Dynamics and drivers of mycorrhizal fungi after glacier retreat

The development of terrestrial ecosystems depends greatly on plant mutualists such as mycorrhizal fungi. The global retreat of glaciers exposes nutrient-poor substrates in extreme environments and provides a unique opportunity to study early successions of mycorrhizal fungi by assessing their dynamics and drivers. We combined environmental DNA metabarcoding and measurements of local conditions to assess the succession of mycorrhizal communities during soil development in 46 glacier forelands around the globe, testing whether dynamics and drivers differ between mycorrhizal types. Mycorrhizal fungi colonized deglaciated areas very quickly (< 10 yr), with arbuscular mycorrhizal fungi tending to become more diverse through time compared to ectomycorrhizal fungi. Both alpha- and beta-diversity of arbuscular mycorrhizal fungi were significantly related to time since glacier retreat and plant communities, while microclimate and primary productivity were more important for ectomycorrhizal fungi. The richness and composition of mycorrhizal communities were also significantly explained by soil chemistry, highlighting the importance of microhabitat for community dynamics. The acceleration of ice melt and the modifications of microclimate forecasted by climate change scenarios are expected to impact the diversity of mycorrhizal partners. These changes could alter the interactions underlying biotic colonization and belowground-aboveground linkages, with multifaceted impacts on soil development and associated ecological processes.

The importance of species addition 'versus' replacement varies over succession in plant communities after glacier retreat

The mechanisms underlying plant succession remain highly debated. Due to the local scope of most studies, we lack a global quantification of the relative importance of species addition 'versus' replacement. We assessed the role of these processes in the variation (β-diversity) of plant communities colonizing the forelands of 46 retreating glaciers worldwide, using both environmental DNA and traditional surveys. Our findings indicate that addition and replacement concur in determining community changes in deglaciated sites, but their relative importance varied over time. Taxa addition dominated immediately after glacier retreat, as expected in harsh environments, while replacement became more important for late-successional communities. These changes were aligned with total β-diversity changes, which were more pronounced between early-successional communities than between late-successional communities (>50 yr since glacier retreat). Despite the complexity of community assembly during plant succession, the observed global pattern suggests a generalized shift from the dominance of facilitation and/or stochastic processes in early-successional communities to a predominance of competition later on.

Local climate modulates the development of soil nematode communities after glacier retreat

The worldwide retreat of glaciers is causing a faster than ever increase in ice-free areas that are leading to the emergence of new ecosystems. Understanding the dynamics of these environments is critical to predicting the consequences of climate change on mountains and at high latitudes. Climatic differences between regions of the world could modulate the emergence of biodiversity and functionality after glacier retreat, yet global tests of this hypothesis are lacking. Nematodes are the most abundant soil animals, with keystone roles in ecosystem functioning, but the lack of global-scale studies limits our understanding of how the taxonomic and functional diversity of nematodes changes during the colonization of proglacial landscapes. We used environmental DNA metabarcoding to characterize nematode communities of 48 glacier forelands from five continents. We assessed how different facets of biodiversity change with the age of deglaciated terrains and tested the hypothesis that colonization patterns are different across forelands with different climatic conditions. Nematodes colonized ice-free areas almost immediately. Both taxonomic and functional richness quickly increased over time, but the increase in nematode diversity was modulated by climate, so that colonization started earlier in forelands with mild summer temperatures. Colder forelands initially hosted poor communities, but the colonization rate then accelerated, eventually leveling biodiversity differences between climatic regimes in the long term. Immediately after glacier retreat, communities were dominated by colonizer taxa with short generation time and r-ecological strategy but community composition shifted through time, with increased frequency of more persister taxa with K-ecological strategy. These changes mostly occurred through the addition of new traits instead of their replacement during succession. The effects of local climate on nematode colonization led to heterogeneous but predictable patterns around the world that likely affect soil communities and overall ecosystem development.

Quantitative assessment of present and the future potential threat of coastal erosion along the Odisha coast using geospatial tools and statistical techniques

The eastern coast of India is one of the regions where most of the population resides in urban areas in the low-elevation coastal zone, making it vulnerable to frequent extreme weather events. The objectives of this study are to assess the short- to long-term shoreline changes of the Odisha coast, to understand how anthropogenic influences, and particularly extreme natural events, affect these changes, and to predict shoreline changes for 2050. This study utilized multi-temporal/spectral/spatial resolution satellite images and a digital shoreline analysis (DSAS) tool to appraise the short- (at five/six-year intervals) and long-term (1990-2019) shoreline dynamics along the coastal part of Odisha over the past three decades (1990-2019). The long-term shoreline analysis shows that the mean shoreline change is about 0.67 m/year and highlights that 52.47 % (227.4 km), 34.70 % (150.4 km), and 12.83 % (55.6 km) of the total Odisha coastline exhibit erosion, accretion, and stability, respectively. During the short-term analysis, the 2000-2005 period had the highest percentage of erosion (64.27 %), followed by the 2005-2010 period with an erosional trend of 59.06 %. The 1995-2000 period showed an accretion trend, whereas, during the last period, i.e., 2015-2019, the percentage of transects depicting erosion and accretion was almost similar. In 2050, 55.85 % of the transects are expected to show accretion, while 44.15 % would show erosion or a constant trend. The study identified the hotspots of coastal erosion along delineated study zones by synthesizing data from previous studies as well. The regional analysis of shoreline change along the Odisha coast would not only provide coastal managers with critical information on shoreline dynamics but also draw attention to vulnerable areas linked to shoreline dynamicity along the coast.

