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Viral hepatitis represents a major global health problem with 170 million Hepatitis C Virus (HCV) carriers worldwide, and 12–13 million HCV carriers in India. HCV genotypes are of clinical significance in indicating drug responsiveness and prognosis of the patient. The HCV genotypes are of epidemiologic significance as well, as they are indicative of transmission route of infection and have not been extensively studied in the Indian context. In the current study, HCV genotyping was examined in 2118 patients from different geographic regions of India. HCV was detected by PCR amplification of 5′ UTR and core-envelope1 regions, followed by genotyping using nucleotide sequencing and analysis with NCBI tool (http://www.ncbi.nlm.nih.gov/projects/genotyping/formpage.cgi). HCV genotype distribution in the 2118 Indian patients demonstrated prevalence of HCV3 (3a/3b primarily) in 62% and HCV1 (1a/1b primarily) in 31% patients. The predominance of HCV3 was significant in northern (p = 0.01) and eastern (p = 0.008) regions of India. HCV types 2, 4, 5, and 6 were detected in 0.05–4.5% of the patient group. Thus, our studies demonstrate HCV genotype prevalence in the cohort group in different regions of India.  相似文献   
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Odabasi  O; Basak  O; Basak  S; Mutlu  C; Erpek  G 《Family practice》1998,15(4):332-335
BACKGROUND: Middle ear pathology, either otitis media with effusion or tubal dysfunction, is frequently seen in day-care centre children. Recognition and early treatment of this condition is crucial to the prevention of chronic otitis media, which is a major cause of hearing loss in later life. OBJECTIVES: We aimed to reveal the incidence of silent otitis media in day-care centre children and to determine the predisposing factors, risk factors and the awareness of the parents of the middle ear disease of their children. METHOD: Two hundred and thirteen children, aged 3-6 years, were screened in four daycare centres. A questionnaire was prepared that would reveal the predisposing factors. Information was gathered from both the parents and teachers. Children were examined by otoscopy, pneumotoscopy, tympanometry and X-rays for sinus pathology. RESULTS: Forty-three of 213 children had middle ear pathology; 39 of them were confirmed by tympanometry; 56.1 % of children had some degree of sinus pathology. We revealed that, although most of the children do not have the risk factors, they develop middle ear pathology. Among the parents, 81.4% of them were unaware of the condition. CONCLUSION: Early diagnosis of middle ear pathologies is necessary for prevention of future complications. In early stages the condition is silent. We emphasize the importance of the primary care physician's role in diagnosing the early stages of middle ear pathologies and recommend that teaching of otoscopic and pneumotoscopic skills should be part of the training for family physicians.   相似文献   
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Purpose: Our purpose was to determine the feasibility and efficacy of performing testicular or epididymal sperm retrieval prior to the injection of human chorionic gonadotropin (hCG). Methods: This report deals with 87 sperm-positive percutaneous epididymal sperm aspiration (PESA), percutaneous testicular sperm aspiration (PTSA), or testicular sperm extraction (TESE) cycles. All sperm retrieval procedures were performed prior to administration of hCG to the women. Retrieved spermatozoa were cultured in vitro in simple medium for approximately 40 hr prior to intracyto-plasmic sperm injection. Results: In all but one cycle in which TESE was performed for nonobstructive azoospermia, motile sperm were available for ICSI. The overall fertilization rate was 53%. Pregnancy rate per transfer and implantation rate per embryo were 41.2 and 15.7%, respectively. Conclusions: Satisfactory fertilization and pregnancy rates can be achieved when PESA, PTSA, or TESE is performed prior to the injection of hCG followed by in vitro culture of spermatozoa approximately 40 hr before ICSI. Scheduling of testicular or epididymal sperm retrieval cases in this way appears to ease the workload on laboratory and operating room personnel. Furthermore, withholding hCG when sperm is absent may obviate the unnecessary risk of ovarian hyperstimulation when spermatozoa cannot be retrieved.  相似文献   
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OBJECTIVE: To determine risk factors for tuberculin skin test (TST) positivity among healthcare workers (HCWs). DESIGN: Two-step TST was performed in 2002. SETTING: Tertiary-care hospital in Ankara, Turkey. PARTICIPANTS: A sample of 491 hospital HCWs were included. Information related to demographics, profession, work duration, department, and individual and family history of tuberculosis (TB) was obtained by a structured questionnaire. RESULTS: Four hundred eight (83%) had two-step TST positivity. On multivariate analysis, male physicians (relative risk [RR], 1.5; 95% confidence interval [CI95], 1.23-1.69; P = .001), nurses (RR, 1.5; CI95, 1.29-1.66; P = .005), radiology technicians (RR, 1.7; CI95, 1.35-1.73; P = .002), laboratory technicians (RR, 1.6; CI95, 1.3-1.74; P = .007), and male housekeepers (RR, 1.6; (HCWs). CI95, 1.38-1.7; P < .001) had a higher risk than did female physicians. Among laboratory technicians, radiology technicians had the highest TST positivity (85%). HCWs working for less than 1 year (RR, 0.8; CI95, 0.72-0.98; P = .027) had a lower risk of infection. The HCWs having bacille Calmette-Guerin vaccination (RR, 1.12; CI95, 1.08-1.45) had higher TST positivity. CONCLUSION: Male physicians, nurses, and laboratory technicians had increased risk of Mycobacterium tuberculosis infection in this setting, but community exposure likely accounted for most infections.  相似文献   
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BackgroundIn this retrospective study, we compared the results from 2 pulmonary valve augmentation techniques in patients undergoing surgical repair of tetralogy of Fallot.MethodsBetween 2015 and 2018, 18 patients had anterior pulmonary valve repair at our institution, and 26 patients had both anterior and posterior pulmonary valve repair.ResultsPatients ranged from 6 months to 30 years of age. The median follow-up period was 8 months in the anterior augmentation group and 5 months in the anterior and posterior augmentation group. Postoperative echocardiograms indicated that only 2 patients (11%) in the anterior augmentation group had moderate or severe pulmonary insufficiency, compared with no patients in the anterior and posterior augmentation group. At follow-up, pulmonary insufficiency was seen in 3 patients (17%) in the anterior augmentation group and no patients in the anterior and posterior augmentation group.ConclusionReconstruction of the native pulmonary valve accompanied by pulmonary cusp augmentation can decrease or even circumvent postoperative pulmonary insufficiency. Both anterior augmentation and anterior and posterior augmentation techniques are easily applied; however, we believe that the anterior and posterior augmentation technique is superior in terms of early postoperative and follow-up pulmonary insufficiency outcomes.  相似文献   
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Appendicitis in newborns is uncommon and difficult to diagnose. Reports on neonatal appendicitis subsequent to inguinal hernia incarceration are exceptionally rare. We present the case of a 26‐day‐old infant with perforated appendicitis due to incarceration of a right inguinal hernia, mimicking right testicular torsion.  相似文献   
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