Gastrointestinal parasites are common in pet animals, despite the existence of therapeutic and prophylactic measures. Protozoa and helminths are of great importance for Unique Health, mainly due to their zoonotic potential. In this study, we investigated the occurrence of the main gastrointestinal parasites in domestic dog puppies in the city of Araçatuba, São Paulo. Thus, 100 fecal samples were collected from dogs up to six months of age. The samples were processed using Willis and Faust’s coproparasitological techniques and negative malachite green staining. The statistical analysis consisted of descriptive analysis. In addition, a general assessment of positivity between the techniques was carried out, in which if the animal was positive in a test it was considered positive in this criterion, due to each test being specific to a type of gastrointestinal parasite. With the results obtained it was possible to observe that animals that have age range less than or equal to six months of age had a higher occurrence for Toxocara spp. Eggs, and in some of theses animals it was possible to observe feces with normal consistency. The positivity for the parasites, by at least one of the techniques mentioned above, was: Toxocara spp. (34%); Isospora spp. (28%); Ancylostoma spp. (22%); and, Giardia spp. (8%). Thus, we concluded for the first time the occurrence of gastrointestinal parasites in domestic dog puppies less than six months of age, with detection of helminths and protozoa with zoonotic potential, being Toxocara spp. most prevalent. Finally, in our study, we diagnosed asymptomatic parasitized dogs, which may represent a risk in terms of Unique Health. Keywords: Helminths, Protozoa, Unique Health, Dogs, Diagnosis

The erosion mechanism on steep grass slopes is the basis and difficulty of grassland erosion model, but few related studies.The erosion mechanism on steep slopes covered by grass was studied by artificial rainfall experiments. Results showed the following: (1) The contributions of the Rω(reduction of stream power) and RK(reduction of soil erodibility) to the decreasing erosion modulus (REM) are 61.02% and 33.55%, respectively, totalling to 94.57%. This finding indicates that herbaceous vegetation decreases the interrill erosion mainly by decreasing the stream power.(2) The relationship between the Rω and grass cover, and phytyl cover can be described with logarithmic equations.The calculation under different rainfall intensities or slopes showed contribution rates of 82.86%-97.51% or 86.36%-97.51%, and 1.48%-14.82% or 1.48%-20.44%. (3) The relationship between the RK androot volume (RV), and soil bulk density (SD) can be described with binary logarithmic equations.The calculation showed contribution rates of 73.61%-97.94, and 0.04%-0.22%. (4) In-depth analysis found the regulation effect of grass on stream power is mainly achieved by grass cover, and the regulation effect of grass on soil erodibility is mainly achieved by root volume. The research focus should be on the impact of vegetation layout, vegetation types, vegetation density, and soil properties on soil erosion under large-scale conditions.

COVID-19 is a new pandemic caused by SARS-CoV-2 which has created a havoc worldwide. Within no time it prevailed throughout the world compelling all countries to take emergency measures to overcome the pandemic. To overcome the disease, there is still no vaccine developed, however, different drugs are under trial. So, the only strategy to overcome the deadly virus is to avoid each and every way of contact with the already infected patients. For the assurance of avoidance policy, different countries took different measures according to their circumstances. Developing countries are much more infected than the developed ones as they already lack in fulfilling many basic necessities of life including economy. Pakistan is one of those developing countries whose economy is badly hit by following the model strategies of developed countries. So, Pakistan introduced different strategies like smart lock down, tiger force, etc. Pakistan has faced the worst peak of pandemic latter than most of the countries, so, to walk with the world in all aspects, Government should put its best efforts in the health zone to overcome COVID-19 as soon as possible.

Abstract Journal clubs are a valued source of teaching for medical professionals. We launched a novel podcast delivered journal club utilising commonly used social media applications to drive asynchronous discussion around key topics. This design uses commonly accessible freeware and can be customised to suit the cohort of participants. We demonstrate changes of practice achieved through the journal club discussion, a sustained response of contributors, links to external papers and links to external media to augment the discussion. We are hoping to launch this intervention at our sister sites and assess over a longer time frame to demonstrate sustainability and validity of this teaching intervention.