Heterogeneity in glacier thinning and slowdown of ice movement in the Garhwal Himalaya, India

Limited ground-based surveys and extensive remote sensing analyses have confirmed glacier thinning in the Garhwal Himalaya. More detailed studies on specific glaciers and the drivers of reported changes are essential to comprehend small-scale differences in the effects of climatic warming on Himalayan glaciers. We computed elevation changes and surface flow distribution for 205 (≥0.1 km²) glaciers in the Alaknanda, Bhagirathi, and Mandakini basins, all located in the Garhwal Himalaya, India. This study also investigates a detailed integrated analysis of elevation changes and surface flow velocities for 23 glaciers with varying characteristics to understand the impact of ice thickness loss on overall glacier dynamics. We observed significant heterogeneity in glacier thinning and surface flow velocity patterns using temporal DEMs and optical satellite images with ground-based verification. The average thinning rate was found to be 0.07 ± 0.09 m a^-1 from 2000 to 2015, and it increased to 0.31 ± 0.19 m a^-1 from 2015 to 2020, with pronounced differences between individual glaciers. Between 2000 and 2015, Gangotri Glacier thinned nearly twice as much as the neighbouring Chorabari and Companion glaciers, which have thicker supraglacial debris that protects the beneath ice from melting. The transitional zone between debris-covered and clean ice glaciers showed substantial flow during the observation period. However, the lower reaches of their debris-covered terminus areas are almost stagnant. These glaciers experienced a significant slowdown (~25 %) between 1993-1994 and 2020-2021, and only the Gangotri Glacier was active even in its terminus region during most observational periods. The decreasing surface gradient reduces the driving stress and causes slow-down surface flow velocities and an increase in stagnant ice. Surface lowering of these glaciers may have substantial long-term impacts on downstream communities and lowland populations, including more frequent cryospheric hazards, which may threaten future water and livelihood security.

Deciphering the impact of anthropogenic coastal infrastructure on shoreline dynamicity along Gopalpur coast of Odisha (India): An integrated assessment with geospatial and field-based approaches

Odisha's coastline supports various development activities that are critical to the state and national economy, such as oil and gas, ports and harbors, power plants, fishing, tourism, and mining that continues to not only detriment the coastal ecology but also affect the overall shoreline morphodynamics. The morphological changes are complicated processes involving both natural and human-induced drivers, but it is critical to understand how recent development activities further impact beach morphodynamics and shoreline dynamicity. The study analyzes the overall shoreline morphodynamics in response to the recent development of port and other related infrastructure for annual and decadal scale using two-dimensional (2-D) shoreline changes along with detailed 3-D beach profile volumetric changes for different studied zones along the Gopalpur coast. The results reveal that nearly all studied zones of the Gopalpur shoreline, Zone-4 (EPR = -05.64 m a^-1 and LRR = -04.25 m a^-1), Zone-3 (EPR = -04.51 m a^-1 and LRR = -07.01 m a^-1) and Zone-1 (EPR = -2.85 m a^-1 and LRR = -01.46 m a^-1), experienced erosion between 2010 and 2020 except Zone-2 (EPR = 24.31 m a^-1 and LRR = 25.96 m a^-1), which showed overall sign of deposition. The interannual shoreline analysis depicted that Zone-1 (tourist beach area) remained almost stable, Zone-2 (south of the breakwater of Gopalpur Port) showed accretion trends, Zone-4 (north side of the port) dominantly showed an erosion pattern, whereas Zone-3 (port area) showed a high level of uncertainty in the context of erosional or deposition trends. Calculated volumetric loss along the surveyed 3-D beach profiles supports these 2-D changes for all the studied zones. The results showed substantial changes in coastal morphodynamics in different studied zones of the Gopalpur region and severe erosion along its northern segment of the constructed coastal infrastructure. These findings can potentially promote effective coastal zone management and prevent further deterioration along the Gopalpur coast in future.

Knowledge of Stroke among Hypertensive Patients in Dhulikhel

Background More than 50% of patients with stroke have hypertension, a common modifiable risk factor for stroke. Studies reported that 90% of diagnosed hypertensive patients do not seek for treatment in Nepal and the reason for this remains unexplored. There is a possibility that lack of knowledge of stroke and its potential causes may be the reason. Objective To assess the knowledge of stroke in a group of patients with hypertension in suburban Nepal. Method Hypertensive patients visiting a tertiary care hospital in Nepal were approached and were included if they were 18 years or older. We used the Nepali version of 'Awareness of Stroke, Risk Factors, and Treatment' questionnaire to assess the knowledge of stroke. Descriptive statistics were used to analyze the results. Result A total of 273 patients were included with the mean age of 56 years. Almost half (48%) of the patients were uneducated. We found that only 24% of the patients identified brain as an organ affected by stroke, only 32% were aware about more than one warning signs of stroke, 64% reported that they were unaware of the treatment options for stroke and only 5% reported control of blood pressure as a part of stroke management. The commonest reported identifiable risk factor for hypertension was high blood pressure (44%). Conclusion There are significant knowledge gaps regarding stroke in hypertensive patients. Although most patients recognized hypertension as a risk factor for stroke, they were unaware of treatment options. Increasing awareness of hypertension as a risk factor for stroke may help to prevent the stroke burden in Nepal.

Spatio-temporal characterization of tropospheric ozone and its precursor pollutants NO2 and HCHO over South Asia

In recent decades, South Asia has experienced declining air quality, with much of the attention being focused on extremely high levels of particulate matter. Here, we analyze tropospheric ozone (O₃), formaldehyde (HCHO), and nitrogen dioxide (NO₂) to assess other measures of air quality across South Asia from 2008 to 2018. The IASI-Forli retrieved tropospheric ozone data was validated with ozonesonde, reanalysis (ERA5), satellite (TES), and model simulation products (GEOS-Chem and TOMCAT/SLIMCAT). Space-based observations of these three trace gases were used to conduct a spatio temporal analysis over South Asia using trend analysis (Theil-Sen and linear regression), change-point detection (Pettitt's test), and hotspot identification (Getis-Ord G_i*). We used the formaldehyde-nitrogen dioxide ratio (FNR) to identify NO_x limited, VOC limited, and transitional regimes in South Asia. Counter to previous studies, a statistically significant decrease of HCHO (-0.0041 DU yr^-1) and O₃ (-0.064 DU yr^-1) was detected for South Asia; however, NO₂ is increasing the 0.001 DU yr^-1 over South Asia during 2008-18. The Indo-Gangetic Plains emerged as being critically affected by the three trace gases. Certain parts of southern and south-eastern India are gradually emerging as NO₂ and HCHO hotpots. No significant O₃ hotspots were discernible, though coldspots existed along the Himalaya belt of India, Nepal, and Bhutan and mountainous tracts of Pakistan. FNR indicates the reduction of NO_x in NO_x-limited regime of the Indo-Gangetic Plains reduced the formation of tropospheric O₃ over South Asia.

