Common Offenders Research Articles

Unravelling Peptic Ulcers: Comprehensive Insights into Etiology, Diagnosis, Screening Techniques, and Treatment.

The risk of illnesses is increasing in the modern era due to unhealthy and modern lifestyles. Research has shown that the most frequent acid-induced abrasion, which often occurs in the stomach and proximal duodenum, is gastric and Peptic Ulcer Disease (PUD), which is a primary worldwide health concern. The deformity is characterized by denuded mucosa and spreads into the submucosa. Non-steroidal antiinflammatory drugs (NSAIDs) and H. pylori infections are two common offenders. In the past, it has been thought that dietary variables, stress, and an acidic hypersecretory state encourage mucosal disruption in peptic acid disease patients. Peptic ulcers continue to be a significant health issue because of their potential for substantial consequences, including bleeding, blockage, and perforation, even with advancements in detection and treatment. This review discusses current screening methods for peptic ulcers and the challenges in diagnosis and treatment, emphasizing the need for precise diagnosis and more effective therapies.

Case Report: Allergic bronchopulmonary aspergillosis in a 21-year-old female patient with no prior asthma

Hypersensitivity brought on by Aspergillus causes a lung illness known as allergic bronchopulmonary aspergillosis (ABPA). ABPA is a common fungal disease that affects individuals with uncontrolled asthma, cystic fibrosis, and immunocompromised patients. Aspergillus mould species are highly prevalent in the environment, especially in organic waste. There are more than a hundred different species of Aspergillus throughout the world, but the most common offenders are Aspergillus fumigatus, Aspergillus niger, Aspergillus flavus, and Aspergillus clavatus. Several Aspergillus species, most notably Aspergillus fumigatus, are responsible for human diseases. Depending on the amount and virulence of inhaled Aspergillus and the host’s genetic vulnerability and immunity, Aspergillus can produce allergic or allergic (Aspergillus-mediated allergies and asthma, hypersensitivity pneumonia, and ABPA pulmonary disorders. Because of its unique appearance, particularly when there is no medical history of asthma, it may be challenging to diagnose in some circumstances. Although side effects from treating ABPA are regularly described, cumulative medication toxicity caused by several compounds is uncommon. It’s essential to make a wise decision among the several compounds that are available and efficient against ABPA. We document a case of ABPA in a female patient who had no prior history of asthma. She had complained about having trouble breathing. The presence of specific IgE antibodies against Aspergillus fumigatus & an elevated eosinophil count were used to make the diagnosis of ABPA.

Microsurgical Procedures of Microvascular Decompression for Trigeminal Neuralgia

Microvascular decompression for trigeminal neuralgia was successfully performed following the secure surgical steps. The most crucial step involves creating a safe operative field in the dural opening. The petrotentorial junction should be identified without cerebellar retraction before proceeding to the deeper areas. Dissecting the petrosal vein and opening the horizontal fissure contributed to the expansion of the operative field. Bleeding often occurs from the dorsal cerebellar bridging vein and junction of the petrosal vein into the superior petrosal sinus. Transposition of the most common offenders, the superior and anterior inferior cerebellar arteries, is effectively achieved by dissecting both the proximal and distal sides of the neurovascular compression site. Teflon should be placed at a sufficient distance to prevent contact with the nerve, which can lead to recurrence. Treating vertebrobasilar artery-related cases is challenging and involves the risk of cranial nerve injuries. Multiple offending vessels are commonly involved. In such cases, it is essential to be aware of the course of the trochlear and abducens nerves during decompression. Applying the most effective and least risky maneuver is necessary for treating cases involving the vertebrobasilar artery.

Punishing the Last Citizens? On the Climate Necessity Defence

Faced with the inaction of liberal democracies to effectively tackle global warming, many climate activists engage in forms of protests that involve committing minor criminal offences. They seek to shape official decisions on climate policies by resorting to civil disobedience. Some of these activists, rather than accepting punishment, have successfully claimed to be acting in a justified manner by invoking the necessity defence. The aim of this article is to show that, within the framework of representative democracies guided by the rule of law, the climate necessity defence must be rejected, since such protests do not meet the ‘non-legal alternatives’ requirement. This does not mean, however, that protesters should be punished as common offenders. Their acceptance of responsibility and political motivation should be taken into account as a mitigating factor at sentencing.