Prior to March 2020, publications involving COVID-19 and nutrition were scarce. After six months of spreading of the infection, clinical trials involving nutritional therapy are still scarce; however consensuses built on the experiences of specialists are relevant for the development of guidelines. Thus, the main objective of this publication is to present the knowledge, to this date, that underlies nutritional therapy in hospital care for COVID-19 in-patients. As a final consideration, it should be pointed out the consensus that has been built from the experience of specialists that all precautions must be taken for the safety of the team and the inpatients, whether in the clinic or in the intensive care units and that in the current absence of specific recommendations, generic protocols be adopted; also nutritional care of these patients should be given priority as an important condition for the positive outcome of each case. Another recommendation in order to generate evidence so that more specific protocols be adopted, is the careful recording of the procedures used and that research protocols be established as well as multicenter studies in order to accelerate investigations, which results can be promptly applied in clinical practice.

Objectives This study aimed to define the clinical features of anosmia, a symptom observed in patients with coronavirus disease 2019 (COVID-19). Methods The presence of olfactory symptoms, such as loss of smell, in COVID-19 patients and their relationship with the disease process were evaluated. Results A total of 217 patients with COVID-19 were evaluated, of which 135 patients were interviewed via phone calls. The patients were divided into four subgroups: group 1 had only olfactory complaints (isolated, sudden-onset loss of smell); group 2 had isolated, sudden-onset loss of smell, followed by typical COVID-19 complaints; group 3 initially had typical COVID-19 complaints, but gradually developed olfactory complaints; and group 4 had no olfactory complaints. In total, 59.3% of the patients had olfactory complaints. In groups 1–3, the odor scores after the disease were significantly lower than those before the disease; this decrease was more evident in groups 1 and 2 than in group 3 (p = 0.003, p = 0.000, and p = 0.014, respectively). Groups 1 and 2 had a greater loss of smell than group 3 (7.8 ± 2.1 in groups 1 and 2 vs. 6.2 ± 2.6 in group 3; p = 0.01). The odor scores completely returned to the pre-disease values in 51.2% of patients with olfactory dysfunction (41 patients); the mean duration of loss of smell was 7.1 ± 2.4 days. Conclusion Timely detection of anosmia is important in patients with COVID-19 in order to help control the spread of this highly contagious disease.

Wind erosion process is natural process but might be substantially accelerated by adverse human activities. Wind erosion in the arid and semiarid zones, in particular, it may have dramatic impact on the current and potential productive capacity of the lands. The main goal of this paper is to present review of research on wind erosion which is prevalent in Sudan, besides displaying studies and research that must be carried out to fill the gaps in wind erosion research. Due to limited financial resources for anti-desertification research, there is a real gap in combating desertification research generally and wind erosion especially such as: stabilizing soil particles by various natural or synthetic cementing and flocculating materials that increase the non- erodiable soil particles on the soil surface, maintaining sufficient vegetative cover and establishing barriers or shelter belts barriers to reduce effective field length traveled by the wind. Lack of studies for measures sand encroaching into the Nile, winds data analysis beside calculation of wind erosivity, losses of nutrients and organic matter particularly that caused by wind erosion. Still there is urgent need to conduct researches on design and implementation of shelter belts and specify type of trees, number of rows, density and distance. Moreover intensity wind erosion research conducted in a part of affected states. It is time to fill the gap in studies and research and covers the all types of desertification processes integrated with sustainable development program, poverty alleviation and national action programmer for combating desertification.

A document by Maliha Nishat. Click on the document to view its contents.

