjuvanted cell culture veterinary rabies vaccine. Two experiments were undertaken to assess the efficacy and immunogenicity of Rabivac. MATERIALS AND METHODS: The first experiment involved 13 caged dogs (8 vaccinated and 5 negative controls). Dogs were bled at day 0 (D0) and at days D7, D14, D21, D28, D35, D49, D56, D64, D70, D77, D84, D91, D98, D105, D112, and D119 post-vaccination. At D121, a virulent challenge was performed. After 70 days monitoring period, seven out of eight vaccinated dogs survived the challenge (one dog succumbed to a mesenteric torsion accident) and four out of five controls succumbed. All vaccinated dogs seroconverted and the control dogs remained negative. The second experiment consisted in a field study involving 919 owned dogs randomly selected in eight Moroccan districts located in different parts of the country. The dogs were identified and vaccinated by the parenteral route and bled on the vaccination day (D0) and on D30. RESULTS: Ninety-two percent of dogs developed a positive rabies virus neutralizing antibody response to vaccination and 24% were positive at D0, suggesting that dogs were previously vaccinated. The increase in rabies antibody titers was highly significant in all districts. No significant difference seemed occurring between the geographical status (rural, semiurban, or urban) of the districts on the results obtained. CONCLUSION: Rabivac is efficacious both in experimental and field conditions. This supports its use in dog mass vaccination campaigns.
Animals* ; Antibodies, Neutralizing ; Cell Culture Techniques ; Dogs ; Mass Vaccination ; Morocco* ; Rabies Vaccines ; Rabies virus ; Rabies* ; Vaccination

PURPOSE: Canine rabies is a serious health problem in Morocco and about 22 human deaths are reported yearly. Following the World Health Organization (WHO) recommendations, Moroccan authorities evaluated oral rabies vaccine baits specially designed for dogs. MATERIALS AND METHODS: The study was performed in Tiflet area. The vaccine strain was SAG2, a modified live oral rabies vaccine strain. Each bait contained an aluminium/PVC capsule filled with a liquid. Two kinds of baits were used: placebo baits containing methylene blue as a topical marker and vaccine baits containing vaccine suspension. The study was performed according to recommended WHO strategies, i.e., door to door model (DDDM), hand-out and wildlife immunization model (WIM). The DDDM was performed in the rural area of Tiflet on 60 owned dogs. The hand-out strategy was tested on 15 stray dogs. The WIM was performed on 4 transects lines near Tiflet slaughterhouse and near the weekly traditional market location. RESULTS: Using the DDDM, 100% of owned dogs were attracted by the baits and 77% ate the bait. Using the hand-out model, 100% of dogs showed interest in baits and 46.7% took the baits. Using the WIM in stray dogs, up to 73% of baits disappeared and 68% of the capsules containing the SAG2 vaccine were found pierced, depending on the sites of distribution. CONCLUSION: This pilot study showed that baits have a good palatability and that oral vaccination of both owned and stray dogs is feasible with baits specifically developed for dogs and with adapted strategy of distribution.
Abattoirs ; Administration, Oral ; Animals ; Capsules ; Dogs* ; Humans ; Immunization ; Methylene Blue ; Morocco* ; Pilot Projects ; Rabies Vaccines ; Rabies* ; Vaccination* ; World Health Organization

Schwannomas are benign, usually slow-growing tumors that originate from Schwann cells surrounding peripheral, cranial, or autonomic nerves. The most common form of these tumors is acoustic neuroma. Schwannomas of the brachial plexus are quite rare, and symptomatic schwannomas of the brachial plexus are even rarer. A 47-year-old woman presented with a 1-year history of dysesthesia, neuropathic pain, and mild weakness of the right upper limb. Results of physical examination and electrodiagnostic studies supported a diagnosis as thoracic outlet syndrome. Conservative treatment did not relieve her symptoms. After 9 months, a soft mass was found at the upper margin of the right clavicle. Magnetic resonance imaging showed a 3.0x1.8x1.7 cm ovoid mass between the inferior trunk and the anterior division of the brachial plexus. Surgical mass excision and biopsy were performed. Pathological findings revealed the presence of schwannoma. After schwannoma removal, the right hand weakness did not progress any further and neuropathic pain gradually reduced. However, dysesthesia at the right C8 and T1 dermatome did not improve.
Autonomic Pathways ; Biopsy ; Brachial Plexus* ; Clavicle ; Diagnosis ; Female ; Hand ; Humans ; Magnetic Resonance Imaging ; Middle Aged ; Neuralgia ; Neurilemmoma* ; Neuroma, Acoustic ; Paresthesia ; Physical Examination ; Schwann Cells ; Thoracic Outlet Syndrome* ; Upper Extremity

Minor fibrillar collagen types V and XI, are those less abundant than the fibrillar collagen types I, II and III. The alpha chains share a high degree of similarity with respect to protein sequence in all domains except the variable region. Genomic variation and, in some cases, extensive alternative splicing contribute to the unique sequence characteristics of the variable region. While unique expression patterns in tissues exist, the functions and biological relevance of the variable regions have not been elucidated. In this review, we summarize the existing knowledge about expression patterns and biological functions of the collagen types V and XI alpha chains. Analysis of biochemical similarities among the peptides encoded by each exon of the variable region suggests the potential for a shared function. The alternative splicing, conservation of biochemical characteristics in light of low sequence conservation, and evidence for intrinsic disorder, suggest modulation of binding events between the surface of collagen fibrils and surrounding extracellular molecules as a shared function.
Alternative Splicing ; genetics ; Animals ; Fibrillar Collagens ; chemistry ; genetics ; metabolism ; Humans ; Sulfates ; chemistry ; metabolism ; Surface Properties ; Tyrosine ; analogs & derivatives ; chemistry ; metabolism