INCIDENCE, RISK FACTORS, AND OUTCOME OF ACUTE KIDNEY INJURY AMONG CHILDREN IN PEDIATRIC INTENSIVE CARE UNIT IN A TERTIARY CARE HOSPITAL

Objective: The study aimed to study the incidence, risk factors, outcome, and disease pattern of acute kidney injury (AKI) among children admitted in the pediatric intensive care unit (PICU). Methods: The present study was a prospective study done to study the incidence, risk factors, and outcome of AKI among children of the age group 1 month–12 years admitted in PICU at a tertiary care hospital. Results: A total of 480 PICU admissions were recruited, of which 276 children met the inclusion criteria. Of these, AKI was diagnosed in 119 children (50.4%) using pediatric risk, injury, failure, loss, and end-stage renal disease criteria, and the remaining 117 children were classified as non-AKI. The majority of children (63%) were in the age group of 5–12 years, and the male-to-female ratio was 1.2:1. From this study, it was recorded that the pathogenesis of AKI could be attributed to acute glomerulonephritis (AGN) (85%), sepsis (74%), and others like snake bite, diarrhea, poisoning cases, scorpion sting, diabetic ketoacidosis, heart failure, and unclassified causes with observable numbers. The most common offender is shock (91.4%) with vasopressor support (85.4%). Out of 82 children on inotropic support, 46 were on adrenaline. It was observed that the majority of children (93.5%) developed AKI during the course in hospital. The mortality rates were 64.7% and 24.5% among AKI and non-AKI patients. The mean duration of hospital stays among children without AKI was 5 days. Conclusion: The presence of AKI is associated with longer PICU and hospital stay, with higher mortality imposing a significant burden to health-care system.

Acute angioedema in Cape Town emergency centres and a suggested algorithm to simplify and improve management.

Angioedema is the most common acute allergic presentation to emergency centres (EC), with hospitalisation rates increasing in high-income countries. Angioedema can complicate with life-threatening laryngeal obstruction. There are no local data; therefore, we aimed to characterise acute angioedema cases presenting to ECs and develop a simple management algorithm. To characterise the clinical presentation, management and outcomes of acute angioedema cases presenting to ECs. Based on these findings, we developed a management algorithm for acute angioedema to improve the care of acute angioedema in South Africa (SA). We conducted a retrospective folder review of all patients admitted to Groote Schuur Hospital (tertiary) and Mitchells Plain District Hospital (secondary) ECs from 1 June 2018 to 31 June 2020. Using ICD-10 coding, folders of adults ≥18 years with possible angioedema presenting to the ECs were screened. An allergist extracted demographics, medical history, management and outcome data for each angioedema event. A total of 142acute angioedema episodes were included, with a median (interquartile range) age of 42 (28- 58) years, and 62% of patients were female. The majority (124/142, 87%) of acute angioedema EC presentations involved swelling above the shoulders, with airway involvement in 20(14%) patients, with two patients requiring intubation. Nineteen (13%) patients required admission, with five (26%) admitted to high care/intensive care. Drug-induced angioedema was the most common cause, with 64/142 (45%) linked to a known offending drug, 42/64 (65.6%) being angiotensin-converting enzyme inhibitor (ACE-I). Critical information to guide angioedema management, including past personal/family allergy history, and duration of angioedema prior to EC visit, was not recorded in 64.7% and 37.8% of EC records, respectively. Unnecessary treatment with corticosteroids or antihistamines occurred in 19/53 (36%) and 16/53 (30%) cases with bradykinin-mediated angioedema ACE-I angioedema and hereditary angioedema). Overall, only 36/142 (25%) of angioedema patients were connected to allergy care. Angioedema is the most common allergy presentation to two ECs in Cape Town, SA. Bradykinin-mediated angioedema secondary to ACE-I therapy is the single most common offender, and was not appropriately managed in more than a third of cases. Based on these findings, we have developed a management algorithm that easily stratifies patients into bradykinin or mast cell-mediated angioedema with a step-by-step management approach that is applicable to the SA context. Ongoing awareness and education on allergy emergencies are required to ensure accurate diagnosis of less common causes of angioedema (particularly bradykinin-mediated angioedema) and linkage to allergy specialist care.