Objective: To investigate the clinical significance of dynamically monitoring serum estradiol (E2) and β-human chorionic gonadotropin (β-HCG) in early pregnancy assessment and their values in predicting pregnancy outcomes.. Methods: In this retrospective study, two hundred early pregnancy women were divided into two groups according to their early pregnancy outcomes: the ongoing pregnancy group and inevitable abortion group. Serum E2 and β-HCG levels and their growth rates were compared weekly. Results: E2 and β-HCG of the ongoing pregnancy group were significantly higher than that of the inevitable abortion group from the 5th to 10th week of pregnancy. Taking 489.5 pg/ml in the 5th and 6th week, 590.5 pg/ml in the 7th week and 614.5 pg/ml in the 8th week as cut-off levels of E2, the sensitivity and specificity for E2 to predict bad pregnancy outcome were 91.7% and 41.5%, 82.9% and 71.1%, 84.8% and 84.7%, 75.0% and 95.7%, respectively (P< 0.05). Both E2 and β-HCG increased much more rapidly in the ongoing pregnancy group. 80% of the normal pregnancy women showed continuously increasing E2 level. Meanwhile, the inevitable abortion group presented E2 variation types as slow increase or fluctuation, continuous decline, and sudden drop, which account for 54.0%, 34.0%, and 12.0%, respectively. Conclusion: Low values and low growth rates of E2 and β-HCG probably indicate bad pregnancy outcomes.

In the present study, polyacrylonitrile (PAN)-co-polymer nanofibers as well as PAN-co-polymer nanofibers reinforced with functionalized single - walled carbon nanotubes (F-SWCNTs) were produced by electrospinning and stabilized. The samples were evaluated using DSC, FTIR, SEM and XRD. In the sample containing F-SWCNT the amount of heat released during the stabilization reactions was lower than that of pure PAN nanofibers. This indicates that the F-SWCNT prevents the sudden release of heat and damage to the nanofibers during stabilization. The carbon nanotubes greatly prevent the reduction of the diameter of the nanofibers as well as the decrease in the size of the crystals and the decrease of the arrangement of the nanofibers during stabilization.

Coronaviruses are a group of enveloped viruses with non-segmented, single-stranded, and positive-sense RNA genomes. Human coronavirus infection causes respiratory diseases with mild to severe outcomes. In December 2019, a new outbreak of the novel coronavirus disease 2019 (COVID-19) emerged in Wuhan, China and spread around the world. Genomic analysis revealed that severe acute respiratory syndrome coronavirus (SARS-CoV-2) is phylogenetically related to SARS-like bat viruses. The intermediate source of origin of SARS-CoV-2 and its transfer to humans is not known; however, it acquired efficient human-to-human transmissibility while retaining human pathogenicity. Spike protein of SARS-CoV-2 has the potential furin-like cleavage site may play a significant role in virus entry. Receptor binding domain (RBD) of SARS-CoV-2 attaches with angiotensin-converting enzyme -2 (ACE2) of epithelial cells. The SARS-CoV-2 genome encodes four major structural proteins: the spike (S) protein, nucleocapsid (N) protein, membrane (M) protein, and the envelope (E) protein are involved in assembly, budding, envelope formation, and pathogenesis. Notably, E protein act as viroporin and there is no mutation found on E protein among SARS-CoV-2 strains. At present, the case fatality rate is estimated to range from 6 to 7%. COVID-19 is now a public health emergency of international concern. There is no clinically approved antiviral drug or vaccine available against COVID-19. This review summarized the latest information on the structural and molecular biology infectivity, host immune response and molecular immunopathology of the SARS-CoV-2.

Ellagic acid (2,3,7,8-tetrahydroxy-chromeno[5,4,3-cde]chromene-5,10-dione) is a polyphenol found in several fruits. We think that it can be effective in the treatment of COVID-19 .

A 57-year old woman with Alzheimer’s disease developed liver injury 4 days after starting GV-971 therapy. This woman had no history of drug allergy before her AD diagnosis. After started her GV-971 medication (150 mg bid) while taking donepezil and memantine hydrochloride, she presented with jaundice of the skin and sclera, loss of appetite and fatigue. Laboratory examination suggested that liver function was abnormal with serum levels of alanine transaminase (ALT) (737 U/L), aspartate transaminase (1006 U/L). And Magnetic Resonance Imaging (MRI) showed the interstitial edema of the portal vein and the thickened gallbladder wall, which suggested the possibility of active liver disease or liver injury. Our report showed that GV-971 may lead to liver injury and we suggest that clinicians should monitor liver functions when using GV-971 in AD patients.

