“CLINICO-PATHOLOGICAL STUDY OF SURGICAL LESIONS OF FILARIASIS”

Background: Lymphatic lariasis, transmitted by mosquitoes is the commonest cause of lymphedema in endemic countries. Among 120 million infected people in 83 countries, up to 16 million have lymphedema. Microlariae ingested by mosquitoes grow into infective larvae. These larvae entering humans after infected mosquito bites grow in the lymphatics to adult worms that cause damage to lymphatics resulting in dilatation of lymph vessels. This earliest pathology is demonstrated in adults as well as in children, by ultrasonography, lymphoscintigraphy and histopathology studies. Once established, this damage was thought to be irreversible. This lymphatic damage predisposes to bacterial infection that causes recurrent acute attacks of dermato-lymphangio-adenitis in the affected limbs. Bacteria, mainly streptococci gain entry into the lymphatics through 'entry lesions' in skin, like interdigital fungal infections, injuries, eczema or similar causes that disrupt integrity of skin. Methods-This study was conducted among 124 patients who attended SOPD and Filaria clinic (103) and admitted in Surgical wards (21) of S.G.M Hospital Rewa. All incidence, surgical manifestations and clinical diagnosed of lariasis in surgical patients include the study. Children with <6 years of age, critically ill patients and cases where calcication has been established for the exclusion criteria. Follow up of the patients was done on 7th, 14th and 21th day and the treatment effects were recorded every time. Complications, progression / regression and over all effects were recorded. Results- Filarial disease was diagnosed in 124 patients. The majority of the patients with Filarial disease 28.22% and Microlaria positive 80% were in the age group of 21-30 years . Youngest patient was 7 years male with right thigh lymphedema and oldest patient was 74 years old male with bilateral hydrocele. male : female ratio with Filarial disease is 2.86:1. Regional lymphadenopathy was noted in 17.74%, overlying skin was inamed and oedematous in 12.9%, hypertrophic or thick skin 4.03%, ulceration and nodularity was present in 2.41% each .Maculopapular eruption and blisters was present in 1.61 % cases each. The commonest manifestation constituted 54.03% of cases. Epididymoorchitis was present in 25%, lymphangitis in 13.71%, lymphadenitis in 11.29%, hydrocele in 7.26%, and cellulitis in 4.84% cases. Funiculitis and elephantiasis in 4.84% and 4.03% respectively. Conclusion- Reducing the suffering caused by LF through morbidity management and disability prevention. The general population should be well educated and informed about the disease and prevention from mosquito bite. Patients who are already suffering from the disease should be made aware of the treatment modalities available and benets of promoting self-hygiene and self-help regimens. From the current study we can conclude that prevalence of laria in Vindhya Region is 0.11% which is less than 1% which was target under NPELF.

Taxonomic revision of Hopliancistrus Isbrücker & Nijssen, 1989 (Siluriformes, Loricariidae) with redescription of Hopliancistrus tricornis and description of four new species

Hopliancistrus is an Ancistrini genus diagnosed by having few and very strong cheek odontodes on interopercular area, and a patch of strong and stiff odontodes on the antero-lateral border of the snout. The type species is herein redescribed based on types and recently collected specimens. In addition, four new congeneric species are described based on specimens collected in other parts of the Rio Xingu and Rio Tapajós basins. Hopliancistrus tricornis is distributed in the lower Rio Tapajós and is diagnosed by the possession of four branched anal-fin rays and relatively large white to yellow spots on trunk and pectoral and pelvic fins, and dark brown spots on dorsal, caudal and anal fins. Hopliancistrus munduruku is described based on specimens from Rio Jamanxim (Rio Tapajós basin) and Rio Curuá (Rio Xingu basin) and is diagnosed by the possession of five branched anal-fin rays and large yellow blotches on trunk and dark brown to black spots over the fins. Hopliancistrus wolverine is distributed in the rapids of the lower and middle Rio Xingu and is diagnosed by the possession of five branched anal-fin rays and conspicuous small yellow dots on head, trunk and fins. Hopliancistrus xikrin is distributed in medium- to small-sized tributaries of the lower portion of Rio Xingu basin, and is diagnosed by absence of contact between the transverse process of the first dorsal-fin pterygiophore and the transverse process of the second pterygiophore. Hopliancistrus xavante is distributed in the tributaries of upper Rio Xingu basin, and is diagnosed by having a thick skin covering the nuchal plate; by having large white spots on trunk and fins; and by the possession of five branched anal-fin rays. An osteological description and a key for species identification are also provided.

Intricacies of Upper Blepharoplasty in Asian Burden Lids

Differences between Oriental and Caucasian eyelids have been explained in great detail in several reports in the past. The purpose of this article is to discuss the functional aspects of Asian double fold upper blepharoplasty and to present techniques that help to improve both the functional and cosmetic outcomes and satisfaction after surgery. The eyes of Asians are relatively small with thick skin in the eyelids and periorbital area. They typically lack the upper eyelid crease (creating the so-called double eyelid) due to burden factors like thick skin, hypertrophied orbicularis oculi muscle (OOM), submuscular fibroadipose tissue, thick orbital septum, abundant preaponeurotic fat, and lower positioned transverse ligament. Asian eyes may also have a superior visual field defect due to skin overriding the upper lid margin (skin–OOM–fat complex slide down). These burden factors result in the eyelashes appearing short and becoming misdirected and pressed toward the globe, causing functional discomfort. As a compensatory mechanism, Asian people tend to engage the frontalis muscle to lift the eyebrow to help them open their eyes. Along with aesthetic enhancement, double-eyelid surgery in Asian burden lids can improve the functional deficiencies helping the patients to open the eyes more easily. In addition, treatment of the Mongolian fold (medial epicanthal fold), caused by medial hypertrophy of preseptal OOM, augments the surgical results. In this report, we present the appropriate preoperative assessment, surgical technique, and postoperative care that should be employed to achieve consistently good functional and aesthetic outcomes in these patients.

Public Transport Route Selection, Bus Stops Location and Guidance to the Users in Dar Es Salaam

Transportation planning is very important in improving quality of transportation which in turn improve quality of life but still this profession is not much appreciated in the society. Good planning make progress towards paradise while bad or no planning leave legacy of problems and disputers. Planners perform vital role by anticipating and resolving community conflicts. Good planning requires special skills and perspectives:●Most people prefer to ignore problems until they become unavoidable. Planners are professional worriers who seek out potential problems so they can be mitigated.●Most people look at a problem from a single perspective. Planners are responsible for considering multiple perspectives; they ask, “what is best for everybody overall?”●Most people prefer simple problems and solutions. Planners learn to appreciate complexity, and search for deeper meanings and underlying causes. Planners learn to work with uncertainty and ambiguity.●Most people consider compromise a sign of weakness and failure. Planners are passionate about compromise because it resolves conflicts and often leads to better solutions and justice to everyone and every situation.●Most people prefer to consider one issue at a time. Planners apply integrated analysis, so individual, short-term decisions are consistent with multiple, long-term goals.Despite the effort of planners to help in maintaining balance between the human and natural world, yet, planners often receive little respect. Our successes are taken for granted, and we are often blamed for failures beyond our control. As coordinators of public decision-making, planners are lightning rods to criticism. Our role as unbiased facilitators is often misinterpreted as heartless bureaucrats. Stakeholders frequently hold planners personally responsible when dissatisfied with outcomes. Planners need diplomatic skills and a thick skin: if we do our job well, we are criticized approximately equally by all sides.