Response of long- to short-term tidal inlet morphodynamics on the ecological ramification of Chilika lake, the tropical Ramsar wetland in India

The long- to short-term morphodynamic response in low-lying coastal wetlands raises serious concerns worldwide about the loss of their biodiversity and ecological ramifications due to change in tidal amplitude and cyclonic events. One such place worth studying is Chilika lake, India, a prominent Ramsar site, the largest brackish water lagoon in Asia, and the second-largest coastal lagoon in the world. It experiences frequent cyclone landfalls and strong littoral drift that tends to open/close the tidal inlet. The goal of this study was to analyze the response of slow onset events such as long- (1952-2020) to short-term (~annual scale from 1989 to 2020) tidal inlet movement, shoreline change (1990-2020 with almost every five-year interval), spit morphodynamics (~annual scale from 1989 to 2020) on ecological ramification in Chilika lake as well as the implications of sudden onset event such as cyclonic landfall. In this study, we used the Digital Shoreline Change Analysis System (DSAS) to compute the statistics of shoreline change rate by calculating end point rate (EPR) values for short-term shoreline change (1990, 1995, 2000, 2005, 2011, 2016, and 2020) and weighted linear regression (WLR) for long-term shoreline change (1990-2020). The results show that Chilika lake experienced both erosion and accretion processes with a remarkably high erosion rate of 19.87 m year^-1 and accretion of 16.91 m year^-1 during a long-term scale (1990-2020). The average erosion and accretion rates were 2.25 m year^-1 and 4.67 m year^-1, respectively, during the past three decades (1990-2020). The short-term analysis suggests that the highest mean erosion of 4.37 m year^-1 occurred during 2005-2011, mainly due to cyclonic storms, reduction in sediment discharge, and lunar eclipse, which induced tide with very high amplitude in August 2008. Overall, the annual scale analysis of tidal inlet shows a shifting trend towards the northward side even after the artificial opening of an inlet in 2000. It can be ascribed mainly to the prevalent direction of longshore drift along this coast. This study observed that the landfall of cyclones significantly affects the spit morphodynamics and opening of the tidal inlet, which defines the inflow of the seawater into the lagoon and further substantial impacts on the ecological ramification. The current study's methodology can be extended to comprehend the response of long- to short-term changes of the tidal inlet, shoreline, and spit morphodynamics on the ecological ramification of coastal lagoons worldwide along with impacts of sudden-onset events caused by cyclonic landfall.

Patient’s perspective on early treatment retention in take home buprenorphine maintenance treatment- an explorative study from India

Introduction

Currently, Buprenorphine maintenance therapy (BMT) is an evidence-based treatment in retaining patients who are dependent on opioids. However, factors influencing retention are often measured objectively. Studies on patient’s perspectives on take home BMT in developing countries are limited.

Objectives

This study examines the potential factors influencing treatment compliance in the early phase of Buprenorphine maintenance treatment from the patient’s perspective

Methods

Participants (n=89) who were initiated on BMT were recruited and followed after six weeks. A semi-structured interview was conducted with 62 patients who remained in treatment and 24 patients who dropped out of the study

Results

Based on the semi qualitative analysis some of the factors which facilitated the patient’s retention in treatment were: (1) Effectiveness in blocking withdrawal symptoms (2) effectiveness in reducing their cravings and controlling their opioid use (3) decreased fear of withdrawal and/or missing doses(4) improvement in the quality of life(5) patient-related factors like family support (6) effectiveness of the treatment program. Around nine percent of patients reported family support as the reason for retention, which is not noticed in other studies. Barriers reported by the patients while on medication were: (1) negative effect experienced with medication (2) program related difficulties like distance, unavailability (3) major life event interrupting the treatment (4) patient-related factors like low mood, financial constraints.

Conclusions

Understanding factors associated with barriers to treatment provide insights into preventable factors that contribute to premature drop out from BMT and to improve clinical practice, policy decisions, or future research.

The hazardous 2017-2019 surge and river damming by Shispare Glacier, Karakoram

In 2017–2019 a surge of Shispare Glacier, a former tributary of the once larger Hasanabad Glacier (Hunza region), dammed the proglacial river of Muchuhar Glacier, which formed an ice-dammed lake and generated a small Glacial Lake Outburst Flood (GLOF). Surge movement produced the highest recorded Karakoram glacier surface flow rate using feature tracking (~18 ± 0.5 m d⁻¹) and resulted in a glacier frontal advance of 1495 ± 47 m. The surge speed was less than reports of earlier Hasanabad advances during 1892/93 (9.3 km) and 1903 (9.7 km). Surges also occurred in 1973 and 2000–2001. Recent surges and lake evolution are examined using feature tracking in satellite images (1990–2019), DEM differencing (1973–2019), and thermal satellite data (2000–2019). The recent active phase of Shispare surge began in April 2018, showed two surface flow maxima in June 2018 and May 2019, and terminated following a GLOF on 22–23 June 2019. The surge likely had hydrological controls influenced in winter by compromised subglacial flow and low meltwater production. It terminated during summer probably because increased meltwater restored efficient channelized flow. We also identify considerable heterogeneity of movement, including spring/summer accelerations.

Comorbid depressive symptoms in persistent delusional disorder: A retrospective study from India

Background

Previous studies have reported depressive symptoms in patients with persistent delusional disorder (PDD). Patients with PDD and depression may need antidepressants for treatment.

Aim

The aim of the study was to compare the sociodemographic profile, clinical presentation and treatment response in patients with PDD with and without comorbid depressive symptoms.

Methods

We conducted a retrospective chart review of patients diagnosed with PDD (ICD-10) from 2000 to 2014 (n = 455). We divided the patients into PDD + depression (n = 187) and PDD only (n = 268) for analysis.