COVID-19 patients in China exhibit a proinflammatory environment that is stronger in severe cases requiring intensive care. The immunity modulators, the aryl hydrocarbon receptor (AhR) and the nuclear NAD+-consuming enzyme poly (ADP-ribose) polymerase 1 (PARP 1) may play a critical role in COVID-19 pathophysiology. The AhR is over-expressed in a variety of coronaviruses, including COVID-19 and, as it regulates PARP gene expression, the latter is likely to be activated in COVID-19. PARP expression is enhanced in other lung conditions: the pneumovirus respiratory syncytial virus (RSV) and chronic obstructive pulmonary disease (COPD). I propose that PARP 1 activation, which leads to cell death mainly by depleting NAD+ and ATP, is the terminal point in a sequence of events culminating in patient mortality and should be the focus of COVID-19 immunotherapy. Potent PARP 1 inhibitors are undergoing trials in cancer, but a readily available inhibitor, nicotinamide, which possesses a highly desirable biochemical and activity profile, merits exploration. It conserves NAD+ and prevents ATP depletion by PARP inhibition, enhances NAD+ synthesis, and hence that of NADP+ which is a stronger PARP inhibitor, reverses lung injury caused by ischaemia/reperfusion, inhibits proinflammatory cytokines, and is effective against HIV infection. Its unique biochemical properties qualify nicotinamide for therapeutic use initially in conjunction with standard clinical care or combined with other agents, and subsequently as an adjunct to stronger PARP 1 inhibitors.

The Revivent TC™ TransCatheter Ventricular Enhancement System (BioVentrix Inc, San Ramon, CA, USA) is intended for use in heart failure with cardiac dysfunction a previous myocardial infarction. The resultant increased left ventricular systolic volume and discrete, contiguous, non-contractile (akinetic and/or dyskinetic) scar located in the antero-septal, apical (may extend laterally) region of the left ventricle (LV) lends itself to Revivent. The procedure, called Less Invasive Ventricular Enhancement (LIVE), consists of the implantation of a series of micro-anchors pairs in order to exclude the scarred myocardium, in order to reduce and reshape the LV. We present the procedure step-by-step, as team coordination between the cardiac surgeon and the interventional cardiologist is essential to ensure good procedural outcomes. This is a novel and new technique to address Heart Failure secondary to Myocardial Infarction.

Background: Multi-agent chemotherapy is the primary treatment for acute lymphoblastic leukemia (ALL), of which the asparaginase including Escherichia coli L-asparaginase (E. coli L-Asp) and Pegylated-asparaginase (PEG-Asp) is a cornerstone component. The study aimed to conduct a meta-analysis to compare the efficacy and safety of PEG-Asp with E. coli L-Asp in Chinese children with ALL. Methods: A systematic literature search was conducted to collect randomized controlled trials (RCTs) on PEG-Asp versus E. coli L-Asp in Chinese children with ALL. Two reviewers independently selected articles and extracted data. Risk-of-bias assessment used the Cochrane recommendation tool. Pooled estimates and risk ratios with 95% confidence intervals (CIs) for all outcomes in Review Manager 5.3. Results: 15 studies of a total of 470 publications were included, involving 1 194 patients. Pooled estimates showed that there were no significant differences in CR, ORR, gastrointestinal symptoms, and coagulation abnormalities rate between the PEG-Asp and E. coli L-Asp group (all P>0.05). Hypersensitivity (RR=0.63; 95%CI 0.40-1.01; Ρ=0.05) and hepatic injury rate (RR=0.45; 95%CI 0.27-0.75; Ρ=0.002) were lower in the PEG-Asp group. The frequency of administration and length of hospital stay of patients in the PEG-Asp group was less than that in the E. coli L-Asp group (both Ρ<0.0001). Conclusions: Current evidence pointed out a similarity efficacy in the two groups. While the PEG-Asp group had a lower hypersensitivity and hepatic injury rate. Besides, using PEG-Asp decreased the frequency of administration and the length of hospital stay, which, to some extent, might reduce patients’ burden caused by medical resources consumption.