El Odio y la Violencia hacia el Exogrupo. Análisis Psicosocial de una Muestra de Personas Condenadas por Delitos de Odio

Although there is a growing social and academic interest in understanding why hate crimes are committed, there are very few empirical studies on this crime typology. This study aims to overcome these limitations by examining the characteristics of a sample of hate crimes offenders. To this end, 33 criminals who committed hate crimes were compared with 38 people convicted of other types of crime. The results show that those who committed hate crimes are mostly male, younger than other criminals, and single. In most cases, they lived with their family of origin, lacking a partner relationship or job stability. Finally, compared to the group of common offenders, hate crimes appear to be related to membership in organised gangs. Interventions to reduce recidivism in this type of crime should be based on the specific characteristics of the group.

TOO HOT TO GET DRESSED?

TOO HOT TO GET DRESSED?

Discrimination in an “equal country”—a survey amongst Swedish final-year medical students

BackgroundDiscrimination due to gender and ethnicity has been found to be widespread in medicine and healthcare. Swedish and European legislation list seven discrimination grounds (age, sex, ethnicity, religion, sexuality, non-binary gender identity, and disability) which may intersect with each other; yet these have only been sparsely researched. The aim of this study was to assess the extent of discrimination, based on these seven discrimination grounds, amongst final-year medical students in Sweden.MethodsA web-based survey, based on the CHERRIES-checklist, was disseminated to course coordinators and program directors in charge of final year medical students at all seven medical schools in Sweden. Quantitative data were analyzed using descriptive statistics, Fisher’s exact test, and logistic regression. Free-text answers were analyzed thematically using the “Master Suppression techniques” conceptual framework.ResultsOf the 1298 medical students contacted, 247 (19%) took part in the survey. Almost half (n = 103, 42%) had experienced some form of discrimination, and this difference was statistically significant by gender (p = 0.012), self-perceived ethnicity (p < 0.001), country of birth other than Scandinavia (p < 0.001) and visible religious signs (p = 0.037). The most common type of discrimination was gender-based (in 83% of students who had experienced discrimination), followed by age (48%), and ethnicity (42%). In the logistic regression, women/non-binary gender (p = 0.001, OR 2.44 [95% CI 1.41–4.22]), country of birth not in Scandinavia (p < 0.001, OR 8.05 [2.69–24.03]), non-Caucasian ethnicity (p = 0.04, OR 2.70 [1.39–5.27]), and disability (p = 0.02, OR 13.8 [1.58–12040]) were independently associated with discrimination. Half of those who had experienced religion-based discrimination and nearly one-third of victims of ethnicity-based discrimination reported “large” or “extreme” impact of this. Clinical staff or supervisors were the most common offenders (34%), closely followed by patients and their relatives (30%), with non-Caucasian respondents significantly more likely to experience discrimination by patients (p < 0.001).ConclusionsDiscrimination appears to be frequent in medical school, even in one of the world’s “most equal countries”. Discrimination is most commonly gender- or ethnicity-based, with ethnicity- and religion-based discrimination appearing to have the largest impact. Future research should continue to evaluate discrimination from an intersectional perspective, adapted for local contexts and legislations.

The Myth of the ‘Ideal Offender’: Challenging persistent human trafficking stereotypes through emerging Australian cases

Human trafficking and slavery offences are often constructed through prominent stereotypes of the ideal victim and the ideal offender. This article examines four common offender stereotypes created by representations of trafficking seen in the media, popular culture, government reports, and awareness campaigns, and challenges these stereotypes by comparing them with international and Australian research and statistics. This comparison demonstrates that the ideal trafficking offender is a myth that must be broken. To support this argument, the article explores two emerging Australian cases involving sexual exploitation and allegations of slavery and servitude that significantly depart from stereotypical representations of trafficking. This shows the limitations of offender stereotypes in explaining trafficking offences and demonstrates the need for greater emphasis on the role of coercive control in trafficking offences, the impact of trust and changing relationships, and the interrelationship of trafficking with domestic violence.