Results

Of the 187 patients with PDD + D, only eighteen (3.9%) were diagnosed with syndromal depression. There were no significant differences in sociodemographic profile including sex, marital and socioeconomic status (all P > 0.05). PDD + D group had a significantly younger age at onset ([PDD + D: 30.6 9.2 years vs. PDD: 33.5 11.1 years]; t = 2.9, P < 0.05). There was no significant difference between the clinical presentation including mode of onset, the main theme of their delusion and secondary delusions (all P > 0.3). However, comorbid substance dependence was significantly higher in patients with PDD only. (χ2 = 5.3, P = 0.02). In terms of treatment, response to antipsychotics was also comparable ([> 75% response: PDD + D = 77/142 vs. PDD = 106/179); χ2 = 1.9, P = 0.3). There was a significant difference between the two groups in terms of antidepressant treatment ([PDD + D = 32/187; 17% vs PDD: 17/268; 6%), χ2 = 12.9, P = 0.001).

Discussion

Patients with PDD + D had significantly earlier onset of illness. These patients may require antidepressants for treatment.

Disclosure of interest

The authors have not supplied their declaration of competing interest.

Primary Total Hip Replacement in The Military Hospital in Kathmandu

INTRODUCTION

Total hip replacement is one of the most widely performed and amongst the most successful orthopedic procedures performed worldwide. Even though it is a common orthopedic procedure in developed nations, it is performed only in selected centers in Nepal. This study will review the functional outcome of total hip replacements carried out in Shree Birendra Hospital.

METHODS

We reviewed the records of total hip replacements, which were carried out in Shree Birendra Hospital, Kathmandu. Twenty-one hips were cemented and nineteen were uncemented. Cases were followed up in six weeks, twelve weeks, six months and every year from then on. Outcome in terms of Harris hip score of 40 osteoarthritic hips were measured pre-operatively as well as post-operatively.

RESULTS

The mean age of the patients was 50.63 years (range 22-79 years). The commonest reason for the replacement was primary osteoarthritis of the hip. Thirty-nine patients underwent unilateral total hip replacement while in one patient both hips were replaced. The mean Harris hip score for the forty hips that were available at the latest follow-up examination at an average of five years (range two to six and a half years) after the operation was 85.2 ± 7.65 points as compared to the pre-operative mean Harris hip score of 32.38 ± 3.4.

CONCLUSIONS

Based on improved Harris hip scores, we believe that THR is a good option in patients with end stage arthritis of the hip.

A comparison of risperidone and olanzapine in the acute treatment of persistent delusional disorder: Data from a retrospective chart review

Introduction

There is a lack of pharmacological trials studying drug response in Persistent Delusional Disorder (PDD) to guide clinical practice. Available reviews of retrospective data indicate good response to second-generation antipsychotics, but even such data from India is sparse.

Objectives and aims

We aimed to compare the response of acute PDD to risperidone and olanzapine in our retrospective review.

Methods

We conducted a retrospective chart review of patients diagnosed with PDD (ICD-10) from 2000 to 2014 (n = 455) at our Center. We selected the data of patients prescribed either olanzapine or risperidone for the purpose of this analysis. We extracted data about dose, drug compliance and response, adverse effects, number of follow-up visits and hospitalizations. The study was approved by the Institute Ethics Committee.

Results

A total of 280/455 (61%) were prescribed risperidone and 86/455 (19%) olanzapine. The remaining (n = 89; 20%) had received other antipsychotics. The two groups were comparable in socio-demographic and clinical characteristics of PDD. Compliance was good and comparable in both groups (> 80%, P = 0.2). Response to treatment was comparable in both groups (85% partial response and > 52% good response, all P > 0.3). Olanzapine was effective at lower mean chlorpromazine equivalents than risperidone (240 vs. 391, P < 0.05).

Conclusion

Our study indicates a good response to both risperidone and olanzapine, if compliance to treatment can be ensured. In the absence of specific treatment guidelines for PDD, second-generation antipsychotics like risperidone and olanzapine offer good treatment options for this infrequently encountered and difficult to treat psychiatric disorder.

Disclosure of interest

The authors have not supplied their declaration of competing interest.

Return to preinjury status after routine knee arthroscopy in military population

BACKGROUND

Knee arthroscopy is frequently advised procedure for knee-related problems in serving soldiers. The scanty published literatures have documented wide range of recovery duration ranging from nine days to four weeks even for routine uncomplicated arthroscopy. However, neither of these studies evaluated military population, where arthroscopic procedures are frequent and physical demands are different. The aim of this study was to ascertain the time required to return to unrestricted physical activities in serving military population.

METHODS

This was a prospective descriptive study enrolling 51 patients who underwent two portal arthroscopic procedures like diagnostic arthroscopy, meniscectomy, loose body removal and excision of plica or combination of these. A uniform home based physiotherapy protocol was used for everyone. All of them were followed up at 2nd, 4th, 6th, 8th and 12th postoperative weeks. At each follow up, 2000 International Knee Documentation Committee subjective knee evaluation form was filled and submitted for analysis.

RESULTS

Although all of our patients were able to walk around without any support at two weeks follow up, 88% had restriction to activities of daily living because of knee related problems. The mean International Knee Documentation Committee score was 41 at 1st follow up, which gradually improved to 64, 86, 94, 94 at 4th, 6th, 8th and 12th week follow up respectively. At 6 weeks 91% resumed their preinjury status which reached 94% in eight weeks.

CONCLUSIONS

Most of the soldiers return to unrestricted activities within six to eight weeks after diagnostic arthroscopy, meniscectomy, loose body removal and excision of plica or combination of these procedures.

Cephalometric evaluation of mandibular advancement at different horizontal jaw positions in obstructive sleep apnoea patients: a pilot study

BACKGROUND

The aim of this study was to comparatively evaluate the efficacy of the mandibular advancement device (MAD) at 50% (P2) and 75% (P3) of maximum mandibular advancement, relative to maximum intercuspation (P1) subjectively and objectively.

METHODS

Eighteen subjects previously diagnosed with obstructive sleep apnoea (OSA) were selected for the study. ESS score, VAS score, soft palate angle, MP-H distance, S-H distance, a C4 -H distance, a Pu -p Pu distance and total pharyngeal area were calculated at P1, P2 and P3 positions with the help of an adjustable MAD. The results were statistically analysed.

RESULTS

ESS score, VAS score, soft palate angle, MP-H distance, S-H distance and radius of curvature of airway at P2 and P3 were significantly lower compared to P1, but there was no significant difference between P2 and P3.