Background The clinical features and surgical outcomes of patients with Kaposiform hemangioendothelioma (KHE) is not fully clear. The purpose of this study is to better understand the therapeutic effect and hematological indices of surgical therapy for KHE. Procedure A retrospective study was conducted to review the medical documents of 43 patients with KHE who were treated with surgical resection at our hospital between February 2016 and November 2019. Multiple anatomical sites were involved. The curative effect was evaluated according to the tumor volume shrinkage, color shade, and blood examinations including platelet count, hemoglobin level, red blood cell number, clotting time and D-dimer concentration. Results For all cases underwent surgical treatment, the curative effects accounted for 100%. At the end of the treatment, 9 children were followed up for 6 months, and no evidence of the recurrence of KHE was not found in any case. The number of red blood cells and clotting time were maintained at normal levels during different stage of treatment. The concentrations of hemoglobin and fibrinogen and the average number of platelets increased significantly after surgical treatment. The concentrations of D-dimer were much higher than normal value during admission with a high variability, and significantly decreased after surgery treatment. Further analysis found that the changing trends of D-dimer was positively correlated with fibrinogen protein or platelet number, but not clotting time. Conclusions The surgical treatment method is highly effective and of great significance for KHE therapy in pediatric clinic.

Scavenging can have important consequences for food web dynamics, for example, it may support additional consumer species and affect predation on live prey. Still, few food web models include scavenging. We develop a dynamic model that includes predators, scavengers, live prey, and a carrion pool to show ramifications of scavenging for predation in simple food webs. We explicitly model carrion biomass and scavenging behavior and investigate the effect of scavenging for predation under different assumptions. Our modeling suggests that the presence of scavengers can both increase and decrease predator kill rates and overall predation in model food webs and the impact varies (in magnitude and direction) with context. In particular, we explore the impact of the amount of dynamics allowed in the predator, scavenger, and prey populations as well as the direction and magnitude of interference competition between predators and scavengers. We provide a road map to the different outcomes and link these theoretical outcomes to evidence from different empirical studies.

Donor-derived CD19-directed chimeric antigen receptor-modified T (CAR-T) cell therapy seems be effective and safe for relapsed B-ALL after allogeneic haematopoietic stem cell transplantation (allo-HSCT). We report two cases of children who received Donor-derived CAR-T cell therapy. After transfusion, the children experienced different degrees of chronic graft-versus-host disease (cGVHD). Early intervention included strengthening immunosuppressant, FAM regimen, tyrosine kinase inhibitor, and auxiliary cell therapy. Their dyspnoea and lung function were significantly improved and recovered. They did not receive the second transplant. Timely and effective intervention is crucial to improve both prognosis and quality of life.