Comprehensive Study on Key Pollen Allergens

Pollens are typically the primary reason for seasonal hypersensitivity caused in many people that are released by a hundred different species of plants for fertilization. Not all pollens are the same or have the same effect on human beings, there are those worse than others. The human body works out on a defence mechanism by creating certain reactions against those offensive pollens as a response by the immune system. The allergic reactions include sneezing, coughing, wheezing, itching, red-watery swelled eyes, runny nose, inflammation in the nasal passage frequently leading to rhinitis, asthma, skin irritation, and other respiratory disorders. This study is intended to acquire knowledge about a few plants with high allergenic properties along with their major allergens. It is evident that the pollination of the plants varies from season to season as it depends on various factors such as species, weather, and geographical location. Understanding these high allergenic plants with respect to their varying factors and cross-reacting properties is the purpose of this study. It is an effort to obtain deeper insights into these common pollen offenders.

Relevance of patch testing in patients of chronic spontaneous urticaria and its correlation with serum IgE level

Objectives: Chronic spontaneous urticaria (CSU) is defined as short lived (&lt; 24h) wheals occurring spontaneously without any triggering factors, daily or almost daily for at least 6 weeks. Though CSU is mainly a Type 1 hypersensitivity reaction, earlier studies suggested contact allergy may have some role to play an important role in the etiopathogenesis of CSU. The objective of the study is to find out the relevance of patch test in the etiopathogenesis of and its correlation with serum IgE level. Materials and Methods: Thirty-one patients of CSU were thoroughly evaluated for clinical and laboratory parameters. We conducted patch testing with Indian Standard Series (ISS) in all of them and tried to find out the relevance of every positive reaction. Relevant positive cases were asked to avoid exposure for 2 months and were maintained only in breakthrough antihistamines. Furthermore, correlation of positive patch test reaction with high IgE and eosinophil count were studied. Results: Seventeen (55%) cases came positive for patch test. Potassium dichromate, lanolin, benzocaine, and fragrance mix were the most common offenders. Patients with very high IgE count had patch test positivity with multiple allergens. Seven of the fifteen patients who had relevant positive patch results could be followed up to remission; three were lost to follow-up. Conclusion: Patch test with ISS may give important clue to in a subset of patients of CSU and thus may be considered an important part of routine investigations of CSU.

Bio-fabricated green silver nano-architecture for degradation of methylene blue water contaminant: A mini-review.

The advent of global industrialization advancements has proven to be both a blessing and a curse for humanity, with significant detrimental consequences on marine bodies, and methylene blue is one of the common offenders through textile industry runoffs. These dye runoffs are complex, neurotoxic, and carcinogenic and prevent sunlight from penetrating the water to hinder photosynthesis and increase the biological/biochemical oxygen demand (BOD), hence hampering the ontogenesis of photoautotrophic organisms and thus threatening marine life and causing an increase in unavailability and inaccessibility to healthy water for eco-fundamental networking. Traditional methods came into the limelight, but they are costly and inefficient. Amazingly, due to exceptional surface features, eco-friendliness, cost-effectiveness, catalytic efficiency, and antibacterial capabilities, biosynthesized nanoparticles emerged as a potential solution to these drawbacks encounter by the traditional approach. This review was based on a comprehensive review of publicly available literature (majorly 2019-2021 original research reports) using major scientific databases such as SciFinder, Scopus, PubMed, Google Scholar, and Science Direct. The keywords that were utilized to scoop up the scientific journals were as follows: dye degradation and decolorization, biosynthesis, methylene blue, silver nanoparticles, wastewater, and dye runoffs. Thus, this review highlights the green sources used for the bio-fabrication of silver nanoparticles, the current level of knowledge of biosynthesis mechanism, mechanism of degradation, and methylene blue dye degradation efficiency. PRACTITIONER POINTS: Bio-fabrication mechanism of green silver nano-architecture from plant, bacteria, fungi, and algae extract has been discussed. Various biological capping/reducing agents have been reported. Degradation efficiency of methylene blue dyes using silver nanoparticles has been discussed. Mechanism of degradation of methylene blue by green silver nanoparticles has been reported.