CONCLUSIONS

The MAD produced significant improvement in objective signs and subjective symptoms at both 50% and 75% of the maximum mandibular protrusion positions at comparable comfort levels. Therefore, MAD may be given at 50% of maximum advancement in order to reduce dental or temporomandibular joint disturbances.

Calcaneal Myxoid Chondrosarcoma: A Rare Case

Skeletal myxoid chondrosarcoma is an extraordinarily rare neoplasm with a distinct histological morphology. Although it grows slowly, the clinical course was found to be worse than usual chondrosarcoma. We report a case of a Skeletal myxoid chondrosarcoma in the calcaneus of a 21-year-old female who presented to us with a feature of gradually increasing benign swelling left foot for last two years. Initial investigations were indicating towards a benign lesion for which excision of the lesion was performed. But intra operative findings were suggestive of an aggressive lesion, and to our utter surprise histopathologically it turned out to be Myxoid Chondrosarcoma. Because of its high malignant nature below knee amputation was performed as second definitive surgery. Since her clinical course and radiological pictures were suggestive of benign lesion we got carried away with a diagnosis of chondrmyxoid fibroma and excision of the lesion was attempted without attempting histopathological diagnosis by less invasive methods. Keywords: caldaneal; chondrosarcoma; myxoid.

Reduction of Acute Anterior Shoulder Dislocation Using Intraarticular Lidocaine(IAL) and Stimson’s Technique

Introduction: Shoulder dislocation is common injury requiring urgent reduction. For the reason that patient is not nill orally and anesthetists are not available, reduction under intra venous anaesthesia is not possible. This study was aimed to evaluate the effectiveness of intraarticular lidocaine and stimson’s technique of shoulder dislocation, which could be performed without anesthetist and irrespective of nill orally status. Methods: A prospective observational study was performed from December 2009 to December 2010. Under all antiseptic precautions 20 ml of Lidocaine was injected intraarticularly and reduction was performed by Stimson’s technique. Visual Analogue Score, time for reduction and failure to reduction by this technique was recorded. Results: Out of 27 dislocations 22 were successfully reduced and remaining required added scapular manipulation. The mean VAS scor was 2.3±1.26 and the mean time of reduction was 17.96±1.9 minutes. Conclusion: Stimson’s method with Intraarticular Lidocaine is effective, safe, less costly and can be performed in periphery where anesthetist and monitoring facilities are not available. DOI: http://dx.doi.org/10.3126/mjsbh.v10i1.6406 Medical Journal of Shree Birendra Hospital Jan-June 2011 10(1) 6-8

Combined Spinal Epidural Anesthesia for Total Hip Replacement Surgery in Birendra Army Hospital

Introduction: Total Hip Replacement surgery is one of the most commonly performed surgeries worldwide. Epidural anaesthesia have shown decrease incidence of DVT in these patient. Hence, combined spinal epidural spinal anesthesia is now a preferred technique over spinal anesthesia alone. We have been practicing combined spinal epidural anesthesia routienely in total joint replacement, but have not analyzed the result. The aim of this study was to analyse various aspect of combined spinal epidura anesthesia. Methods: thirteen cases of ASA I and II who underwent Total Hip Arthroplasty under combined spinal epidural anesthesia were analysed. First epidural was given in space L2-3/L3-4 and patency was confirmed with test dose with InjXylocaine 2% with Adrenaline 3 ml, followed by Spinal anesthesia one space below with Bupivacaine 0.5% 3 ml. Results: Intra operative Mean Blood Pressure had dropped up to 55 mm of Hg.To maintain Blood pressure, Intravenous Fluid was given in average is 2423.077 ml and Vasopressure drug (Mephenteramine Maleate) was given in average of14.769 mg. Dura was accidentally puncture in one patient during epidural insertion and two epidural failed to provide post operative analgesia. Post operative rehabilitation was easy, one one patient developed DVT after 4 weeks of surgery. Conclusion: Combined epidural analgesia effectively manages postoperative pain, allows early ambulation and reduces the risk of deep vein thrombosis and thromboembolism, Although significant drop of Blood pressure was noted in all cases. DOI: http://dx.doi.org/10.3126/mjsbh.v10i1.6447 Medical Journal of Shree Birendra Hospital Jan-June 2011 10(1) 32-36

Calcaneal myxoid chondrosarcoma: a rare case

Skeletal myxoid chondrosarcoma is an extraordinarily rare neoplasm with a distinct histological morphology. Although it grows slowly, the clinical course was found to be worse than usual chondrosarcoma. We report a case of a skeletal myxoid chondrosarcoma in the calcaneus of a 21-year-old female who presented to us with a feature of gradually increasing benign swelling left foot for last two years. Initial investigations were indicating towards a benign lesion for which excision of the lesion was performed. But intra operative findings were suggestive of an aggressive lesion, and to our utter surprise histopathologically it turned out to be myxoid chondrosarcoma. Because of its high malignant nature below knee amputation was performed as second definitive surgery. Since her clinical course and radiological pictures were suggestive of benign lesion we got carried away with a diagnosis of chondromyxoid fibroma and excision of the lesion was attempted without attempting histopathological diagnosis by less invasive methods.

Comparative study on the effect of chemicals on Alternaria blight in Indian mustard--a multi-location study in India

High severity of Altemaria blight disease is a major constraint in production of rapeseed-mustard in India. The aim of this study was to investigate the suppressive potential of chemicals viz., zinc sulphate, borax, sulphur, potash and calcium sulphate, aqueous extracts viz., Eucalyptus globosus (50 g l-1) leaf extract and garlic (Allium sativum) bulb (20 g l-1) extract, cow urine and bio-agents Trichoderma harzianum, Pseudomonas fluorescence in comparison with the recommended chemical fungicide (mancozeb), against foliar disease Alternaria blight of Indian mustard [Brassica juncea (L.) Czern. and Coss] under five different geographical locations of India. Mancozeb recorded the lowest mean severity (leaf: 33.1%; pod: 26.3%) of Alternaria blight with efficacy of garlic bulb extract alone (leaf = 34.4%; pod = 27.3%) or in combination with cow urine (leaf = 34.2%; pod = 28.6%) being statistically at par with the recommended chemical fungicide. Chemicals also proved effective in reducing Alternaria blight severity on leaves and pods of Indian mustard (leaf = 36.3-37.9%; pod = 27.5-30.1%). The effective treatments besides providing significant reduction in disease severity also enabled increase in dry seed yield of the crop (mancozeb = 2052 kg ha-1; garlic = 2006 kg ha-1; control = 1561 kg ha-1).

