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Background: This study explored whether emotional distress, coping, and/or resilience contributed to return to driving (RTD) following experienced mild traumatic brain injury, and whether these variables of interest differed among those who had and had not RTD.  Methods: The present study evaluated de-identified archival data of 65 patients with mTBI following an MVA. Patients were either the driver, passenger, /or pedestrian struck by a motor vehicle, and aged 22 to 69 years. The sample consisted of 36 men and 29 women with an average education. The mean months elapsed between the accident and the assessment was 16.82 months. Pearson correlations were used to test for associations between all explanatory and outcome variables. Separate linear and hierarchical regressions were carried out to evaluate whether variables of interest were significant predictors of RTD.  Results: Findings revealed that the presence of depressive symptoms was associated with coping, irrespective of style, resilience, driving-related anxiety, and RTD. Moreover, RTD was related to driving-related anxiety, too, and in fact, anxiety (considering the presence of depressive symptoms) appeared to be an even greater limiting factor when considering RTD in this population. Age, gender, and education did not influence RTD. Conclusion: The present study revealed that depressive symptoms and driving-related anxiety in particular contribute to whether patients with mTBI RTD, irrespective of time since injury, age, and gender. Coping styles and resilience did not predict RTD. Further work is warranted to address the paucity of research investigating RTD parameters that contribute to and/or hinder RTD among mTBI sufferers.

Aims: The purpose of this research was to study the effects of preoperative training on static and dynamic balance among female athletes with injured ACLs. Methods: This semi-experimental study involved a 2-group pretest-post-test design. Subjects were 36 (19 control and 17 experimental) female athletes with injured ACLs, that were chosen with the available sampling method. The experimental group did the preoperative training in the eight weeks and the control group did not participate in any training program during this period. Static and dynamic balance and lower body muscle strength were measured. The paired sample T-test was used to compare pre and post-test results and the independent sample T-test achieved comparisons between the two groups. Results: The results indicated that static (with eyes opened and closed) dynamic balance and muscle strength were improved significantly (p < 0.05) in the exercise group, but no significant change (p > 0.05) was found in the control group. Also, significant differences were found in improvement changes results between the two groups (p < 0.05). Conclusion: Results of the study confirmed that preoperative training can have a beneficial effect on improving static and dynamic balance among female athletes with injured ACLs.

TEmphysematous pyelonephritis (EPN) is a rare but potentially life-threatening necrotizing renal parenchymal infection characterised by the production of intra-parenchymal gas. The approach and the management of emphysematous has changed dramatically over the last two decades with the advent of computed tomography (CT)-based diagnosis and advances in antibiotic therapy as well as multidisciplinary intensive care of sepsis leading to an overall decline in mortality rates to 20-25%. The previously standard treatment for EPN which included nephrectomy of the affected kidney has been replaced by minimally invasive and nephron sparing surgery with better patient outcomes. We present our case series of 12 patients with EPN over a short period of two years treated at our tertiary care centre in South Western India.

Anemia due to gastrointestinal blood loss can occur due to many conditions and rarely to bowel structural anomalies. We report a 12 years old girl with anemia due to small bowel duplication cyst, posing diagnostic challenge intra operatively. Surgery offered cure without recurrence of bleeding. Common symptoms can be due to a rare surgical condition in practice.

Excitation functions (EF) for four reactions of the type 93Nb (α, xn); x = 1-4 were studied. This study provides current evidences about the dominance of pre-equilibrium processes at high energies followed by compound nucleus equilibration at low energies. The main objective of the work is to look pre-equilibrium emission induced by alpha particle energies up to 100 MeV on Niobium through describing, analyzing and interpreting the theoretical results of cross sections obtained from computer code COMPLET by comparing with experimental data obtained from EXFOR library. COMPLET code has been used for the analysis using the initial exciton number n0 = 4(4p+oh) and level density parameter ACN/10. A general agreement was found for all reactions.