A Review on Medical Child Abuse and Child Protection

Background&#x0D; Medical child abuse describes a child receiving unnecessary, harmful, or potentially harmful medical care at the caretaker's instigation.&#x0D; Objectives&#x0D; To focus on medical child abuse as an entity and emphasize its epidemiology, clinical presentations, prevention, and management.&#x0D; Results&#x0D; In the UK, the annual incidence of medical child abuse in children below one year increased to 3:100,000, while its prevalence in Arabs, including Iraq, is ambiguous due to lack of evidence and improper clinician's awareness. The mean age at diagnosis is 14 months to 2.7 years. Female caregivers are the most common offenders. Clinically, medical child abuse could fit into three stages; falsification of illness story, falsification of illness story and physical signs' fabrication, or induction of illness in children. A successful diagnosis mandates a comprehensive review of medical records to identify discrepancies between caregivers' stories versus clinical findings or investigations. Management requires recognizing abuse, halting it, securing the child's safety, maintaining the family's integrity when possible, and aborting unnecessary lateral referrals within the healthcare system.&#x0D; Conclusion&#x0D; Reported cases of medical child abuse are increasing steadily, while less severe ones go unrecognized. No diagnostic tool can help other than the physician's high index of suspicion. The management follows the same principles applied for other forms of child abuse, while good medical practice ensures its prevention.

Phenotypic and Prognostic Relevance of the Who Diagnostic Distinction between Polycythemia Vera and JAK2 -Mutated Essential Thrombocythemia: Combined Analysis of 785 Informative Cases

Background:The 2016 World Health Organization (WHO) classification system (Arber et al. Blood 2016;127:2391) distinguishes essential thrombocythemia (ET) from polycythemia vera (PV), based primarily on hemoglobin/hematocrit level. However, there is significant overlap between the two in terms of other clinical and laboratory parameters and the majority of patients with both ET and PV share the JAK2 V617F mutation. These observations have suggested the possibility that JAK2 -mutated ET and PV represent a clinic-pathologic disease continuum with similar phenotype and prognosis; we explored this possibility by a combined analysis of 785 consecutive cases of WHO-defined PV or JAK2 -mutated ET.Methods:Study patients were selected from our institutional database of myeloproliferative neoplasms (MPN). Diagnoses of ET, PV, blast phase disease, and post-ET/PV myelofibrosis (MF) were according to WHO (Arber et al. Blood 2016;127:2391) and international working group for MPN research and treatment (IWG-MRT; Barosi et al. Leukemia 2008;22:437) criteria. Statistical analyses considered clinical and laboratory data collected at the time of diagnosis. Overall (OS), leukemia-free (LFS), myelofibrosis-free (MFFS) and thrombosis-free (TFS) survivals were calculated from the date of diagnosis to the date of death, event or last contact.Results:The study population (n=785) was selected from a larger cohort of 1383 consecutive cases of PV and ET and included 456 cases with PV and 329 with JAK2 -mutated ET. 1.Phenotypic comparisons at diagnosis between PV and JAK2-mutated ETOutside of the expected differences in hemoglobin level and platelet count, the 329 patients with JAK2 -mutated ET, compared to the 456 with PV, displayed a preponderance of female gender (63% vs 48%; p<0.0001) and lower incidences of leukocytosis (28% vs 55%; p<0.0001), microcirculatory symptoms (20% vs 34%; p=0.0005) and palpable splenomegaly (20% vs 29%; p=0.005). On the other hand, notable similarities included the incidences of age ≥60 years (51% vs 53%; p=0.6), thrombosis history (24% vs 25%; p=0.70), arterial thrombosis history (18% vs 16%; p=0.66) and abnormal karyotype (14% vs 19%; p=0.1). Of note, when PV was compared to all ET cases regardless of JAK2 mutational status (n=927), significant differences were also noted for age, abnormal karyotype and venous thrombosis. 1.Rates of complications post-diagnosis in PV vs JAK2-mutated ETAt a median follow-up of 9 years, 323 (41%) deaths, 26 (3%) leukemic transformations, 89 (11%) fibrotic progressions, and 161 (20%) thrombotic complications, including 115 (15%) arterial events were recorded. Compared to that of JAK2 -mutated ET, mortality (44% vs 36%; p<0.0001) and fibrotic progression (14% vs 8%; p=0.02) rates were higher in PV; there was no significant difference in blast transformation (4% vs 3%; p=0.44) or post-diagnosis thrombotic events (21% vs 20%; p=0.8). 1.Combined analysis of OS, LFS, MFFS and TFS:When all 785 study patients were analyzed together, multivariable analysis identified diagnosis of “PV” vs “ JAK2 -mutated ET” (HR 1.5, 95% CI 1.03-2.1), age ≥60 years (HR 4.3, 95% CI 3.0-6.2), leukocyte count ≥11 x 10(9)/L (HR 1.4, 95% CI 1.03-2.0) and abnormal karyotype (HR 1.9, 95% CI 1.3-2.8) as significant risk factors for OS; figure 1 depicts survival comparisons of PV vs JAK2 -mutated ET vs JAK2- unmutated ET; the apparent difference in survival between the latter two was accounted for by the significant difference in age distribution. A similar analysis for TFS identified history of diabetes (HR 2.0, 95% CI 1.3-3.2) and thrombosis (HR 1.9, 95% CI 1.4-2.7), but not the specific diagnosis of PV vs ET (p=0.7) as significant risk factors. The number of events was too small to determine the relevance of PV vs ET diagnosis for LFS or MFFS.Conclusions:The current study validates the phenotypic and prognostic relevance of the current WHO-defined diagnostic distinction between JAK2 -mutated ET and PV; phenotypically, the two were primarily different in their gender distribution and leukocyte count while survival was worse in PV; thrombotic complication rates between the two were similar, implicating the JAK2 mutation as the common offender. [Display omitted] DisclosuresNo relevant conflicts of interest to declare.