Barriers to care for women with substance use

Introduction

Substance use among females showing an increasing trend in India. Though there is an increase in the rate of women approaching Deaddiction centre for treatment it is lower than the community prevalence of women with substance use.

Objectives

This study aims to look at the barriers preventing women from seeking treatment.

Aim

To assess the self reported barriers to seek treatment for women with substance users.

Methodology

A total of 50 substance using women were included among 52 visiting our de-addiction centre from Oct 09 till early part of Jan 10. All of them were self rated on barrier to care questionnaire specially prepared for the study.

Results

The mean age of the sample was 42.32 (SD 12.37). Majority of them were married, house wives studied up to primary. The most common substances used were Alcohol and tobacco (36%), followed by alcohol (26%) and tobacco (26%). The common perceived barriers to care are substance use has a solution to their problem (80%), disadvantage life circumstances (70%), lack of information on treatment options (64%), limited knowledge about treatment available (64%), shame/guilt of using the substance (64%) and limited knowledge about substance use problems (62%).

Conclusion

Findings highlights the areas that require attention for women with substance use. Handling these issues in a better way may increase the treatment seeking in women substance users.

Baclofen in cannabis dependence syndrome - a open-label study and a brief follow up

Aim

To study the effect of baclofen in preventing drug use in persons with cannabis misuse.

Methodology

An open label study to asses the effect of baclofen in treating persons with cannabis dependence (ICD-10 criteria) with assessments of outcome every month for a period of three months.

Results

20 male subjects (mean age of 29.70 ± 10.19 years) with a mean age at development of dependence of 20.75 ± 09.34 years and mean duration of cannabis use of 89.40 ± 57.41 months, were treated with baclofen (mean dose of 33.75 ± 04.83 mg./day). At three months 12 subjects (60%) completely stopped, 6 subjects (30%) decreased the frequency and 2 subjects (10%) continued the same frequency of the cannabis intake.

Conclusion

Our findings provide preliminary support for the use of baclofen in maintaining abstinence and improving outcome in patients with cannabis dependence.

Adamantinoma of tibial shaft

Adamantinoma is an extremely rare primary bony neoplasm. Because of its malignant nature, accurate and early diagnosis is very important. On the other hand adamantinoma mimics many benign conditions, so it is doubly important to establish correct tissue diagnosis to avoid radical surgery with morbidities. Because of its rarity, diagnosing adamantinoma still remains difficult, even if when it occurs in classical sites. We report a case of adamantinoma of tibial shaft diaphysis in a 23 year male. In this case, because of classic clinic-radiological features, we were suspecting adamantinoma from very beginning but final diagnosis was delayed for nine months.

Adamantinoma of Tibial Shaft

Abstract

Gluon-spin contribution to the proton spin from the double-helicity asymmetry in inclusive pi0 production in polarized p+p collisions at [sqrt]s=200 GeV

The double helicity asymmetry in neutral pion production for pT=1 to 12 GeV/c was measured with the PHENIX experiment to access the gluon-spin contribution, DeltaG, to the proton spin. Measured asymmetries are consistent with zero, and at a theory scale of micro2=4 GeV2 a next to leading order QCD analysis gives DeltaG[0.02,0.3]=0.2, with a constraint of -0.7<DeltaG[0.02,0.3]<0.5 at Deltachi2=9 (approximately 3sigma) for the sampled gluon momentum fraction (x) range, 0.02 to 0.3. The results are obtained using predictions for the measured asymmetries generated from four representative fits to polarized deep inelastic scattering data. We also consider the dependence of the DeltaG constraint on the choice of the theoretical scale, a dominant uncertainty in these predictions.

Neuronal classes in the corticoid complex of the telencephalon of the strawberry finch, Estrilda amandava

The present study, based on neurohistological techniques (Nissl-staining, Golgi-impregnation), focuses on the cytoarchitecture of the corticoid complex in the strawberry finch, Estrilda amandava. This complex in birds occupies the dorsolateral surface of the telencephalic pallium and remains subdivided into an intermediate corticoid area (CI) and a dorsolateral corticoid area (CDL). The CDL in the strawberry finch is a thin superficial part of the caudal pallium adjoining the medially situated hippocampal formation, whereas the CI is demarcated between the CDL and the parahippocampal area of telencephalon. Neurons of the corticoid complex are classified into three main cell groups: predominant projection neurons, local circuit neurons and stellate neurons. The spinous projection neurons send out distant projecting axons that typically extend several varicose collaterals. Most of these collaterals lie parallel to the ventricle. These neurons are subclassified into pyramidal neurons (localized only in the CI) and multipolar neurons (present in both the CI and CDL). The CDL also possesses small and medium-sized horizontal cells, which are bitufted or multipolar with smooth, moderately branching dendrites. The aspinous local circuit neurons extend short axons that ramify locally. Stellate neurons have sparse spinous dendrites and locally arborizing axons. The corticoid complex of birds corresponds to the lateral cerebral cortex of lizards and to the entorhinal cortex of mammals on the basis of neuronal morphology and bidirectional connections between adjacent areas.

Femoral neck stress fractures in military personnel

INTRODUCTION

Stress fractures are common during military training but femoral neck stress fractures are uncommon and sometimes pose diagnostic and therapeutic challenges. An incomplete stress fracture with excellent prognosis, if left unprotected, can lead to displaced femoral neck fracture with almost 63% complication rate even with best of the treatment. The aim of this study was to analyze various aspects of the femoral neck stress fracture so that early diagnosis can be made to prevent devastating complications like osteonecrosis and non-union.

METHODS

The four year army hospital record of 16 patients with femoral neck stress fracture were studied. Their demographic profile, type of fracture, presentation delay, on set of clinical symptoms and complication of femoral neck stress fracture were critically analyzed.