Alopecia is associated with an increased risk of coronary heart disease, and it appears that there is a relationship between the degree of hair loss and the risk of coronary heart disease, meaning, the greater the severity of alopecia, the greater the risk of coronary heart disease. Alopecia is also associated with an increased risk of hypertension, hyperinsulinemia, insulin resistance, metabolic syndrome as well as elevated serum total cholesterol and triglyceride levels. It has not been definitively established whether patients with androgenetic alopecia have a higher cardiovascular risk or prevalence of metabolic syndrome, and results of recent studies indicate that androgenetic alopecia patients do not show differences in insulin resistance or the prevalence of metabolic syndrome. However, androgenetic alopecia patients do show a higher cardiovascular risk, characterised by increased inflammatory parameters and Lp(a) levels. Data collected from female populations are scarce, but it would be interesting to extend our clinical knowledge with this type of data to further our understanding of the connection between androgenetic alopecia, metabolic syndrome and cardiovascular risk. The divergence in results from different studies done in this context may simply be a result of the composition of the study populations with respect to age, gender, severity of alopecia, sample size and perhaps ethnicity. In this connection, a large group of androgenetic alopecia patients is necessary, including different representative groups and varying severities of alopecia. Furthermore, it is recommended that all women and men with androgenetic alopecia be thoroughly examined and that lifestyle changes are made early on to reduce the risk of various problems associated with metabolic syndrome, since androgenetic alopecia can be considered an early marker of metabolic syndrome.

Linear IgA bullous dermatosis (LABD) is a rare, chronic, autoimmune bullous dermatosis affecting young children and adults. The exact pathogenesis of this disease is still unknown, although both humoral and cellular immune response are involved. Clinically, it may show heterogeneous skin manifestations. However, it is characterized histologically by linear immunoglobulin A (IgA) deposits over the basal membrane, causing subepidermal blisters. Studies on LABD are relatively sparse and most of the publications are small series or single case reports. Several treatments are reported in literature, however, they should be used with care due to the risk of side effects. We report a case of linear IgA dermatosis with generalized lesions in a 7 year old child, with good outcome under dermocorticoids and antibiotics.

Background: The band erosion (BE) is defined as the partial or complete movement towards the lumen of the stomach, is also known as migration, gastric incorporation and gastric inclusion. The presentation of this complication involves failure of bariatric procedures being ineffective and consequently requires the removal of the laparoscopic adjustable gastric banding (LAGB), usually through laparoscopic surgery. The objective of this study is to describe the clinical presentation, diagnostic methods, surgical procedure, postoperative evolution in the integral treatment of BE. Material and Methods: We captured the data of patients with BE since January 2010 to October 2017. Database included the year of patient care, age, and sex, BMI before band placement, percentage of excess weight loss, number of device adjustments, clinical data and surgical procedure performed for resolution. Results: A total 379 LAGB complications were diagnosed in our Institution; 210 patients with BE were diagnosed and treated, the average age was 39 years; range from 19 to 66 years, sex was 178 women and 32 men. The diagnosis was endoscopic in the 210 patients (100%). The surgical procedure to solve the problem was: to remove the LAGB, the fistulous orifice was closed and patch of omentum. The hospital stay was 3-5 days. The motility was zero. Complications were minor in 3% of the 210 patients (fever, atelectasis, wound infection). One patient was re-operated for evolving to residual abscess. Conclusions: The BE is a serious failure in bariatric surgery. The resolution in this group of patients was to remove the band, direct closure of the fistulous orifice with patch of omentum. The surgical technique that was performed in this complication is safe, effective and easily reproducible.

Granulomatous diseases can cause hypercalcemia due to elevated 1,25-dihydroxyvitamin D through the production of 1-α hydroxylase by macrophages in the granulomas. Tophaceous gout is not considered to cause this picture. However, there are a few case reports of this occurrence in tophaceous gout, as well as the description of intense 1-α hydroxylase activity in granulomas of tophi in gout patients. We review this literature, and we report a well-documented case of hypercalcemia with elevated serum 1,25 dihydroxyvitamin D in a patient with extensive tophaceous gout and tophi loaded with granulomas. An extensive work-up ruled out other causes of hypercalcemia and granulomatous diseases. Prednisone corrected the chemical abnormalities. Diffuse tophaceous gout should be considered a rare cause of hypercalcemia due to excessive 1,25 dihydroxy vitamin D.

Hallucinogenic fishes are fishes that can create hallucinations if their tissue is ingested. These incorporate certain types of fish found in a several parts of the tropics. The impacts of eating hallucinogenic fishes are rumored to be comparative in a few viewpoints to lysergic acid diethylamide (LSD) or dimethyltryptamine (DMT). The encounters may incorporate distinctive sound-related and visual hallucinations. This has offered ascend to the collective common name “dream fish” for hallucinogenic fish. Sarpa salpa, a species of sea bream, is commonly claimed to be hallucinogenic. In 2006, two men who apparently ate the fish experienced mind flights going on for a few days. It is misty whether the poisons are delivered by the fish themselves or by marine algae in their diet.