To the Editor: The coronavirus disease 2019 (COVID-19) pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARC-CoV-2) has led to an imminent need for an effective vaccination to constrain viral spread and reduce global disease morbidity and mortality. BCG, a live attenuated vaccine against tuberculosis, was demonstrated to have a non-specific immunomodulatory effects, by training the innate immune system to generate memory, which aided the host in fighting a wide range of viral infections in subsequent years.1 BCG was reported to reduce viremia, respiratory tract infections, and neonatal mortality,1 but it was not tested effectively in a recent, large randomized trial.2 Several ecological studies reported that BCG vaccinations could have a beneficial effects against COVID-19;3-5 they also suggested that different BCG strains might vary in their protective ability.6 In contrast, one study in Israel found no difference in the SARS-CoV-2-positive rate between individuals born during the period of mandatory BCG vaccinations and those born outside that period.7 All these studies analyzed aggregated data at the population level without directly comparing individuals that did to those that did not receive BCG vaccinations. Meanwhile, even if BCG vaccination is found to be effective in reducing COVID-19 incidence and mortality, it remains unclear whether the protective effect might change with time (age) or different BCG strains, or whether protection might be increased with a booster. In this study, we described the clinical syndrome in confirmed COVID-19 cases and their BCG vaccination history. We aimed to elucidate the potential protective association between a neonatal BCG vaccination and the clinical severity of COVID-19.In the 1950s, the BCG vaccination policy in Taiwan mainly targeted school children with negative tuberculin skin test (TST) results. In 1965, a nationwide neonatal BCG vaccination program was started. Initially, neonates were vaccinated with the Pasteur-1173 P2 strain, but in 1979, vaccinations shifted to the less reactogenic, Tokyo-172 strain. In 1965–1997, booster BCG vaccinations were given to 12 year-old adolescents with negative TSTs. The BCG vaccine coverage rate increased to 87% in 1975,8 and it has remained at 95.7%–98.8% since 1996.For the present study, records of BCG vaccinations in COVID-19 cases were obtained from the web-based National Immunization Information System (NIIS), established by the Taiwan Centers for Disease Control (Taiwan CDC) in 2013. Eletronic vaccine records were compiled for individuals born as early as the 1980s. However, individual BCG vaccination records were unavailable in NIIS for individuals born in 1965-1985, and some were incomplete for those born in 1986-1995. The Taiwan CDC surveyed the NIIS database and found that the completeness of public-funded childhood immunization electronic records was above 90% for individuals born after 1996.Through the National Notifiable Disease Surveillance System in Taiwan, COVID-19 was confirmed in 416 Taiwanese patients (median age: 36.3 years; mean: 40.2 years, range: 4-88 years; with 212 [51.0%] females) between Jan 21 and May 5, 2020. The diagnoses were based on positive SARC-CoV-2 RNA identification in real-time reverse transcriptase-polymerase chain reactions (RT-PCRs). Among the 416 patients with COVID-19, 366 (88.0%) had imported the disease from other regions. These patients reported travel to the following regions within 14 days of disease onset: 184 (50.3%) to European regions, 91 (24.9%) to American regions, 26 (7.1%) to Western Pacific regions, 11 (3.0%) to Eastern Mediterranean regions, 9 (2.5%) to South-East Asia regions, 4 (1.1%) to African regions, and 41 (11.2%) to at least two of the regions mentioned.The highest rate of COVID-19 cases occurred among individuals aged 18–24 years (56.3 per million), followed by individuals aged 25–33 years (38.1 per million), and individuals aged 34–41 (14.4 per million). According to the clinical syndrome associated with COVID-19, defined by the World Health Organization,9 the clinical severity of these COVID-19 cases varied by age (Table 1 ). Approximately 80% of individuals aged 18–41 years with COVID-19 experienced a mild illness (including asymptomatic infections). In contrast, among individuals aged 42–54 and ≥ 55 years, 43.1% and 38.9%, respectively, had a mild illness, up to 2% and 16%, respectively, had severe pneumonia, and 10% in both age groups had acute respiratory syndrome. Among 9 children (<18 years) with COVID-19, three had pneumonia.We examined the relationship between COVID-19 severity and BCG vaccination status among individuals aged 4–24 and individuals aged 25–33 years with electronic vaccination records (Table 2 ). In the 4–24 age group, among individuals that received neonatal BCG vaccinations, 15.4% had pneumonia and 2.4% had severe pneumonia. In contrast, all three individuals in this age group that did not receive neonatal BCG vaccinations experienced mild illness. In the 25–33 age group, pneumonia or severe pneumonia occurred in a lower proportion of those with neonatal BCG vaccination records, compared to the group without neonatal BCG vaccination records (6.1% vs. 18.4%). However, these data should be interpreted cautiously, because the numbers of cases in the vaccinated and unvaccinated groups were small, some vaccination records in childhood were incomplete, and host genetic factors and SARS-CoV-2 virulence factors might have had a substantial influence on the COVID‑19 outcome. In conclusion, our data suggested that, compared to individuals that did not have BCG vaccination records at birth, young adults aged 25-33 years that received the Tokyo-172 BCG vaccination at birth appeared to experience lower COVID-19 severity. However, this finding must be confirmed in future randomized controlled trials.