RESULTS

The mean age of the patient was 19.94 years. Total 74% of them developed first symptoms of stress fracture between four to seven weeks of training. There was 3.4 weeks delay from the clinical onset of symptoms to the diagnosis of stress fracture. The type of femoral neck stress fracture were compression (31.25%), tension (18.75%) and displaced (50%). Out of eight displaced type of fractures, 5 (62.5%) had developed complications (3 osteonecrosis and 2 nonunion).

CONCLUSIONS

Femoral neck stress fracture occurs in initial four to seven weeks of training. The high index of suspicion in initial period of training can help to detect and decreases significant morbidity.

Femoral Neck Stress Fractures in Military Personnel

Introduction: Stress fractures are common during military training but femoral neck stress fractures are uncommon and sometimes pose diagnostic and therapeutic challenges. An incomplete stress fracture with excellent prognosis, if left unprotected, can lead to displaced femoral neck fracture with almost 63% complication rate even with best of the treatment. The aim of this study was to analyze various aspects of the femoral neck stress fracture so that early diagnosis can be made to prevent devastating complications like osteonecrosis and non-union. Methods: The four year army hospital record of 16 patients with femoral neck stress fracture were studied. Their demographic profi le, type of fracture, presentation delay, on set of clinical symptoms and complication of femoral neck stress fracture were critically analyzed. Results: The mean age of the patient was 19.94 years. Total 74% of them developed fi rst symptoms of stress fracture between four to seven weeks of training. There was 3.4 weeks delay from the clinical onset of symptoms to the diagnosis of stress fracture. The type of femoral neck stress fracture were compression (31.25%), tension (18.75%) and displaced (50%). Out of eight displaced type of fractures, 5 (62.5%) had developed complications (3 osteonecrosis and 2 nonunion).Conclusions: Femoral neck stress fracture occurs in initial four to seven weeks of training. The high index of suspicion in initial period of training can help to detect and decreases significant morbidity.Key Words: displaced stress fractures, non-union, osteonecrosis, recruits

Cyto-architecture and neuronal types of the dorsomedial cerebral cortex of the common Indian wall lizard, Hemidactylus flaviviridis

The cyto-architecture and morphology of the neuronal types of the dorsomedial cortex of the lizard, Hemidactylus flaviviridis has been studied with the help of Cresyl violet staining and Golgi impregnation method. The dorsomedial cerebral cortex displayed three neuronal layers. Layer-I contains only few neuronal somas and also the dendrites ascending from the subjacent layers. Layer-II is characterized by two to three cell thick densely packed neuronal somas. Layer-III contains loosely packed neuronal somas and the dendrites and axon descending from layer-I and II. Below the layer-III an ependymal layer is observed just above the ventricle. Six classes of neurons were distinguished in the cellular layer of dorsomedial cortex of Hemidactylus flaviviridis: bitufted neurons, pyramidal neurons, inverted pyramidal neurons, bipyramidal neurons, multipolar neurons, and candelabra-like monotufted neurons. The pyramidal cells were large showing more or less single type present in the cellular layer. The multipolar neurons have mostly intracortical dendritic branching and connections. Bipyramidal neurons showed pyramidal appearance of their soma and send dendritic branches towards the superficial plexiform layer and deep plexiform layer. The candelabra-like monotufted neurons have very high dendritic branching. The comparison of the neuronal types of dorsomedial cortex of reptiles with the parahippocampal area of birds and CA3 region of mammalian hippocampus suggests possibility of their homology.

Tolosa-Hunt syndrome: MRI appearances

A review of MRI findings in seven patients with Tolosa-Hunt syndrome was carried out. Seven patients presented with unilateral painful ophthalmoplegia. Magnetic resonance imaging studies were carried out to evaluate the cavernous sinuses and orbits. Coronal fast spin-echo T2-weighted images and fat-saturated T1-weighted coronal and transverse images with and without contrast enhancement were obtained for the cavernous sinuses and orbits. All patients showed focal-enhancing masses expanding the ipsilateral cavernous sinus. In one patient the mass was extending to the orbital apex and intraorbitally. All patients recovered on corticosteroid therapy and resolution of the masses was documented on follow-up MRI studies in five patients. One patient had a relapse of symptoms after discontinuing therapy. Magnetic resonance imaging studies of the cavernous sinus and orbital apex show high sensitivity for the detection and follow up of inflammatory mass lesions in Tolosa-Hunt syndrome. Magnetic resonance imaging should be the initial screening study in these patients.

Intestinal myiasis caused by Muscina stabulans

Intestinal maggots were isolated from a patient, who had reported to the Department of General Medicine of Sri Manakula Vinayagar Medical College, Puducherry, in southern India with complaints of abdominal distress, bloating of abdomen and intestinal hurry following a meal. He was diagnosed as a case of intestinal myiasis. Maggots obtained from his stool were identified to be Muscina stabulans based on characteristic patterns of posterior spiracles. He was treated with purgatives and albendazole. This intestinal myiasis case caused by M. stabulans is reported here because of its rare occurrence and the need to establish a correct diagnosis.

System size and energy dependence of jet-induced hadron pair correlation shapes in Cu+Cu and Au+Au collisions at square root sNN=200 and 62.4 GeV

We present azimuthal angle correlations of intermediate transverse momentum (1-4 GeV/c) hadrons from dijets in Cu+Cu and Au+Au collisions at square root sNN=62.4 and 200 GeV. The away-side dijet induced azimuthal correlation is broadened, non-Gaussian, and peaked away from Delta phi=pi in central and semicentral collisions in all the systems. The broadening and peak location are found to depend upon the number of participants in the collision, but not on the collision energy or beam nuclei. These results are consistent with sound or shock wave models, but pose challenges to Cherenkov gluon radiation models.

