Despite advances in chronic heart failure (CHF) medical and device therapy in recent years, CHF continues to be a syndrome associated with significant morbidity and mortality. Abundance of data suggests that anemia is prevalent in CHF. The pathophysiology of CHF-related anemia is complex and poorly understood. Earlier small trials demonstrated improvement in morbidity with use of erythropoietin stimulating agents (ESA) and parenteral iron but that was not supported by more recent large randomized trials. There is a concern regarding the safety of ESA. Small studies showed benefits from parenteral iron alone or combination with ESA. This was promising since parenteral iron is a relatively cheap therapeutic intervention to treat anemia in CHF patients. So far there are no clear recommendations regarding the treatment of CHF related anemia. The purpose of this article is to review the most recent epidemiology, pathophysiology, and therapeutic options for anemia in CHF.

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Introduction: Cervical node metastasis in oral cancer is an indicator of advanced disease. It is therefore important to evaluate neck node involvement as a predictor of progression and treatment planning. Materials & Methods: Eleven patients with age range between 38 to 63 years (median age 54 years) undergoing neck dissection simultaneously with the resection of primary intraoral squamous cell carcinoma formed the basis of the present study. A pre-operative assessment of neck by clinical examination, ultrasonography and computed tomography scan was done, which was then compared to the histopathological assessment. The histopathological examination formed the reference. Results: The percentage of sensitivity by clinical examination was 46%. The percentage of sensitivity by ultrasonogram was 69%. The percentage of sensitivity by computed tomography (CT scan) was 85%. These were against the histopathological examination. Conclusion: The study reported an error of almost 50% for the clinical examination alone. The margin of error decreases when combining ultrasonography or CT scan in the examination. However, in the existing economic condition in India, even the use of CT scan can be prohibitive. Nevertheless, it is advised to combine other diagnostic modalities during the clinical examination of cervical metastasis.

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The present study compares the effectiveness of isokinetic and Isotonic exercises on maximum power of quadriceps in 45 healthy young males. The subjects were randomly assigned into three groups (n=15): Group A- Isokinetic group, Group B- Isotonic group, Group C-Control group. Maximum power of quadriceps at velocities of 220°/sec, 160°/sec 100°/sec and 40°/sec was tested twice with a gap of 4 weeks using isokinetic dynamometer. The isokinetic protocol consisted of one set of ten repetitions at velocities of 220°/sec, 160°/sec, 100°/sec, and 40°/sec each while, the Isotonic protocol included three sets of 10 repetitions at 50% 10 RM, 75% 10 RM and 100% 10 RM. Each exercise protocol was performed thrice a week for four weeks with 1 minute rest interval. The subjects in the control group were not prescribed any kind of exercise training. Paired t-test showed significant changes at 220°/sec (t=7.15, p<0.001), 160°/sec (t=7.54, p<0.001), 100°/sec (t=9.24, p<0.001) and 40°/sec (t=7.59, p<0.001) in Group A, also at 2200/ sec (t=8.56, p<0.001), 160°/sec (t=8.80, p<0.001), 1000/ sec (t=10.11, p<0.001) and 40°/sec (t=10.50, p<0.001) in Group B and non-significant changes in Group C. Post-test One way ANOVA revealed significant changes at 220°/sec (F= 10.85, p<0.001), 160°/sec (F=16.96, p<0.001), 1000/ sec (F=14.60, p<0.001) and 40°/sec (F=14.00, p<0.001). Isotonic exercises were found to be more effective than Isokinetic exercises in increasing the maximum power at high velocity.

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A 38 year old woman who presented with right flank pain of unclear aetiology. Imaging studies demonstrated a cystic mass in the right upper pole of the kidney causing the ureteropelvic junction obstruction with a with a significant proximal urinary tract dilatation. She underwent a careful excision of the cyst and the pathological examination confirmed a hydatid cyst (HC) of the right adrenal gland. We describe the radiological and perioperative findings of this rare case. We have also reviewed the recent medical literature of similar case reports.

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The unsuccessful outcome of a number of vaccine trials in the quest to conquer HIV-1 demonstrates the difficulties inherent in fighting diseases that afflict our world, and the poor disproportionately, especially the developing nations. A quarter century has elapsed since AIDS became a recognized major threat to human health, yet the evergrowing volume of scientific data has failed to meet its prime objective, a cure for AIDS or an HIV prevention vaccine. This brief article suggests several intriguing possibilities for researchers to consider, including small RNA-based immunity, as they seek to find a vaccine for the HIV-1 infection that threatens not only individuals and families, but in some cases entire nations.

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A seven-month-old Hispanic girl was referred to the pediatric emergency department for evaluation of acute onset of supraventricular tachycardia. Physical exam revealed an extremely agitated infant with inconsolable crying, tachycardia, tachypnea and hypertension. Toxicologic studies of urine were positive for pseudoephedrine. The possible mechanisms and the principle of management of pseudoephedrine toxicity are discussed. List of abbreviations: Pseudoephedrine (PE), Emergency Department (ED), Beats per minute (bpm), Central nervous system (CNS)

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