Dengue causing relapse of minimal change disease: A double-edged sword

Dengue virus infection is endemic in India with seasonal variations.It can lead to lethal consequences with plasma leakage and/or bleeding[1,2].Dengue shock syndrome has high mortality in developing countries like India.Dengue can cause functional proteinuria and even heavy proteinuria[3-6].Though dengue has been implicated to cause glomerulonephritis[7],to the best of our knowledge,dengue as a cause of relapse of minimal change disease(MCD)has not been reported.

Targeting biosignatures of hyperglycemia and oxidative stress in diabetes comorbid depressive rats: effectiveness of hydroethanolic extract of the whole plant of Ludwigia octovalvis

Background:The prime objective of the current research was to evaluate the whole plant hydroalcoholic extract of Ludwigia octovalvis(HLO)against hyperglycemia,and oxidative stress biomarkers in rats induced with diabetes comorbid depression,diabetes comorbid depression(streptozotocin-nicotinamide+electric footshocks).Methods:2,2-Diphenyl-1-picrylhydrazyl assay of HLO versus ascorbic acid was done.Effects of 200 and 400 mg/kg body weight/day HLO doses versus 25 mg/kg body weight/day metformin was studied through insulin,glucose,superoxide dismutase,lipid peroxidation,catalase,and behavioral assessment(forced swim and open field tests).Results:IC50 values of HLO and ascorbic acid were 33.52 and 27.86μg/mL respectively.Both the HLO doses showed intended results with respect to oxidative stress biomarkers in diabetes comorbid depression rats in comparison to metformin.Open field test showed better results for HLO in diabetes comorbid depression rats.However,hypoglycemic effects,and forced swim test performance of metformin was slightly higher than the 400 mg dose,followed by the 200 mg dose of HLO.Ethyl gallate,gallic acid,β-sitosterol,and quercetin in HLO might resulted in attenuating diabetic as well as depression biomarkers.Conclusion:Inhibition of glucosidase and lipase activity,and AMP-activated protein kinase phosphorylation might be the possible biochemical changes occurred in HLO treated rats.

Conservative management of small bowel perforation in Ehlers-Danlos syndrome type Ⅳ

Ehlers-Danlos syndrome (EDS) is a group of inherited connective tissue disorders caused by collagen synthesis defects. EDS type Ⅳ, or vascular EDS, is caused by loss-of-function mutations in the type Ⅲ pro-collagen gene (COL3A1 ). Common complications of EDS type IV include gastrointestinal bleeding and bowel perforations, posing diagnostic and therapeutic dilemmas for both surgeons and gastroenterologists. Here, we describe a complicated case of EDS type Ⅳ in a 35-year-old caucasian female who presented with overt gastro-intestinal bleeding. The patient had a prior history of spontaneous colonic perforation, and an uncomplicated upper endoscopy was performed. A careful ileoscopy was terminated early due to tachycardia and severe ab-dominal pain, and a subsequent computed tomography scan confirmed the diagnosis of ileal perforation. The patient was managed conservatively, and demonstrated daily improvement. At the time of hospital discharge, no further episodes of gastrointestinal blood loss had occurred. This case highlights the benefit of conservative management for EDS patients with gastrointestinal hemorrhage. It is recommended that surgical treatmentshould be reserved for patients who fail conservative treatment or in cases of hemodynamic instability. Finally, this case demonstrates the necessity for a higher threshold of operative or endoscopic interventions in EDS type Ⅳ patients.

Outcome measures following tele-rehabilitation and conventional face to face rehabilitation in paediatric cochlear implant users during COVID-19 pandemic:A pilot study in a tertiary care setup

Background:Following the COVID-19 pandemic,majority of paediatric cochlear implantees(CI)lost follow ups for rehabilitation and tele-therapy was initiated.Present study thus compared the outcome measures of paediatric CI users on tele-therapy versus conventional face to face therapy following COVID-19 pandemic.Method:Twenty seven unilateral paediatric cochlear implantees in the age range of 2e11 years were divided into two groups based on the therapy modality,viz,tele-and face-to-face therapy.Based on the hearing age,participants were further divided into three groups,viz,0e2,2e4,and greater than four years.A complete the test battery comprising Integrated Scales of Development,Speech Intelligibility Rating scale,and Revised Categorical Auditory Perception were administered.The speech&language test battery was performed prior to initiating the rehabilitation and post 12 months of rehabilitation.Results:Results of the present study revealed that conventional rehabilitation had better outcomes compared to teletherapy.The rate of progress after one year of rehabilitation with respect to hearing-age showed a significant difference for the hearing-age group of 0e2 years across the domains of audition,speech and language.Conclusion:The present study indicates that conventional method of the speech-language and auditory rehabilitation is far better compared to the tele rehabilitation services especially for those visiting tertiary care hospitals as most of them belong to lower and middle socioeconomic status.From the results,it can be delineated that with lesser hearing experience,paediatric CI users always need to initially enroll for conventional therapy for better speech-language and auditory outcomes.

Knowledge, attitude, and practice of techniques of breastfeeding among new mothers: A survey across Delhi Region

Objective:The present study aims to evaluate aims to assess the knowledge,attitude,and practice of primiparous mothers in the immediate postpartum period regarding breastfeeding techniques which will be helpful in forming awareness and training programs.Materials and Methods:A cross-sectional survey was used.A total of 120 primiparous mothers with a mean age of 24.92 years participated in the survey and filled the questionnaire related to the knowledge,attitude,and practice of techniques of breastfeeding.Results:Results revealed that 48.3%of new mothers were not aware of the correct techniques to initiate breastfeeding,whereas 68.3%of subjects reported that during latching,the baby’s upper and lower lip should be everted.The majority of new mothers were aware of breastfeeding techniques with some misconceptions as in our culture,most of the breastfeeding information passed from generation to generation.Conclusion:The level of awareness about feeding skills among primiparous mothers can be further improved by antenatal counseling or training from health-care workers during the gestational period.This will further help new mothers to educate and will provide adequate information which will decrease the myths.