Cytoarchitectonic organization and morphology of the cells of hippocampal complex in strawberry finch, Estrilda amandava

Neurons in the hippocampal complex (dorsomedial forebrain) were described and located following Golgi impregnation. Five fields were recognized in the hippocampal complex: medial and lateral hippocampus, parahippocampal area, central field of the parahippocampal area and crescent field. In the medial hippocampus three layers have been observed: suprapyramidal towards the pial surface, pyramidal at the central and infrapyramidal adjacent to the ventricle. Neurons of the hippocampal complex were classified in to two main cell groups: predominant projection neurons with spinous dendrites and local circuit neurons. Projection neurons were further sub classified into three main types: pyramidal, pyramidal like, and multipolar neurons. In addition to these neurons, monotufted and bitufted neurons were also observed in the medial and lateral hippocampus with low frequency. The pyramidal neurons were dominant neuronal types in the pyramidal layer-II of the medial hippocampus, mixed with pyramidal like and multipolar neurons. Pyramidal and pyramidal-like neurons were found restricted in the pyramidal layer II of the medial hippocampus while the multipolar neurons were uniformly distributed in all subfields of the hippocampal complex. In the lateral hippocampus irregular shaped radial glial cells were present near the ventricular wall and projecting their dendrites towards the pia. Second group of local circuit neurons with local arborization of their projections were present in the medial hippocampus and in parahippocampal area.

Evidence for a long-range component in the pion emission source in Au+Au collisions at sqrt sNN=200 GeV

Emission source functions are extracted from correlation functions constructed from charged pions produced at midrapidity in Au+Au collisions at sqrt[s(NN)]=200 GeV. The source parameters extracted from these functions at low k(T) give first indications of a long tail for the pion emission source. The source extension cannot be explained solely by simple kinematic considerations. The possible role of a halo of secondary pions from resonance emissions is explored.

Discovery of highly potent small molecule kallikrein inhibitors

Uncontrolled kallikrein activation is involved in diseases such as hereditary angioedema, bacterial septic shock and procedures such as cardiopulmonary bypass. Here we report a series of small molecule compounds that potently inhibit kallikrein activity in vitro. Kinetic studies indicate that some of these compounds are slow binding inhibitors of kallikrein with Ki final less than a nanomolar. The ability of these compounds to inhibit the activity of kallikrein was further confirmed in a plasma model by quantitating the release of bradykinin, an endogenous cleavage product of plasma kallikrein. To understand the inhibitory mechanism of the selected compounds toward kallikrein, the interactions between the selected compounds and kallikrein was explored using molecular modeling based on the information of crystal structures of TF/FVIIa and kallikrein. The information presented in the current study provides an initial approach to develop more selective and therapeutically useful small molecule inhibitors.

Measurement of direct photon production in p+p collisions at sqrt[s] = 200 GeV

Cross sections for midrapidity production of direct photons in p+p collisions at the Relativistic Heavy Ion Collider (RHIC) are reported for transverse momenta of 3 < pT < 16 GeV/c. Next-to-leading order perturbative QCD (pQCD) describes the data well for pT >5 GeV/c, where the uncertainties of the measurement and theory are comparable. We also report on the effect of requiring the photons to be isolated from parton jet energy. The observed fraction of isolated photons is well described by pQCD for pT >7 GeV/c.

Effects of caffeine on levodopa pharmacokinetics and pharmacodynamics in Parkinson disease

The authors studied the acute effect of caffeine on the levodopa pharmacokinetics and pharmacodynamics in 12 patients with idiopathic Parkinson disease. This double-blind, randomized, crossover study revealed that caffeine shortened the maximal plasma concentration of levodopa, decreased the latency to levodopa walking and tapping motor response, and increased the magnitude of walking response. Caffeine administered before levodopa may improve its pharmacokinetics in some parkinsonian patients.

Dense-medium modifications to jet-induced hadron pair distributions in Au+Au collisions at sqrt s NN=200 GeV

Azimuthal correlations of jet-induced high-p(T) charged hadron pairs are studied at midrapidity in Au+Au collisions at sqrt[s(NN)]=200 GeV. The distribution of jet-associated partner hadrons (1.0<p(T)<2.5 GeV/c) per trigger hadron (2.5<p(T)<4.0 GeV/c) is found to vary with collision centrality, in both shape and yield, indicating a significant effect of the nuclear collision medium on the jet fragmentation process.

Azimuthal angle correlations for rapidity separated Hadron pairs in d+Au collisions at square root of sNN=200 GeV

Deuteron-gold (d+Au) collisions at the Relativistic Heavy Ion Collider provide ideal platforms for testing QCD theories in dense nuclear matter at high energy. In particular, models suggesting strong saturation effects for partons carrying small nucleon momentum fraction (x) predict modifications to jet production at forward rapidity (deuteron-going direction) in d+Au collisions. We report on two-particle azimuthal angle correlations between charged hadrons at forward/backward (deuteron/gold going direction) rapidity and charged hadrons at midrapidity in d+Au and p+p collisions at square root of sNN=200 GeV. Jet structures observed in the correlations are quantified in terms of the conditional yield and angular width of away-side partners. The kinematic region studied here samples partons in the gold nucleus with x~0.1 to ~0.01. Within this range, we find no x dependence of the jet structure in d+Au collisions.

A novel locus for hereditary spastic paraplegia with thin corpus callosum and epilepsy

BACKGROUND

Hereditary spastic paraplegia (HSP) are classified clinically as pure when progressive spasticity occurs in isolation or complicated when other neurologic abnormalities are present. At least 22 genetic loci have been linked to HSP, 8 of which are autosomal recessive (ARHSP). HSP complicated with the presence of thin corpus callosum (HSP-TCC) is a common subtype of HSP. One genetic locus has been identified on chromosome 15q13-q15 (SPG11) for HSP-TCC, but some HSP-TCC families have not been linked to this locus.

METHODS

The authors characterized two families clinically and radiologically and performed a genome-wide scan and linkage analysis.

RESULTS

The two families had complicated ARHSP. The affected individuals in Family A had thin corpus callosum and mental retardation, whereas in Family B two of three affected individuals had epilepsy. In both families linkage analysis identified a locus on chromosome 8 between markers D8S1820 and D8S532 with the highest combined lod score of 7.077 at marker D8S505. This 9 cM interval located on 8p12-p11.21 represents a new locus for ARHSP-TCC. Neuregulin and KIF13B genes, located within this interval, are interesting functional candidate genes for this HSP form.

CONCLUSION

Two consanguineous families with complicated autosomal recessive hereditary spastic paraplegia were clinically characterized and genetically mapped to a new locus on 8p12-p11.21.

Stress Fracture in Female Officer Cadet Trainees

Stress Fracture in Female Officer Cadet Trainees