Paravalvular Leaks are well-recognized complications after artificial valve replacement and sometimes can be fatal. Symptomatic periprosthetic leaks are closely associated with increased mobility and mortality. Herein, we report the use of transesophageal echocardiogram diagnosis of aortic paravalvular leak after aortic valve replacement and successful percutaneous closure of leak. This case report highlights the role of transesophageal echocardiography in diagnosis of aortic prosthesis leak, and confirms the validity of interventional transcatheter repair.

Introduction.Despite progress obtained with current treatments,the event-free survival of high-risk neuroblastoma(HR-NB)patients does not exceed 40-50% and the prognosis in refractory or relapsed patients is poor,still representing a challenge for pediatric oncologist.Therapeutic Iodine-131 meta-iodobenzylguanidine(Th-131I-MIBG) is a recognized safe and potentially effective treatment in NB.Materials.In this retrospective study,we report outcome of 28 MIBG-avid NB patients with advanced disease,because refractory or relapsed,underwent,from 1996 to 2014,to Th-131I-MIBG administered shortly before(median of 17 days) high-dose chemotherapy with Busulfan and Melphalan(HD-BuMel) and autologous stem cell transplantation(ASCT)at Gaslini Institute in Genoa,with the aim to analyze feasibility,safety and efficacy of this approach.Results.Engraftment occurred in all patients after a median of 14(11-29)and 30 days(13-80)from ASCT for neutrophil and platelet respectively.No treatment-related deaths were observed.The main high grade(3-4)toxicity observed was oral and gastrointestinal mucositis in 78.6% and 7.1% of patients respectively,while high grade hepatic toxicity was observed in 10.7%;two patients developed veno-occlusive-disease(7.1%),completely responsive to defibrotide.Hypothyroidism was the main late complication occurred in 9 patients(31.1%).After Th-131MIBG and HD-BuMel, 19 patients(67.8%) showed an improvement of disease status.Over a median follow-up of 15.9 years,the 3-year and 5-year overall survival(OS)probability were 53%(CI 0.33-0.69)and 41%(CI 0.22-0.59)and the 3-year and 5-year rates of cumulative risk of progression/relapse were 64%(CI 0.47-0.81)and 73%(CI 0.55-0.88),respectively.MYCN amplification emerged as the only risk factor significantly associated with OS(HR 3.58;p0.041).Conclusion.Th-131I-MIBG administered shortly before HD-BuMel turned out to be a safe and effective regimen,suggesting it should be included in a sequential approach in patients with advanced MIBG-avid NB.These patients could be benefit to be manage in centers with proven expertise in these treatments.

Patient presenting with breathlessness has a variety of reasons in the middle age. Apart from respiratory, metabolic, cardiac, infectious, cases have been reported in the literature with compression/impression of Left Atrium (LA) by extracardiac structures like the gastrointestinal tract, aorta / intrapericardial , pulmonary and mediastinal structures. Amongst mediastinal compression, no case has been reported to date due to compression by the dorsal spine. We report such a case of compression of LA due to the dorsal spine, secondary to trauma at a young age, and presenting in the middle age with increasing breathlessness.

Thousands of phyto-oils (POs), also known as essential oils (EOs), isolated from several medicinal and aromatic plants are used in prominent therapeutic approaches from old age to present day drug development modules. In comparison to isolation and utilization, POs are not used adequately in the pharmaceutical, cosmetic and food processing industries for poor solubility, low bioavailability with some uncharacterized mechanisms without proper toxicity reports. Thus, this review focus on the documentation of biological/ therapeutic values, particularly antimicrobial potencies, mode of action, economic importance, toxicity profiles of several classes of POs with available methods to overcome the poor drug-likeness properties of POs. Strategically adopted techniques such as nanoemulsions, liposomes, cyclodextrins, chemical conjugation, etc., are the symbiotic method to enhance the drug-ability, bio-stability, bio-availability, controlled delivery/ releases of POs on a specific target site to use as potent and safer antibacterials. As a result, several biologically active POs could be used in antibacterial drug development towards the control of gruesome multidrug-resistant pathogenic bacterial.