Prevalence of Workplace-Related Violence among Otorhinolaryngology Residents in Riyadh, Saudi Arabia

Background: Violence is one of the prevalent public health concerns that healthcare staff face; a serious problem needs to be focused. Objective: The objective of the study is to estimate the prevalence of workplace-related violence among ear, nose, and throat (ENT) residents in Riyadh, capital of the Kingdom of Saudi Arabia, and to identify the common types, perpetrators, and precipitating risk factors of workplace violence (WPV). Design: This was a cross-sectional, self-administered questionnaire study. Settings: The study was conducted at King Saud University Medical City. Subjects: The study subjects were Riyadh's ENT residents. Intervention: All Riyadh's ENT residents were invited to participate in the survey in which 80 out of 90 residents participated. Our questionnaire included two domains: one includes demographic data and other includes occupational characteristics and some details related to violence. Main Outcome Measures: (1) Prevalence of WPV among Riyadh's ENT residents. (2) Identification of types and risk factors of WPV. Results: More than half of our sample had been through a violent experience before, with 60% experiencing it at least once. Most of the violent experiences were with the adult age group of 25–55 years. Male and companions of the patients were found to the most common offenders, and the most leading factors for violence are misunderstanding and miscommunication being at the top of the list at 20%. Conclusion: As more than half of the sample has experienced violence, hence, this issues needs to be focused on through different ways, including improving resident's communication skills and improving the reporting system for violent behaviors.

A case of invasive fungal sinusitis by candida species causing blindness

Invasive fungal sinusitis (IFS) is a common manifestation in immunocompromised patients. The common offenders are Aspergillus and Mucor. These fungal infections can cause various systemic complications, both intracranial and extracranial. Ultimately it may lead to fungemia and death. Very few cases of IFS caused by candida have been reported in the literature. Candida is a yeast like fungus, present normally as a commensal in the oral cavity and skin. Invasive fungal sinusitis with central retinal artery occlusion (CRAO) with candida is extremely rare. We are reporting a case of cavernous sinus thrombosis (CST) with CRAO causing bilateral blindness in a patient with invasive candida sinusitis.

Gastric mucosal damage with aspirin: results of experimental models in adult albino rats

Background: Non-steroidal anti-inflammatory drugs are the over-the-counter available medicine and are notorious for their potential in causing peptic ulcer disease. Aspirin in used to treat cardiovascular disease and are commonly prescribed medicine.Methods: 24 healthy albino rats of either sex were purchased and kept at controlled in controlled environment. These are mainly divided into the two groups named as group A and group B having 12 rats in each group. 25 gm of the powdered henna was mixed in 250 ml distilled water. Aspirin was used in the dose of 100 mg/kg drug solution is prepared every day before administration. Animals were sacrificed from each group on day 8th and 15th. Macroscopic ulcer was identified and Fibroblast, inflammatory cells, congested blood vessels were counted. SPSS version 21 was used to statistically analyse the data. P value of ≤0.05 was considered as statistically significant.Results: aspirin group have more ulcer, congested blood vessels, inflammatory infiltrate and increased number of fibroblasts compared to control. The values were statistically significant with p value less than 0.05.Conclusions: gastric ulcer is quite common and it occur because of the imbalance between protecting and aggravating factors. aspirin is a common offender of gastric ulcer because of its common use.

Epidemiological Study of Female Death within Seven Years of their Marriage in Kanpur Region

Introduction: When girls get married, this heralds a major change in their immediate environment. Thereis a change of guardianship, separation from the parents and family and creation of a new family. All thiscreates a stressful environment around them, which is further aggravated by pregnancy, the upbringing ofchildren, managing the household and office works. Eventually, when the tolerance breaks down, the bridesare forced to take the extreme step of ending their miserable lives. In the majority of female unnatural deaths,the family members (parents, husbands, in-laws) may be directly or indirectly responsible for precipitatingthe circumstances leading to the death of the victim.Methodology: Material for the present study comprised of all information from the relatives, guardians,police or investigating officers pertaining to the cases of ‘unnatural deaths of females within seven years oftheir marriage’, brought to the District Mortuary, Kanpur during the period of one year.Conclusion: The incidence of unnatural deaths in females who died within seven years of their marriagewas estimated to be 4.17% of the total cases autopsied. Maximum numbers of victims were rural Hinduhousewives belonging to lower-middle or middle socioeconomic classes between 18-22 years of age andmost of them had died within three years of their marriage. In cases of homicidal deaths burning andthrottling/strangulation were found as the most common method used Dowry was the most common motivein homicidal deaths. As such husbands and in-laws were the most common human offenders in homicidalcases. Hanging was the most common method used in suicidal cases followed by burning. Whereas familyquarrel and marital disharmony were the most common motives behind such deaths.

Abiotrophia defectiva liver abscess in a teenage boy after a supposedly mild blunt abdominal trauma: a case report

BackgroundA pyogenic liver abscess (PLA) represents a pus-filled cavity within the liver parenchyma caused by the invasion and multiplication of bacteria. The most common offender isolated from the PLA in children is Staphylococcus aureus. Abiotrophia defectiva is a Gram-positive pleomorphic bacterium, commonly found in the oral cavity, intestinal, and genitourinary mucosa as part of the normal microbiota. It has been proven to be an etiological factor in various infections, but rarely in cases of PLA. The case presented here is, to the best of our knowledge, the first pediatric case of PLA caused by A. defectiva.Case presentationA 13-year-old Caucasian boy presented with a two-day history of abdominal pain, fever up to 40 °C, and polyuria. Contrast-enhanced computed tomography (CT) scan revealed a single, multiloculated liver lesion, suggestive of a liver abscess. The boy had sustained a bicycle handlebar injury to his upper abdomen 3 weeks before the symptoms appeared and had been completely asymptomatic until 2 days before admission. He was successfully treated with antibiotic therapy and open surgical drainage. A. defectiva was isolated from the abscess material. Histopathology report described the lesion as a chronic PLA.ConclusionsA. defectiva is a highly uncommon cause of liver abscess in children. In such cases, various predisposing factors should be considered, including antecedent blunt abdominal trauma.